加味补肾活血膏贴敷联合臭氧关节腔灌洗治疗膝骨关节炎(肾虚血瘀证)的临床观察  

Clinical Observation of Modified Bushen Huoxue Ointment Combined with Ozone Arthroscopic Irrigation for Knee Osteoarthritis with Syndrome of Kidney Deficiency and Blood Stasis

作　　者：李慧 周祥 汪传伟 易天新 陈鑫 刘伟 莫元森 Li Hui;Zhou Xiang;Wang Chuanwei;Yi Tianxin;Chen Xin;Liu Wei;Mo Yuansen(Dianjiang Hospital Affiliated to Chongqing University of Chinese Medicine,Chongqing 408300,China)

机构地区：[1]重庆中医药学院附属垫江医院,重庆市垫江县中医院,重庆408300

出　　处：《中国中医急症》2025年第1期102-105,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市科卫联合中医药科研项目(2023MSXM162)。

摘　　要：目的观察加味补肾活血膏贴敷联合25μg/mL臭氧关节腔灌洗干预膝骨关节炎(KOA)(肾虚血瘀证患者(Kellgren-Lawrence分级Ⅰ~Ⅲ级)的临床疗效。方法采用随机对照试验(RCT)方法,将120例患者按照随机数字表法分为对照组、中医药膏组与联合治疗组各40例。对照组予以洛索洛芬凝胶膏外用,中医药膏组予以加味补肾活血膏贴敷,联合治疗组予以加味补肾活血膏贴敷联合25μg/mL臭氧关节腔灌洗,各组疗程均为10 d。观察治疗前及治疗完成后视觉模拟量表(VAS)评分、西安大略和麦克马斯特指数(WOMAC)、膝关节活动度(ROM)、血清骨碱性磷酸酶(BALP)、血清基质金属蛋白酶-13(MMP-13)的变化。结果联合治疗组总有效率为94.74%,分别高于对照组的77.14%与中医药膏组的78.38%(P<0.05),中医药膏组与对照组总有效率无显著差异(P>0.05)。各组VAS评分、WOMAC指数治疗后均降低(P<0.05),其中中医药膏组与对照组降低幅度比较无显著差异(P>0.05),联合治疗组降低幅度大于对照组及中医药膏组(P<0.05)。对照组及中医药膏组治疗后ROM与治疗前比较无显著差异(P>0.05),联合治疗组治疗后ROM显著增加(P<0.05)。对照组治疗前后血清BALP差异无统计学意义(P>0.05),中医药膏组及联合治疗组治疗后血清BALP均降低(P<0.05),两组之间比较降低幅度无显著性差异(P>0.05)。各组血清MMP-13治疗后均下降(P<0.05),其中中医药膏组与对照组下降幅度比较差异无统计学意义(P>0.05),联合治疗组下降幅度显著大于中医药膏组及对照组(P<0.05)。结论加味补肾活血膏联合25μg/mL臭氧关节腔灌洗治疗KOA(肾虚血瘀证)患者(K-L分级Ⅰ~Ⅲ级)具有增效作用,能有效改善患者临床症状及体征,其机制可能与下调血清BALP及MMP-13有关。Objective:To observe the clinical efficacy of Modified Bushen Huoxue Ointment combined with 25μg/mL ozone arthroscopic irrigation in treating patients with knee osteoarthritis(KOA)(Kellgren-Lawrence gradesⅠ~Ⅲ)characterized by syndrome of kidney deficiency and blood stasis.Methods:A randomized controlled trial(RCT)was conducted.A total of 120 patients were randomly divided into three groups using a random number table method:the control group,the TCM ointment group,and the combined treatment group,each with 40 patients.The control group received topical application of loxoprofen gel patches,the TCM ointment group received Modified Bushen Huoxue Ointment,and the combined treatment group received Modified Bushen Huoxue Ointment combined with 25μg/mL ozone arthroscopic irrigation.The treatment duration for all groups was 10 days.The Visual analog scale(VAS)scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),range of motion(ROM)of the knee joint,serum bone alkaline phosphatase(BALP),and serum matrix metalloproteinase-13(MMP-13)levels were observed before and after treatment.Results:The overall effective rate in the combined treatment group was 94.74%,which was significantly higher than the 77.14%in the control group and 78.38%in the TCM ointment group(P<0.05).There was no significant difference in the overall effective rate between the TCM ointment group and the control group(P>0.05).After treatment,VAS scores and WOMAC index decreased in all groups(P<0.05).The reduction in the combined treatment group was greater than that in the control group and the TCM ointment group(P<0.05),while there was no significant difference between the TCM ointment group and the control group(P>0.05).There was no significant change in ROM in the control group and the TCM ointment group after treatment(P>0.05),whereas the ROM in the combined treatment group increased significantly(P<0.05).There was no significant change in serum BALP in the control group before and after treatment(P>0.05),but it decreased in

关 键 词：膝骨关节炎 补肾活血 臭氧 骨碱性磷酸酶 基质金属蛋白酶-13 

分 类 号：R684.3[医药卫生—骨科学]