舒筋强腰汤离子导入治疗膝关节骨性关节炎肾虚寒湿瘀阻证临床研究

Shujin Qiangyao Decoction Iontophoresis in Treatment of Knee Osteoarthritis with Kidney Deficiency and Cold Damp Stasis Syndrome

目的:观察舒筋强腰汤离子导入治疗膝骨关节炎肾虚寒湿瘀阻证的临床疗效。方法:采用随机数字表法将106例膝骨性关节炎患者分为对照组和观察组,每组53例。两组患者均给予非药物疗法。对照组在此基础上予以硫酸氨基葡萄糖胶囊口服;观察组在对照组基础上采用舒筋强腰汤离子导入,4个疗程后观察两组患者临床症状改善情况、疼痛程度主观评分、肾虚寒湿瘀阻证评分和生存质量改善情况,检测关节液炎症因子水平,评价临床疗效。结果:观察组有效率为90.57%,高于对照组的73.58%,差异有统计学意义(P<0.05);治疗后观察组患者西安大略和麦克马斯特大学骨关节炎指数量表3个维度评分和总分、疼痛视觉模拟评分法评分、肾虚寒湿瘀阻证评分均低于对照组,差异有统计学意义(P<0.05);健康调查简表各指标评分和总体健康状况评分均高于对照组,差异均有统计学意义(P<0.01);观察组患者关节液白细胞介素-1β、白细胞介素-6和肿瘤坏死因子-α水平低于对照组,差异均有统计学意义(P<0.01)。结论:舒筋强腰汤离子导入治疗膝骨性关节炎肾虚寒湿瘀阻证,能减轻患者临床症状,改善关节功能,提高生存质量,其作用机制可能与抑制白细胞介素-1β、白细胞介素-6和肿瘤坏死因子-α等致炎因子有关。

Objective：To observe the clinical effect of Shujin Qiangyao Decoction Iontophoresis in treatment of knee osteoarthritis with Kidney deficiency and Cold Damp Stasis Syndrome.Methods：106 cases of KOA patients were randomly divided into control group and observation group（with 53 cases in each group）.Both groups received nonpharmacological therapy.In addition to that the control group was treated with Glucosamine sulfate capsules,while the observation group was treated with Glucosamine sulfate capsules and Shujin Qiangshen Decoction.After 4 courses of treatment,the improvement of the clinical symptoms of both groups,the subjective score of the pain degree,the Kidney deficiency and Cold Damp stasis Syndrome score as well as the improvement of quality of life were observed.The inflammatory fluid levels of synovial fluid and the clinical efficacy were evaluated.Results：The effective rate of the observation group was 90.57%,which was significantly higher than that（73.58%）of the control group（P〈0.05）.After treatment,the WOMAC scale,the total score,VAS score and the Kidney deficiency and Cold Damp stasis Syndrome score of the observation group were significantly lower than those of the control group after treatment（P〈0.01）.The levels of IL-1βin the synovial fluid of the observation group were significantly higher than those of the control group（P〈0.01）.The scores of SF-36 scale and overall health status were significantly higher than those of the control group,and IL-6 and TNF-αlevels were significantly lower than those in the control group（P〈0.01）.Conclusion：Shujin Qiangyao Decoction iontophoresis in treatment of knee osteoarthritis with Kidney deficiency and Cold Damp Stasis Syndrome can improve the clinical symptoms,improve joint function and improve the quality of life of patients.The mechanism may be related to the inhibition of proinflammatory factors such as IL-1β,IL-6 and TNF-α.