补肝益肾汤加减联合西药治疗老年膝骨关节炎临床研究  

Clinical Study on Modified Bugan Yishen Decoction Combined with Western Medicine for Senile Knee Osteoarthritis

作　　者：王点兵 吴仁政 张志远 WANG Dianbing;WU Renzheng;ZHANG Zhiyuan(Department of Joint,Dongyang Garden Tian′s Hospital,Dongyang Zhejiang 322121,China)

机构地区：[1]东阳花园田氏医院关节科,浙江东阳322121

出　　处：《新中医》2025年第3期85-89,共5页New Chinese Medicine

摘　　要：目的:观察补肝益肾汤加减联合西药治疗老年膝骨关节炎(KOA)的临床疗效。方法:将2021年1月—2023年2月东阳花园田氏医院收治的老年KOA患者148例,按随机数字表法分为对照组与治疗组各74例。2组均给予功能康复锻炼,对照组加用塞来昔布胶囊、维生素AD软胶囊治疗,治疗组在对照组基础上加补肝益肾汤加减治疗,2组均连续治疗8周。比较2组治疗前后症状体征评分、Harris评分、视觉模拟评分法(VAS)评分、 36项健康状况调查问卷(SF-36)评分及Toll样受体(TLR) 2、 TLR4、髓分化因子88 (MyD88)水平,并评估2组临床疗效及不良反应发生情况。结果:治疗过程中,治疗组脱落1例,对照组脱落4例,最终治疗组完成研究73例,对照组完成研究70例。治疗后,治疗组总有效率95.89%(70/73),高于对照组84.29%(59/70)(P<0.05)。治疗后,2组症状体征评分、VAS评分及膝关节液TLR2、TLR4、MyD88水平均较治疗前降低(P<0.05),Harris评分、SF-36各维度评分升高(P<0.05);治疗组Harris评分、SF-36各维度评分高于对照组(P<0.05),症状体征评分、VAS评分及膝关节液TLR2、TLR4、MyD88水平低于对照组(P<0.05)。2组均未发生不良反应。结论:补肝益肾汤加减联合西药治疗老年KOA临床疗效显著,能够减轻患者临床症状及疼痛程度,改善患者膝关节功能,其作用机制与抑制TLRs/MyD88通路有关。Objective:To observe the clinical effect of modified Bugan Yishen Decoction combined with western medicine on senile knee osteoarthritis(KOA).Methods:A total of 148 senile KOA patients admitted to Dongyang Garden Tian′s Hospital from January 2021 to February 2023 were randomly divided into the control group and the treatment group,with 74 patients in each group,using a random number table method.Both groups were given functional rehabilitation exercises.The control group was treated with Celecoxib Capsules and Vitamin A and D Soft Capsules,while the treatment group was treated with modified Bugan Yishen Decoction based on the treatment of the control group.Both groups were treated continuously for eight weeks.Compared the symptom and sign scores,Harris scores,Visual Analogue Scale(VAS)scores,36-Item Short Form Health Survey(SF-36)scores,and Toll-like receptor(TLR)2,TLR4,and myeloid differentiation factor 88(MyD88)levels before and after treatment between the two groups,and evaluated the clinical efficacy and incidence of adverse reactions between the two groups.Results:During the treatment process,one case fell out of the treatment group and four cases fell out of the control group.Ultimately,73 cases were completed in the treatment group and 70 cases were completed in the control group.After treatment,the total effective rate was 95.89%(70/73)in the treatment group,which was higher than that of 84.29%(59/70)in the control group(P<0.05).After treatment,the symptom and sign scores,VAS scores,and knee joint fluid TLR2,TLR4,and MyD88 levels in both groups were decreased when compared with those before treatment(P<0.05),while Harris scores and SF-36 scores were increased(P<0.05);the Harris score and SF-36 score in the treatment group were higher than those in the control group(P<0.05),while the symptom and sign scores,VAS score,and knee joint fluid TLR2,TLR4,and MyD88 levels were lower than those in the control group(P<0.05).Both groups did not experience any adverse reactions.Conclusion:The combination of modified

关 键 词：膝骨关节炎 老年 补肝益肾汤 TOLL样受体2 TOLL样受体4 髓分化因子88 

分 类 号：R684.3[医药卫生—骨科学]