膝关节骨关节炎经中西医不同疗法的对比研究

Comparative Study of Different Therapies for Knee Osteoarthritis in TCM and Western Medicine

目的:比较经不同的药物方案治疗对膝关节骨性关节炎(OAK)患者的疗效,为临床用药提供参考数据。方法:选取2015年1月至2016年12月我院收治确诊为膝关节骨关节炎(Osteoarthritisoftheknee,OAK)的初治患者共103例(132膝)。男性/女性为1.24∶1(57/46)。平均年龄(43.60±10.35)岁。平均病程(20.1±3.4)个月。将全部患者按随机数字表法分为观察1组和观察2组,均经患肢制动、辅以超声下关节腔抽取积液或和关节腔冲洗治疗等。并分别经不同的药物方案治疗,其中观察1组:应用解热镇痛类药布洛芬缓释胶囊(早晚各1次口服,1片/次),盐酸氨基葡萄糖胶囊(1片/次,3次/d)。观察2组:在观察1组治疗基础上额外应用针灸治疗和推拿理疗(隔天1次,3次/周)。疗程均为6周。考察治疗后的疗效和安全性。结果:2组在治疗后2周、4周、6周的膝关节综合评分和治疗后6周临床症状和体征的改善方面,比较的差异均有统计学意义(P<0.05)。2组总的不良事件发生率(在观察1组和观察2组分别为9.62%和7.69%)比较的差异无统计学意义(χ~2=0.24,P=0.63,>0.05)。结论:在临床上针对膝关节骨关节炎患者采用抗炎镇痛类等西药再联合中医的针灸和推拿按摩疗法,可以获得良好的缓解疼痛的效果,并明显改善患肢膝关节的功能,有助于提高患者的生命质量。

Objective： To compare the efficacy of different medicinal regimens in the treatment of knee osteoarthritis（ OAK） to provide reference data for clinical medication. Methods： A total of 103 patients（ 132 knees） with osteoarthritis of the knee（ OAK）who were admitted in the hospital from January 2015 to December 2016 were included in the study. The radio of male/female is 1. 24∶ 1（ 57/46） with the average age of（ 43. 60 ± 10. 35） years and average course of disease of（ 20. 1 ± 3. 4） months. All the patients were divided into two groups according to the random number table and named as the observation I group and the observation II group. All the patients were treated with limb control,supplemented by the extraction of effusion or washing in the inferior articular cavity under ultrasound therapy and each group had different medicinal regimens. Patients in the observation I group had application of antipyretics such as Ibuprofen Sustained-Release Capsules（ oral-taking twice a day,1 tablet a time）,Glucosamine Hydrochloride Capsules（ 1 capsule one time,3 times/day）. Patients in the observation II group were additionally treated with acupuncture and massage therapy（ once the other day,3 times a week）. The course of treatment lasted for 6 weeks. The efficacy and safety of the treatment were investigated. Results： there were statistically significant differences in the knee joint score after 2-week,4-week,and 6-week treatment and improvement in clinical symptoms and signs after 6-week treatment between the two groups（ P 0. 05）. The total incidence rates of adverse events in two groups（ 9. 62% and 7. 69% in observation I group and observation II group respectively） showed no significant difference（ χ~2= 0. 24,P = 0. 63, 0. 05）. Conclusion： may accept with Anti-inflammatory and analgesic western medicine combined with acupuncture and massage therapy for osteoarthritis of the knee obtains good results in pain relief and significantly improve the function of the knee,improving the quality of life of patients.