中药内外合治湿热痹阻型膝骨关节炎临床疗效观察

Clinical curative effect observation of the damp-heat obstruction syndrome knee osteoarthritis by means of combined TCM internal and external treatment

目的：观察黄芩清热除痹胶囊口服联合芙蓉膏外敷治疗膝骨关节炎湿热痹阻型的临床疗效。方法60例膝骨关节炎患者，年龄40～70岁，中医辨证属湿热痹阻证者，随机分为治疗组30例与对照组30例，治疗组用黄芩清热除痹胶囊口服配合芙蓉膏外敷，疗程为2周，对照组给予氨基葡萄糖、美洛昔康口服治疗。结果治疗组总有效率96．7％，对照组总有效率76．7％，治疗组总有效率优于对照组，差异具有统计学意义（P ＜0．05）；两组治疗后均能显著降低患者中医证候总积分、关节疼痛 VAS 评分、WOMAC 指数、血沉（ESR），C －反应蛋白（CRP）水平（P ＜0．05或 P ＜0．01），两组治疗后比较，治疗组 VAS 评分、WOMAC 指数、ESR、CRP 下降的更明显（P ＜0．05或 P ＜0．01）；治疗组在上调超氧化物歧化酶（SOD）方面优于对照组（P＜0．05）；两组治疗后谷丙转氨酶（ALT）、谷草转氨酶（AST）、肌酐（Cre）、血常规均在正常范围。结论黄芩清热除痹胶囊口服联合芙蓉膏外敷能有效改善膝骨关节炎急性期症状，减轻患者疼痛 VAS 评分、WOMAC 指数、降低 ESR、CRP，起效迅速，且安全性良好，未见明显毒副作用。

objective To observe clinical curative effect of the damp-heat obstruction syndrome knee osteoarthritis through the treatment of capsule Huangqin heat-cleaning for oral administration together with lotus paste for external use.Methods 60 cases of patients with knee osteoarthritis aged between 40 and 70 years old,also diagnosed as the damp-heat obstruction syndrome,were randomly divided into two groups,with 30 cases in the treatment group and 30 in the control group.The treatment group was treated with capsule Huangqin heat-cleaning for oral administration together with lotus paste for external use during 2 weeks of treatment course,while the control group was orally treated with glucosamine sulphate and meloxicam.Results The total effective rate of the treatment group was superior to the control group （P 〈0.05）as 96.7% vs 76.7%.After the treatment,both of the two groups could significantly reduce the total score of TCMsyndrome,the VAS score of joint pain,WOMAC index,ESR,and CRP level （P 〈0.05 or P 〈0.01 ）.Comparing the two groups,the treatment group reduced more obviously than the control group on the VAS score of joint pain,WOMAC index,ESR,and CRP level （P 〈0.05 or P 〈0.01）;the treatment group is superior to the control group on raising SOD （P 〈0.05）;ALT,AST,Cre and blood routine of the two groups were in normal range after the treatment.Conclusions Capsule Huangqin heat -cleaning for oral adminis-tration together with lotus paste for external use,which are fast and safe,can effectively control knee osteoarthritis of acute period,re-lieve patients＇VAS pain score,WOMAC index as well as lower ESR and CRP with no side effects.