独活续断汤离子导入对膝骨关节炎患者膝关节肿胀和疼痛程度的影响  

Effects of iontophoresis of Duhuo Xuduan decoction on knee swelling and pain in patients with knee osteoarthritis

作　　者：刘杰 王瑜 牛永强 Liu Jie;Wang Yu;Niu Yongqiang(Department of Orthopedics,Yulin Traditional Chinese Medicine Hospital,Yulin 719000,China;The First Department of Orthopedics and Trauma,Yulin Traditional Chinese Medicine Hospital,Yulin 719000,China)

机构地区：[1]榆林市中医医院骨科,榆林719000 [2]榆林市中医医院骨伤一科,榆林719000

出　　处：《国际医药卫生导报》2025年第7期1098-1102,共5页International Medicine and Health Guidance News

基　　金：陕西省中医药管理局项目(SZY-NLTL-2022-041)。

摘　　要：目的 探讨独活续断汤离子导入对膝骨关节炎患者膝关节肿胀、疼痛程度的影响。方法 纳入2022年6月至2023年12月榆林市中医医院收治的200例膝骨关节炎患者,采用摸球法分组,奇数为对照组(100例),偶数为观察组(100例)。对照组男58例,女42例,年龄(59.57±4.69)岁,病程(3.24±0.67)年,发病位置:左膝46例,右膝54例;观察组男60例,女40例,年龄(59.68±4.75)岁,病程(3.36±0.69)年,发病位置:左膝48例,右膝52例。对照组接受硫酸氨基葡萄糖胶囊治疗(每次0.5 g,每天两次),观察组在对照组基础上予以独活续断汤离子导入治疗(每天30 min),连续治疗1个月。比较两组临床疗效,治疗前后的膝关节肿胀程度、疼痛程度[视觉模拟评分法(Visual Analogue Scale,VAS)]、骨关节炎指数[西安大略麦马斯特大学骨关节炎指数评分(Western Ontario and McMaster Universities,WOMAC)]、关节炎生物标志物[基质细胞衍生因子1(stromal cell-derived factor 1,SDF-1)、基质金属蛋白酶-3(matrix metalloproteinase 3,MMP-3)、CXC趋化因子受体4(CXC chemokine receptor 4,CXCR4)]、炎症因子水平[前列腺素E2(prostaglandin E2,PGE2)、环氧合酶-2(cyclooxygenase-2,COX-2)]。统计学分析采用χ^(2)检验、独立样本t检验。结果 治疗后,观察组总有效率较对照组高[95.00%(95/100)比81.00%(81/100)],差异有统计学意义(χ^(2)=9.280,P=0.002);观察组膝关节肿胀评分、VAS评分较对照组低[(0.60±0.05)分比(0.81±0.08)分,(3.49±0.52)分比(4.81±0.76)分],差异均有统计学意义(t=22.260、14.334,均P<0.05);观察组WOMAC中疼痛、僵硬、日常生活难度得分较对照组低[(4.58±0.96)分比(6.21±1.27)分,(0.70±0.21)分比(1.30±0.49)分,(10.03±1.68)分比(15.54±2.57)分],差异均有统计学意义(t=10.239、11.255、17.946,均P<0.05);观察组SDF-1、MMP-3、CXCR4水平较对照组低[(103.25±8.93)pg/L比(119.16±10.37)pg/L,(1.79±0.31)μg/L比(2.41±0.68)μg/L,(37.52±3.54)pg/L比(49.87±4.76)pg/L],差异均�Objective To investigate the effects of iontophoresis of Duhuo Xuduan decoction on knee swelling and pain in patients with knee osteoarthritis.Methods A total of 200 patients with knee osteoarthritis admitted to Yulin Traditional Chinese Medicine Hospital from June 2022 to December 2023 were divided into two groups by touching ball method,with odd numbers as a control group(100 cases)and even numbers as an observation group(100 cases).In the control group,there were 58 males and 42 females,aged(59.57±4.69)years,with a course of disease of(3.24±0.67)years,and the location of disease was left knee in 46 cases and right knee in 54 cases.In the observation group,there were 60 males and 40 females,aged(59.68±4.75)years,with a course of disease of(3.36±0.69)years,and the location of disease was left knee in 48 cases and right knee in 52 cases.The control group was treated with glucosamine sulfate capsules(0.5 g each time,twice a day),and the observation group was additionally treated with iontophoresis of Duhuo Xuduan decoction(30 min a day)for 1 month.The clinical effects of the two groups were compared,as well as the degree of knee swelling,pain level[Visual Analogue Scale(VAS)],osteoarthritis index[Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)],arthritis biomarkers[stromal cell-derived factor 1(SDF-1),matrix metalloproteinase 3(MMP-3),and CXC chemokine receptor 4(CXCR4)],levels of inflammatory factors[prostaglandin E2(PGE2)and cyclooxygenase-2(COX-2)]before and after treatment.χ^(2) test and independent sample t test were used for statistical analysis.Results After treatment,the total effective rate of the observation group was higher than that of the control group[95.00%(95/100)vs.81.00%(81/100)],with a statistically significant difference(χ^(2)=9.280,P=0.002);the knee swelling score and VAS score in the observation group were lower than those in the control group[(0.60±0.05)points vs.(0.81±0.08)points,(3.49±0.52)points vs.(4.81±0.76)points],with statistically significant differenc

关 键 词：膝骨关节炎 独活续断汤 离子导入 膝关节肿胀 疼痛程度 骨关节炎指数 

分 类 号：R274.9[医药卫生—中西医结合]