独活寄生汤联合膏摩法治疗膝骨性关节炎风寒湿痹兼肝肾亏虚证35例临床观察

Clinical Observation on Duhuo Jisheng Decoction(独活寄生汤) Combined with Ointment Massage in Treating 35 Cases of Knee Osteoarthritis of Wind-Cold-Damp Bi with Liver-Kidney Deficiency Syndrome

目的观察独活寄生汤联合膏摩法治疗膝骨性关节炎风寒湿痹兼肝肾亏虚证患者的临床疗效及安全性。方法将70例膝骨性关节炎风寒湿痹兼肝肾亏虚证患者随机分为治疗组和对照组各35例。治疗组采用口服独活寄生汤,每日1剂,同时配合以通络祛瘀膏为介质的膏摩法治疗,每次15~20 min,每日1次;对照组采用口服盐酸氨基葡萄糖胶囊治疗,每次0.24 g,每日3次。两组均治疗4周,6个月后随访。观察治疗后两组患者临床疗效,于治疗前及治疗14天、28天、随访时进行疼痛视觉模拟评分(VAS)和骨关节炎指数评分(WOMAC),并观察不良反应。结果治疗组临床疗效总有效率为91.43%(32/35),优于对照组的68.57%(24/35)(P<0.05)。两组患者治疗14天、28天及随访时VAS评分和WOMAC评分均较本组治疗前明显降低(P<0.01);治疗28天与本组治疗14天比较,VAS评分和WOMAC评分亦降低(P<0.05);两组随访时与本组治疗14天比较,VAS评分升高,而WOMAC评分降低(P<0.05);两组随访时与本组治疗28天比较,VAS评分和WOMAC评分均升高(P<0.05);与对照组同时间比较,治疗组治疗14天、28天及随访时VAS评分和WOMAC评分均下降(P<0.05或P<0.01)。结论独活寄生汤联合膏摩法治疗膝骨性关节炎风寒湿痹兼肝肾亏虚证疗效肯定,可显著减轻疼痛感,提高运动功能与日常活动能力,且远期疗效好于盐酸氨基葡萄糖胶囊。

Objective To observe the efficacy and safety of Duhuo Jisheng Decoction(独活寄生汤)combined with ointment massage in the treatment of knee osteoarthritis of wind-cold-damp Bi with liver-kidney deficiency syndrome.Methods A total of 70 patients of knee osteoarthritis of wind-cold-damp Bi with liver-kidney deficiency syndrome were randomly divided into a treatment group and a control group,with 35 cases in each group.The treatment group was treated with oral administration of Duhuo Jisheng Decoction(独活寄生汤),one dose per day,and combined with ointment massage with Tongluo Quyu Ointment(通络祛瘀膏),15~20 min each time,once a day.The control group was treated with oral administration of glucosamine hydrochloride capsules,0.24 g each time,3 times a day.Both groups were treated for 4 weeks and followed up for 6 months.The clinical efficacy of the 2 groups of patients was observed after treatment.The changes of visual analog scale(VAS)and the Western Ontario and Mc Master Universities Osteoarthritis(WOMAC score)were observed before treatment,14 days and 28 days after treatment,and adverse reactions were observed.Results The total effective rate of the treatment group was 91.4%(32/35),which was better than 68.6%(24/35)in the control group(P<0.05).On the14 th day,28 th day,and follow-up,the VAS and WOMAC scores of both groups were significantly decreased than those before treatment(P<0.01).After 28 days of treatment in both groups,the VAS score and WOMAC score were also reduced compared with those after 14 days of treatment within group(P<0.05);at the follow-up of the 2 groups,the VAS score increased,while the WOMAC score decreased compared with those of 14 days of treatment within group(P<0.05).The VAS score and WOMAC score were increased in both groups during follow-up compared with those of 28 days of treatment within group(P<0.05).Compared with the control group at the same time,the VAS score and WOMAC scores of the treatment group decreased 14 days,28 days after treatment and during follow-up(P<0.05 or P<0.01).Conclusion Duhuo Jisheng Decoction(独活寄生汤)combined with ointment massage in the treatment of knee osteoarthritis of wind-cold-damp Bi with liver-kidney deficiency syndrome is effective,which can significantly alliviate the patient’s pain,improve the motor function and daily activity.The long-term efficacy of Duhuo Jisheng Decoction combined with ointment massage is supeior to glucosamine hydrochloride capsule.