健脾通络方治疗膝关节骨性关节炎临床观察

Clinical observation on the effects of Jianpi Tongluo recipe on treating KOA

目的:观察健脾活络方配合膝关节冲洗治疗脾虚水泛型膝关节骨性关节炎(KOA)的临床疗效。方法:将77例辨证为脾虚水泛型的KOA患者,采用口服健脾活络方1剂/d,分两次口服,并将药渣热敷患肢,30min/次;同时,应用0.9%生理盐水500ml+庆大霉素16万U关节腔灌注一次。分别于治疗后3、6、12、18个月采用西安大略和麦马思斯特大学骨关节炎指数(WOMAC)、美国特种外科医院膝关节评分(HSS评分)为疗效评价指标。结果:治疗后3个月时,WOMAC评分及HSS评分最高(P<0.05);治疗后18个月时,WOMAC评分有效率依然达到90.9%(P<0.05),HSS评分优良率达到89.6%(P<0.05)。在改善膝关节疼痛及功能方面:在治疗后3个月时,HSS疼痛评分达到25.65(P<0.01),功能评分达到18.12(P<0.01);在治疗后18个月时,HSS疼痛评分为22.76(P<0.01),功能评分为15.25(P<0.01或P>0.05)。结论:健脾活络方配合膝关节冲洗治疗脾虚水泛型KOA起效快,疗效肯定,对于膝关节疼痛的改善及功能的恢复有较明显的作用。

Objective： To observe the clinical effect of Jianpi Tongluo recipe combined with knee joint irrigation treatment on water flooding due to spleen deficiency syndrome of knee osteoarthritis （KOA）. Methods： Totally 77 KOA patients with water flooding due to spleen deficiency syndrome were administrated with Jianpi Tongluo decoction twice daily, while the affected limb accepted herb residuehot compress, 30 minutes each time. In addition, tidal irrigation with 0.9% normal saline 500ml plus gentamicin 160000U was applied for patients once. The Western Ontario and McMaster Universities OsteoarthritiS Index （WOMAC） and Hospital for Special Surgery （HSS） were used to assess therapeutic effect at 3th, 6th, 12th and 18th month after the treatment respectively. Results： WOMAC and HSS reached the highest level in 3th month （P〈0.05）; moreover, the effective rate of WOMAC and the excellent rate of HSS were still as high as 90.9% （P〈0.05） and 89.6% （P〈0.05） respectively at the 18th month. In the other hand, pain score and functional score of HSS were 25.65 （P〈0.01） and 18.12 （P〈0.01） at 3th month; at 18th month they achieved 22.76（P〈0.01） and 15.25 （P〈0.01 P〉0.05） respectively. Conclusion： Jianpi Tongluo recipe with knee joint irrigation is of quick effects on KOA patients in water flooding due to spleen deficiency syndrome, curative effect is positive. In conclusion, this method obviously relief the pain and restore the function of knee joints.