补肾舒筋方联合玻璃酸钠腔内注射治疗对老年早中期膝骨关节炎病情进程的影响

Effect of Bushen Shujin Decoction combined with intra-articular injection of sodium hyaluronate treatment on early and middle stage knee osteoarthritis progress in the elderly

目的：分析补肾舒筋方联合玻璃酸钠腔内注射治疗对老年早中期膝骨关节炎病情进程的影响。方法：选取2012年11月-2015年1月间在湖北省公安县中医医院骨科接受治疗的老年早中期膝骨关节炎患者102例作为研究对象，随机分为观察组及对照组各51例。对照组患者接受关节腔内玻璃酸钠注射治疗，观察组患者接受补肾舒筋方联合玻璃酸钠腔内注射治疗。对比两组患者的血清及关节滑液中炎症相关因子、免疫相关因子等水平差异。结果：观察组患者治疗后d血清及关节滑液中TNF—α、IL-1β、iNOS、bFGF、MMP-3及TIMP-1水平均低于对照组患者（P〈0．05）；观察组患者的治疗后血清及关节滑液中TGF—β1、IGF-1水平低于对照组患者（P〈0．05）；观察组患者的治疗1月及3月后血清CD4＋CD25＋CD12710w／-Treg比例高于对照组患者（P〈0．05）。结论：老年早中期膝骨关节炎患者伴有多种因子及免疫水平异常，补肾舒筋方联合玻璃酸钠腔内注射治疗可以优化患者全身状态、抑制病情进展并促进关节功能恢复。

Objective： To analyze the effect of Bushen Shujin Decoction combined with intra-articular injection of sodium hyaluronate treatment on early and middle stage knee osteoarthritis progress in the elderly. Methods： A total of 102 cases of elderly patients with early and middle stage knee osteoarthritis who received treatment in our hospital from November 2012 to January 2015 were selected as research subjects and randomly divided into observation group and control group, each group with 51 cases. The control group received intra-articular injection of sodium hyaluronate treatment and observation group received Bushen Shujin Decoction combined with intra articular injection of sodium hyaluronate treatment. Differences in levels of inflammation-related factors and immunity-related factors in serum and synovial fluid of two groups were compared. Results： TNF-α, IL-1β, iNOS, bFGF, MMP-3 and TIMP-1 levels in serum and synovial fluid of the observation group were lower than those of the control group （P〈0.05） after the treatment. TGF-β1 and IGF-1 levels in serum and synovial fluid of the observation group were lower than those of the control group （P〈0.05） after the treatment. CD4＋ CD25＋ CD1271loW/-Treg ratios in serum of the observation group were higher than those of control group 1 month and 3 months after the treatment （P〈0.05）. Conclusion： Elderly patients with early and middle stage knee osteoarthritis are accompanied by abnormality of a variety of factors and immune level. Bushen Shujin Decoction combined with intra articular injection of sodium hyaluronate treatment can optimize patients＇ systemic state, inhibit disease progression and promote joint function recovery.