补肾法动员内源性透明质酸治疗膝骨性关节炎的临床研究

Clinical Research of Kidney Invigoration Mobilized Endogenous Hyaluronic Acid in the Treatment of Knee Osteoarthritis

目的:运用中医补肾法治疗膝骨性关节炎以探讨其对内源性透明质酸的动员及其临床疗效的作用机理。方法:随机选取60例膝OA患者分为对照组和治疗组各30例,治疗组以补肾中药治疗,对照组关节腔内注射透明质酸钠,治疗均为1个疗程,治疗后3个月和半年两组分别进行疗效比较;治疗组进行透明质酸浓度检测。结果:3个月后治疗组总有效率93.3%,对照组90%,2组比较差异无统计学意义(P>0.05),半年后治疗组90%,对照组70%,两组比较差异有统计学意义(P<0.01);透明质酸浓度检测显示治疗后3个月和半年血清和滑液HA浓度与治疗前比较差异有统计学意义(P<0.01),血清中的浓度减低,而滑液中的浓度出现了较明显的升高。结论:中医补肾法能够动员内源性透明质酸,提高膝关节透明质酸的水平,同时降解血清中透明质酸的浓度,并且能保持透明质酸浓度持久长效,从而达到保护关节软骨延缓软骨退变、治疗和预防膝骨性关节炎的重要作用。

To investigate the mechanism of kidney invigoration treating knee osteoarthritis through mobilizing en- dogenous hyaluronic acid. Methods：60 patients of knee osteoarthritis were randomly divided into treatment group（n= 30） treated with kidney invigoration and control group（n= 30）treated with injecting hyaluronic acid. The treatment lasted one course. The clinical effect was compared between two groups at 3m and 6m. The concentration of hyaluronic acid in joint was detected in treatment group. Results.. At 3 month, the total effective rate of the treatment group was 93.3 % while the control group was 90% （P〉0.05）. At 6 month, the total effective rate of the treatment group was 90% while the control group was 70% （P〈0.01）. At 3 and 6 month, the concentration of serum hyaluronic acid was lower than that before the treatment, while the concentration of hyaluronic acid in joint was higher than that before the treatment. The difference has statistically signifieanee（P〈0.01）. Conclusion ： Kidney invigoration can mobilize endogenous hyaluronic acid, increase the level of hyaluronic acid in knee joint and decrease the level of serum hyaluronic acid. It plays an important role in delaying the degeneration of cartilage, treating and preventing knee osteoarthritis.