益气化瘀补肾方治疗膝骨关节炎临床研究

Clinical Efficacy of Qi-tonifying,Blood Stasis-removing,and Kidney-tonifying Prescription in Treatment of Knee Osteoarthritis

目的观察施杞教授经验方益气化瘀补肾方治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效,初步分析中药治疗KOA的优势。方法将122例符合纳入标准的患者随机分为两组,治疗组62例采用施杞教授经验方益气化瘀补肾方内服及外用,对照组60例采用美洛昔康治疗,疗程12周,比较两组总体疗效及主要症状评分。结果两组总有效率比较,差异无统计学意义(P>0.05);治疗组改善"膝部肿胀"、"膝部僵硬"、"腰膝酸软"、"膝部怕冷"的疗效优于对照组(P<0.05),对照组改善"疼痛"、"下蹲疼痛"、"上下楼疼痛"的疗效优于治疗组(P<0.05)。结论益气化瘀补肾方治疗KOA的总体疗效与美洛昔康相当,改善"膝部肿胀"、"膝部僵硬"、"腰膝酸软"、"膝部怕冷"的疗效优于美洛昔康,值得推广应用。

Objective To observe the clinical efficacy of qi-tonifying, blood stasis-removing, and kidney- tonifying prescription, the experienced prescription of Professor Shi Qi, in the treatment of knee osteoar- thritis （KOA） and to preliminarily analyze the advantage of traditional Chinese medicine treatment of KOA. Methods A total of 122 patients with KOA who met the inclusion criteria were randomly divided into treatment group （n=62） and control group （n=60）. The qi tonifying, blood stasis-removing, and kidney-tonifying prescription was orally given and externally applied in the treatment group, while meloxi- cam was given in the control group; the course of treatment was 12 weeks. The two groups were compared in terms of overall response rate and main symptom scores. Results There was no significant difference in overall response rate between the two groups （P〉0.05）. The treatment group had significantly more ira- provements in knee swelling, knee stiffness, soreness and weakness of the waist and knees, and cold intol- erance of the knees than the control group （P〈0.05） ; the control group had significantly more improvements in pain, pain during squatting, and pain when walking upstairs and downstairs than the treatment group （P^O. 05）. Conclusion Qi-tonifying, blood stasis-removing, and kidney-tonifying prescription has a comparable clinical effect to meloxicam in the treatment of KOA and is superior to meloxicam in relieving knee swelling, knee stiffness, soreness and weakness of the waist and knees, and cold intolerance of the knees. This prescription shows promise for clinical application.