三痹消颗粒治疗膝骨关节炎的临床观察

Clinical observation on treatment of knee osteoarthritis with San Bi Xiao Granule

目的:观察补益肝肾、活血除痹中药三痹消颗粒(当归、生地黄、川芎、白芍等)治疗风寒湿阻型膝骨关节炎(KOA)的效果及其对患者血清中的炎症因子表达水平的影响,为临床治疗KOA提供实践经验。方法:将92例风寒湿阻型KOA患者按随机数字表法随机分为研究组(三痹消颗粒组)和对照组(硫酸氨基葡萄糖组),各46例。经过4周治疗,分别对研究组和对照组治疗前和治疗后膝骨关节VAS评分、骨关节炎指数WOMAC、膝骨关节肿胀、压痛及关节活动度评分进行比较;使用酶联免疫吸附(ELISA)法检测两组治疗前后血清中TNF-α、TGF-β表达水平。结果:经过4w治疗,研究组和对照组主要临床症状和体征均明显好转,研究组VAS评分、骨关节炎指数WOMAC、膝骨关节肿胀、压痛及关节活动度评分效果明显优于对照组(P<0.01);治疗后两组血清中TNF-α的表达水平均降低,TGF-β的表达水平均升高,研究组血清中TNF-α表达水平明显比对照组低,研究组血清中TGF-β的表达明显比对照组高。结论:用补益肝肾、活血除痹中药三痹消颗粒治疗风寒湿阻型膝骨关节炎疗效显著,明显优于硫酸氨基葡萄糖。三痹消颗粒可以有效抑制膝骨关节炎,减少关节破坏,缓解临床症状,值得临床推广。

Objective：To observe the effect of Tonifying the liver and kidney,promoting blood circulation and removing stagnation of traditional Chinese medicine San Bi Xiao Granule（Angelica,radix rehmanniae,Rhizoma Chuanxiong,Radix Paeoniae Alba and so on）the treatment of wind cold damp type knee osteoarthritis（KOA）and their therapeutic effects on inflammatory factor in serum expression levels,to provide practical experience for the treatment of KOA. Methods：92 cases of wind cold dampness type KOA patients were randomly divided into study group（San Bi Xiao Granule group）and control group（glucosamine sulfate group）,46 cases in each. After 4 weeks of treatment,respectively in the study group and the control group of patients before and after treatment of knee joint osteoarthritis index VAS score,WOMAC,knee joint swelling,tenderness and joint activity score were compared; using enzyme-linked immunosorbent assay（ELISA）method was used to detect the changes of expression level of TNF-a in two groups before and after the treatment of serum,TGF-β. Results：after 4 W treatment,the study group and the control group were the main clinical symptoms and signs were significantly improved,VAS score of the research group,osteoarthritis index WOMAC,knee joint swelling,tenderness and joint activity score was better than the control group（P0.01）; the expression level of TNF-a in serum in two groups were reduced after treatment,the expression level of TGF-βincreased expression of TNF-a in serum alpha level was significantly lower than the control group,the expression of TGF-β in serum beta is significantly higher than the control group. Conclusion：the treatment of knee osteoarthritis with wind cold damp blockage type with the effect of tonifying liver and kidney,activating blood and removing arthralgia,is better than glucosamine sulfate.San Bi Xiao Granule can effectively inhibit knee osteoarthritis,reduce joint destruction,relieve arthritis clinical symptoms and signs,it is worthy of clinical application.