膝骨关节炎近10年文献中内服方药功效和中医证型分析

Analysis of the Effect of Oral Prescription and Syndrome Type of Traditional Chinese Medicine for Knee Osteoarthritis in Recent 10 Years

目的:探讨膝骨关节炎近10年文献中内服方药功效和中医证型规律,为临床用药提供参考依据。方法:通过检索近10年中药内服治疗膝骨关节炎的临床文献,整理、归纳和分析膝骨关节炎的内服方剂功效和中医证型规律。结果:491篇有效文献中共有491个方剂,统计的方剂功效共有12个,总使用频次为1965次。所列的中医证型共有18个,总使用频次为2973次。结论:近10年来治疗膝骨关节炎主要是应用补法(补益肝肾、补益脾肾、强筋壮骨),泻法(通络止痛、活血化瘀、活血行气、散寒除湿、祛风除湿),补泻兼施法(益气活血、扶正驱邪)。现代膝骨关节炎的潜在中医分型是:虚证(肝肾亏虚型、肾虚髓亏型、脾肾亏虚型),实证(寒湿痹阻型、气滞血瘀型、湿热壅盛型、筋脉淤滞型、风湿痹阻型),虚实夹杂证(阳虚寒凝型、气虚湿阻型)。

Objective：To investigate the effect of oral prescription and syndrome type of traditional Chinese medicine for knee osteoarthritis in recent 10 years in order to provide a reference basis for clinical use. Methods： Oral prescription and syndrome type of traditional Chinese medicine for knee osteoarthritis were collected and analyzed according to the clinical literature of knee osteoarthritis with Chinese medicine treatment in recent 10 years. Results：There were 491valid articles recording 491 effective prescriptions, among which there were 12 functions and 1965 times of usage. The syndrome types of traditional Chinese medicine were 18 and the frequency of usage was 2973 times. Conclusion：The main treatment methods for knee osteoarthritis are reinforcing method （tonifying liver and kidney, invigorating spleen and kidney, strengthening tendons and bones）, purgation method （activating meridians to stop pain, promoting blood circulation and removing blood stasis, promoting blood circulation of Qi, expelling cold and dampness, dispelling wind and dampness）, both reinforcing and purgation method （supplementing Qi and activating blood circulation, strengthening vital qi and eliminating pathogens）.The potential types of traditional Chinese medicine of modern knee osteoarthritis are deficiency syndrome （deficiency of liver and kidney, kidney medullary deficiency, spleen and kidney deficiency type）, excess syndrome （cold-dampness obstruction type, Qi stagnation and blood stasis type, dampness-heat accumulation type, channel stasis type, wind-damp stagnation type）, and syndrome of intermingled deficiency and excess （yang deficiency and cold coagulation type, Qi deficiency and dampness stagnation type）.