健脾祛湿散结消肿汤联合石氏伤科推拿疗法治疗痰湿阻络型膝关节骨性关节炎60例

Sixty Cases of Knee Osteoarthritis with Syndrome of Phlegm Dampness Blocking Collaterals Treated with Decoction for Activating Spleen and Removing Dampness and Dispersing Stagnation and Reducing Swelling in Combination with Master Shi′s Orthopedic Massage Therapy

目的:观察健脾祛湿散结消肿汤联合石氏伤科推拿疗法治疗痰湿阻络型膝关节骨性关节炎的临床疗效。方法:将120例膝关节骨性关节炎患者按照随机数字表法分为观察组和对照组,每组各60例。对照组给予关节腔内注射玻璃酸钠进行治疗,观察组在对照组基础上给予健脾祛湿散结消肿汤联合石氏伤科推拿治疗。比较两组患者的临床疗效及治疗前后临床症状积分、膝关节功能评分变化情况,检测两组患者治疗前后红细胞C3b受体花环率(erythrocyte C3b receptor rosette rate,E-C3bRR)及免疫复合物花环率(erythrocyte immune complex rosette rate,E-ICR)。结果:两组患者治疗后临床症状积分低于本组治疗前,且观察组治疗后低于对照组治疗后,差异具有统计学意义(P<0.05)。观察组有效率为96.67%,对照组有效率为76.67%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后膝关节功能疼痛、功能、活动度、屈曲畸形、肌力、稳定性及总分高于本组治疗前,且观察组治疗后高于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后E-C3bRR高于本组治疗前,E-ICR低于本组治疗前,且观察组E-C3bRR高于对照组,E-ICR低于对照组,差异具有统计学意义(P<0.05)。结论:健脾祛湿散结消肿汤联合石氏伤科推拿可改善痰湿阻络型膝关节骨性关节炎患者的临床症状,其作用机制可能与提高E-C3bRR水平、降低E-ICR水平,改善机体免疫反应有关。

Objective:To observe the clinical curative effect of Decoction for Activating Spleen and Removing Dampness and Dispersing Stagnation and Reducing Swelling in combination with Master Shi′s orthopedic massage therapy on knee osteoarthritis with syndrome of phlegm dampness blocking collaterals.Methods:A total of 120 patients with knee osteoarthritis were divided into the observation group and the control group according to the random number table method,with 60 cases in each group.The control group was treated with intraarticular injection of sodium hyaluronate,and the observation group was treated with Decoction for Activating Spleen and Removing Dampness and Dispersing Stagnation and Reducing Swelling in combination with Master Shi′s orthopedic massage therapy on the basis of the control group.The clinical effects and the changes of clinical symptom score and knee joint function score before and after the treatment were compared between the two groups.The erythrocyte C3 b receptor rosette rate(E-c3 bRR)and erythrocyte immune complex rosette rate(E-ICR)were measured before and after the treatment.Results:After treatment,the clinical symptom score of each group was lower than that of the same group before treatment,and the difference was statistically significant(P<0.05).The effective rate was 96.67%in the observation group and 76.67%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the pain,function,activity scope,flexion deformity,muscle strength,stability and total score of knee joint in the two groups were higher than those of the same group before the treatment;the above indexes of the observation group after treatment were higher than those of the control group,and all the differences were statistically significant(P<0.05).After the treatment,E-C3 bRR of each group was higher than that of the same group before the treatment,E-ICR was lower than that before treatment,and E-C3 bRR of the observation group was higher than that of the control group,E-ICR was lower than that of the control group,and all the differences were statistically significant(P<0.05).Conclusion:Decoction for Activating Spleen and Removing Dampness and Dispersing Stagnation and Reducing Swelling in combination with Master Shi′s orthopedic massage therapy can significantly improve the clinical symptoms of patients with knee osteoarthritis with syndrome of phlegm dampness blocking collaterals,and its mechanism may be related to improving the level of E-C3 bRR,reducing the level of E-ICR and improving the immune response of human body.