活血化瘀法加补肾法治疗膝关节骨性关节炎的临床研究

Clinical Study or Treatment of Osteoarthritis by Activating Blood Circulation to Resolve Blood Stasis and Tonifying Kidney

目的:观察活血化瘀法加补肾法治疗膝关节骨性关节炎(膝OA)的临床疗效,探讨其治疗OA的机理。方法:将90例膝OA患者随机分为活血化瘀组、补肾组、活血化瘀加补肾组(每组均为30例)进行治疗观察。治疗3周后参照Ly-sholm膝关节功能评定方法进行评分,并结合国家中医药管理局1994颁布的《中医病论诊断疗效标准》进行疗效评估。结果三组病例治疗前后的Lysholm评分为:活血化瘀组加补肾组(观察组),治疗前平均为39.1分,治疗后平均为65.8分。活血化瘀组(对照组A):治疗前平均为39.3分,治疗后为56分;补肾组(对照组B)治疗前平均为38.9分,治疗后为52.5分;三组疗效评定:对照组A治疗有效率为60.0%;对照组B治疗有效率为30.0%;观察组治疗有效率为83.33%,经统计学处理,观察组疗效优于对照组A(P<0.05),明显优于对照组B(P<0.01)。结论:临床上应用活血化瘀法加补肾法治疗膝OA能获得比单纯运用活血化瘀法或补肾法治疗膝OA更好的疗效,其疗效机理主要是针对膝OA病机———肝肾不足,气血不足为本,气滞血瘀,脉络痹阻为标而辨证用药,达到标本兼治的功效。

Objective:To study the mechanism of treatment for osteoarthritis of knee (KOA) from the result of treatment using activating blood to resolve stagnation and invigorating the kidney. Method:Ninety cases of patients with knee OA were divided into three groups on an average:The first group(control group A)was using activating blood to resolve stagnation, the second group(control group B) was using invigorating the kidney, the third group(observation group)was using activating blood to resolve stagnation and invigorating the kidney. Following the result of treatment. Three weeks later, evaluating the result of treatment in Lysholm’s ways of evaluating functions of knee and The Standard Of TCM Disease Diagnosis And Treatment (State Administration of Traditional Chinese Medicine of China). Results:The score of three groups in Lysholm ’s ways: Before treatment, the observation group score was 39.1, after treatment, the score was 65.8. Before treatment, the control group A, score was 39.3, after treatment, the score was 56 before treatment, the control group B score was 38.9, after treatment, the score was 52.5. Evaluating the result of three groups: The effective rate of the control group A is 60.00%; the effective rate of the control group B is 30.00%;the effective rate of observation group is 83.33%. By statistics treatment, the observation group is superior to the control group A (P<0.05) and the control group B (P<0.01). Conclusion:In clinic, the result for treatment that using activating blood to resolve stagnation and invigorating the kidney better than that using activating blood to resolve stagnation or invigorating the kidney. The mechanism is that aim at pathogenesis of osteoarthritis of knee that asthenia of the kidney and liver, vital energy and blood deficiency is the essence, vital energy, blood, channels and collaterals blocked are the appearance. Diagnosis and treatment based on the overall analysis of symptoms and signs solve the essence and the appearance.