土家药内服外敷配合富血小板血浆治疗肝肾亏虚型膝骨关节炎的疗效观察  

Observation on the Curative Effect of Tujia Medicine for Internal and External Application Combined with Platelet-rich Plasma in the Treatment of Knee Osteoarthritis of Liver and Kidney Deficiency Type

作　　者：宋涛 石海斌 张风帅 王广亮 丁继良 符朝程 王有华 刘黎敏 SONG Tao;SHI Haibin;ZHANG Fengshuai;WANG Guangliang;DING Jiliang;FU Chaocheng;WANG Youhua;LIU Limin(Orthopedics Department of Zhangjiajie Hospital of Traditional Chinese Medicine,Zhangjiajie 427000,Hunan,China)

机构地区：[1]张家界市中医医院骨伤科,湖南张家界427000

出　　处：《医学信息》2025年第1期73-78,共6页Journal of Medical Information

基　　金：湖南省科学技术厅项目(编号:2022SK2135)。

摘　　要：目的评价土家药内服外敷配合富血小板血浆(PRP)治疗肝肾亏虚型膝骨关节炎的疗效观察。方法选取2022年1月-2023年8月在张家界市中医医院门诊及住院部收治的70例肝肾亏虚型膝骨关节炎患者,采用随机数字表法分为对照组和试验组,各35例。对照组予以膝痹汤内服+中药热奄包熏蒸,试验组在对照组基础上加用膝关节PRP治疗,治疗后1、2周对比两组临床疗效、膝关节HSS评分、基质金属蛋白酶-3(MMP-3)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、中医症候总积分水平变化。结果治疗后1、2周,试验组HSS总评分高于对照组(P<0.05);治疗后1周,两组疼痛、功能、活动度、肌力评分、中医证候总积分比较,差异无统计学意义(P>0.05);治疗后2周,试验组疼痛、功能、活动度、肌力评分优于对照组(P<0.05);治疗后1、2周,两组屈曲畸形、稳定性、减分项评分比较,差异无统计学意义(P<0.05);两组治疗后IL-6、TNF-α、MMP-3水平均低于治疗前,且试验组低于对照组(P<0.05);治疗后2周,试验组中医证候总积分低于对照组(P<0.05);试验组临床总有效率为93.94%,高于对照组的71.88%(P<0.05)。结论土家药内服外敷配合富血小板血浆能更有效防治早中期肝肾亏虚型膝骨关节炎患者的临床症状、减轻炎症反应,提高生活水平质量。Objective To evaluate the efficacy of Tujia medicine for internal and external application combined with platelet-rich plasma(PRP)in the treatment of knee osteoarthritis with liver and kidney deficiency type.Methods From January 2022 to August 2023,70 patients with knee osteoarthritis of liver and kidney deficiency type were selected from the outpatient and inpatient departments of Zhangjiajie Hospital of Traditional Chinese Medicine.They were divided into control group and experimental group by random number table method,with 35 patients in each group.The control group was treated with Xibi decoction+traditional Chinese medicine hot package fumigation,and the experimental group was treated with knee joint PRP on the basis of the control group.After 1 and 2 weeks of treatment,the clinical efficacy,knee joint HSS score,matrix metalloproteinase-3(MMP-3),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and changes in the total score of TCM symptoms were compared between the two groups.Results After 1 and 2 weeks of treatment,the total HSS score of the experimental group was higher than that of the control group(P<0.05).After 1 week of treatment,there were no significant difference in pain,function,activity,muscle strength score and total score of TCM syndromes between the two groups(P>0.05).After 2 weeks of treatment,the scores of pain,function,activity and muscle strength in the experimental group were better than those in the control group(P<0.05).At 1 and 2 weeks after treatment,there were no significant difference in the scores of flexion deformity,stability and reduction between the two groups(P<0.05).After treatment,the levels of IL-6,TNF-αand MMP-3 in the two groups were lower than those before treatment,and those in the experimental group were lower than those in the control group(P<0.05).After 2 weeks of treatment,the total score of TCM syndromes in the experimental group was lower than that in the control group(P<0.05).The total clinical effective rate of the experimental group was 93.94%,which was hi

关 键 词：土家药 肝肾亏虚型 膝骨关节炎 富血小板血浆 

分 类 号：R684.3[医药卫生—骨科学]