独活寄生汤治疗膝骨关节炎肝肾不足证临床研究

The clinical observation in the treatment of liver-kidney deficiency of knee osteoarthritis by Duhuo-Jisheng decoction

目的 评价独活寄生汤治疗膝骨关节炎（knee osteoarthritis,KOA）肝肾不足证的疗效.方法 将符合入选标准的80例KOA患者采用随机数字表法分为2组,每组40例.治疗组口服独活寄生汤,对照组口服硫酸氨基葡萄糖.2组均连续治疗30 d.分别于治疗前后观察ESR,采用乳胶增强免疫散射法检测CRP水平,采用VAS量表评价膝关节疼痛程度,采用西部安大略麦克马斯特大学骨关节炎指数可视化量表（Western Ontario MacMaster University Osteoarthritis index,WOMAC）评价症状的严重程度,观察中医证候评分变化,评价临床疗效.结果 治疗组总有效率为95.0%（38/40）,对照组为77.5%（31/40）,2组比较差异有统计学意义（χ2=10.213,P=0.003）.治疗后,治疗组ESR[（15.41±4.23）mm/h比（17.6±7.27）mm/h,t=-4.426]、血清CRP[（4.73±1.28）mg/L比（6.12±2.38）mg/L,t=-14.735]水平低于对照组（P〈0.01）;VAS评分[（2.5±0.6）分比（4.9±0.8）分,t=-15.026]、WOMAC评分[（12.1±4.7）分比（16.7±6.7）分,t=-11.177]及中医证候评分[（6.5±0.4）分比（7.5±0.4）分,t=-3.482]均低于对照组（P〈0.01）.结论 独活寄生汤可改善KOA肝肾不足证患者临床症状,提高生活质量.

Objective To evaluate the curative effect of the Duhuo-Jisheng decoction in treating knee osteoarthritis （KOA） with the deficiency of liver and kidney. Methods Using the random number table method, a total of 80 KOA patients were randomly divided into 2 group, 40 in each group. The treatment group were treated with Duhuo-Jisheng decoction, and the control group with glucosamine sulfate orally. The 2 groups were treated with 30 day. The blood sedimentation （ESR） of before and after treatment was detected. The level of C-reactive protein （CRP） was detected by latex enhanced immunization. The degree of knee joint pain was evaluated by VAS scale. The severity of the symptoms was evaluated by the visual scale of Osteoarthritis Index （Western Ontario Mac Master University Osteoarthritis index, WOMAC index）. The changes of TCM symptoms were observed and the clinical effective rate was evaluated. Results The total effective rate of the treatment group was 95% （38/40）, while the control group was 77.5% （31/40）. The difference between the 2 groups was statistically significant （χ2=10.213, P=0.003）. After treatment, the ESR （15.41 ± 4.23 mm/h vs. 17.6 ± 7.27 mm/h, t=-4.426）, CRP （4.73 ± 1.28 mg/L vs. 6.12 ± 2.38 mg/L, t=-14.735） level in the treatemnt group were significantly lower than those in the control group （P〈0.01）. The VAS scores （2.5 ± 0.62 vs. 4.9 ± 0.8, t=-15.026）, WOMAC index（12.1 ± 4.7 vs. 16.7 ± 6.7, t=-11.177） and TCM symptom score （6.5 ± 0.4 vs. 7.5 ± 0.4, t=-3.482） in the treatment group were significantly lower than those in the control group （P〈0.01）. Conclusions The Duhuo-Jisheng decoction is effective improve the symptom and quality of life of liver-kidney deficiency of KOA.