中医康复治疗老年骨性关节炎80例效果观察

Observation of TCM rehabilitation therapy in treatment of 80 patients with senile osteoarthritis

目的研究中医综合康复疗法在老年骨性关节炎诊治中的治疗效果及安全性。方法随机选取该科2013年2月至2014年1月诊治的80例老年骨性关节炎患者,根据治疗方案分为中医组与西医组,各40例。中医组患者均接受中医康复治疗,主要包括手法推拿、中药熏洗、中药内服(包括六味地黄丸及自制当归四逆汤),疗程3周。西医组患者采用西药治疗,给予关节内注射25 mg玻璃酸钠,每周1次;口服0.75 g盐酸氨基葡萄糖胶囊,每天2次,均连续治疗3周。通过对照分析两组治疗方案的临床疗效及视觉模拟评分表(JOA)、视觉模拟评分表(VAS)评分。结果中医组显效率[62.5%(25/40)]、总有效率[92.5%(37/40)]明显高于西医组[25.0%(10/40)、65.0%(26/40)],差异均有统计学意义(P<0.05);治疗前,中医组JOA、VAS评分[(50.2±10.6)、(7.8±2.3)分]与西医组[(49.9±11.2)、(7.7±2.4)分]比较,差异均无统计学意义(P>0.05);治疗后,两组患者JOA评分[(91.5±16.3)、(84.1±13.3)分]较治疗前明显升高,VAS评分[(2.4±1.2)、(3.6±1.8)分]较治疗前明显降低,且中医组JOA、VAS评分明显优于西医组,差异均有统计学意义(P<0.05)。结论中医康复疗法对老年骨性关节炎不仅具有良好的治疗效果,同时不良反应小、安全可靠,可在临床推广应用。

Objective To approach therapeutic effect and safety of TCM rehabilitation therapy in the treatment of senile osteoarthritis disease. Methods Totally 80 elderly patients with senile osteoarthritis were randomly selected from Feb. 2013 to Jan. 2014 in this department who were divided into the TCM group and the western medicine group, 40 of each group. The patients in the TCM group were accepted TCM rehabilitation therapy,including TCM massage ,TCM fumigation and internal TCM including Liuweidihuang pills and angelica sini decoction,while those in the western medicine group with western medicine,including intra-articular injection of 25 mg sodium hyaluronate, once in each week ,taking 0.75 g glucosamine hydrochloride capsules orally for twice a day lasting 3 weeks continuously. Upon comparison and analysis,the clinic effects ,JOA, VAS grading of the two groups were studied. Results The significant efficiency [62.5%（25/40）],the total efficiency[92.5%（37/40）] of the TCM group were significantly higher than those[25.0% （10/40） ,65.0% （26/40）]of the western medicine group. The differences were statistically significant（P〈0.05 ）. Compared the JOA and VAS scores before treatment, there were no differences in statistical significance between the[ （50.2±10.6 ）, （7.8±2.3）] of TCM group and the[ （49.9±11.2 ）, （7.7±2.4）%] of the western medicine group （P〉 0.05 ） ; The JOA scores[ （91.5 ±16.3 ）, （ 84.1 ±13.3 ） ] were raised but the VAS scores [ （2.4±1.2 ）, （3.6±1.8 ） ]after the treatment of the two groups drop respectively. The JOA and VAS scores of the TCM group were distinctly superior than those of the western group, which had statistical significance （P〈0.05）. Conclusion Upon being confirmed by clinic research, the TCM rehabilitation therapy is not only better in effect in senile osteoarthritiscases but also less in adverse effect with safety and reliablity,being worthy to promotion.