活血通痹汤联合阶段性运动疗法对早中期膝关节骨性关节炎的近期疗效研究

Short- term Efficacy of Huoxue Tongbi Decoction Combined With Multi- stage Exercise Therapy on Knee Osteoarthritis of Early and Middle Stage

目的探讨活血通痹汤联合运动疗法治疗早中期膝关节骨性关节炎(KOA)的近期疗效。方法选取2010年3月—2014年3月在山东省青州市中医院骨伤科、康复科门诊与住院的早中期KOA患者126例,采用随机数字表法分为治疗组60例和对照组66例。两组均进行膝关节腔内注射玻璃酸钠。在此基础上,治疗组采用活血通痹汤联合阶段性运动疗法,对照组口服盐酸氨基葡萄糖片。比较两组治疗前和治疗后6周的临床疗效、视觉模拟评分法(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分。结果对照组中,临床控制32例(占48.5%),显效13例(占19.7%),有效12例(占18.2%),无效9例(占13.6%);治疗组中,临床控制40例(占66.7%),显效14例(占23.3%),有效4例(占6.7%),无效2例(占3.3%)。两组患者的临床疗效比较,差异有统计学意义(u=-2.32,P<0.05)。两组VAS评分比较,治疗前差异无统计学意义(P>0.05);治疗后6周差异有统计学意义(P<0.05)。两组僵硬、疼痛、日常生活受限各项评分及WOMAC总分比较,治疗前差异均无统计学意义(P>0.05);治疗后6周差异均有统计学意义(P<0.05)。结论活血通痹汤联合阶段性运动疗法在早中期KOA患者的治疗中近期疗效显著,安全性佳。

Objective To observe short - term effect of huoxue tongbi decoction combined with exercise therapy on knee osteoarthritis （KOA） of early and middle stage. Methods We enrolled 126 KOA patients who were hospitalized in the Department of Orthopaedics and Traumatology and the Department of Rehabilitation of Qingzhou Hospital of Traditional Chinese Medicine in Shandong Province from March 2010 to March 2014. Using random number table method, the patients were divided into treatment group （ n = 60） and control group （ n = 66） . The two groups were administrated with sodium hyaluronate by injection into knee articular cavity, on the basis of which treatment group was administrated with huoxue tongbi decoction combined with multi - stage exercise therapy and control group was orally administrated with glucosamine hydrochloride tablets. Comparison was made in clinical efficacy, VAS and WOMAC between the two groups before treatment and six weeks after treatment. Resets In control group, the disease of 32 （,48. 5% ） subjects were clinically controlled, 13 （ 19. 7% ） subjects saw obvious efficacy, 12 （18.2%） subjects saw efficacy, and 9 （13.6%） subjects saw no efficacy; in treatment group, the disease of 40 （66. 7% ） subjects were clinically controlled, 14 （23.3%） subjects saw obvious efficacy, 4 （6.7%） subjects saw efficacy, and 2 （ 3.3% ） subjects saw no efficacy. The comparison of clinical efficacy between the two groups showed significant difference （ u= - 2. 32, P 〈 0. 05 ） . The two groups were not significantly different （ P 〉 0. 05 ） in VAS before treatment and were significantly different （ P 〈 0. 05 ） in VAS six weeks after treatment. The two groups were not significantly different （ P 〉 0. 05 ） before treatment and were significantly different （ P 〈 0. 05 ） six weeks after treatment in stiffness, pain, scores of daily life restrictions and the total score of WOMAC. Conclusion Huoxue tongbi decoction combined with multi - stage exercise therapy has remarkable short - term efficacy in the treatment of knee osteoarthritis of early and middle stage and has good safety.