中药红花化瘀汤熏洗联合关节腔注射治疗退行性膝关节炎的临床效果观察

Clinical observation of traditional Chinese medicine Hong-hua-hua-yu decoction fumigation washing combined with intra-articular injection in the treatment of degenerative knee arthritis

目的 探讨中药红花化瘀汤熏洗联合关节腔注射治疗对退行性膝关节炎患者中医证候、细胞因子及关节功能的影响。方法 2016年11月至2019年11月我院收治的150例退行性膝关节炎患者,其中75例采用关节腔注射玻璃酸钠治疗(对照组),75例采用红花化瘀汤熏洗联合治疗(观察组),两组均治疗4周,比较两组临床疗效,治疗前和治疗4周后中医证候改善情况、膝关节功能、血清细胞因子水平变化以及安全性。结果 治疗4周后,观察组临床总有效率高于对照组(P<0.05);治疗后两组膝关节刺痛、屈伸不利、面黧黑、舌暗有瘀、脉沉涩评分、疼痛评分和关节炎指数(WOMAC)指数均降低,Lysholm评分升高,膝关节活动度增加,3种血清细胞因子水平均降低,且观察组上述指标均优于对照组(P<0.05),两组整体安全性比较差异无统计学意义(P>0.05)。结论 中药红花化瘀汤熏洗联合关节腔注射可降低退行性膝关节炎患者中医证候评分,改善膝关节功能,增加关节活动度,减轻炎症反应,疗效显著,整体安全性高。

Objective To investigate the effect of traditional Chinese medicine Hong-hua-hua-yu decoction fumigation washing combined with intra-articular injection on TCM syndrome, cytokines and joint function in patients with degenerative knee arthritis.Methods From November 2016 to November 2019, 150 patients with degenerative knee arthritis were treated in our hospital. Among them, 75 patients were treated with intra-articular injection of sodium hyaluronate(control group), and 75 patients were treated with Hong-hua-hua-yu decoction fumigation washing(observation group). Both groups were treated for 4 weeks. The clinical efficacy, the improvement of TCM syndromes, the knee joint function, the changes in serum cytokine levels and safety before and after treatment were compared between the two groups.Results After 4 weeks of treatment, the total clinical effective rate of the observation group was higher than that of the control group(P<0.05). After treatment, knee joint tingling, poor flexion and extension, swarthy face, dark tongue with blood stasis, pulse sinking and astringency scores, pain scores and arthritis indexes(WOMAC) in the two groups were decreased, while Lysholm scores were increased, and knee joint activity was increased, as well as the levels of three serum cytokines were decreased. The above indicators in the observation group were better than those in the control group(P<0.05). There was no significant difference in overall safety between the two groups(P>0.05).Conclusions Hong-hua-hua-yu decoction fumigation washing combined with intra-articular injection can reduce the score of TCM syndromes in patients with degenerative knee arthritis, improve the function of knee joint, increase the joint mobility, and reduce the inflammatory reaction. It has significant efficacy and high overall safety.