关节内注射透明质酸钠联合健骨逐瘀汤加减外敷治疗膝骨性关节炎50例

Clinical Effect of Intra-articular Injection of Sodium Hyaluronate Combined with External Application of Modified Jiangu Zhuyu Decoction in Comprehensive Rehabilitation of Knee Osteoarthritis:An Analysis of 50 Cases

目的观察中药外敷结合关节内注射治疗膝骨性关节炎(knee osteoarthritis,KOA)的临床疗效。方法将96例KOA患者随机分为治疗组(50例)和对照组(46例)。对照组患者膝关节腔内注射25mg透明质酸钠注射液治疗,并予等速肌力基础康复训练;治疗组在对照组基础上加用健骨逐瘀汤封包泡煎外敷。每1周为1个疗程,共治疗5个疗程。观察治疗前后美国特种外科医院(Hospial for Special Surgery,HSS)膝关节功能评分和临床疗效。结果与治疗前比较,治疗组患者HSS各条目评分明显增加(P<0.05),对照组患者膝关节评分除肌力、稳定性2个条目无显著改善外,其余条目评分均有显著增加(P<0.05);两组治疗后各条目评分差值比较,差异有统计学意义(P<0.05)。两组临床疗效分布比较,差异有统计学意义(P<0.05)。结论关节内注射联合健骨逐瘀汤加减外敷对于KOA具有止痛、改善膝关节功能和减轻临床症状的作用。

Objective To investigatethe clinical effect of external application of traditional Chinese medicine （TCM） combined with intra-articular injection in the treatment of knee osteoarthritis （KOA）. Methods A total of 96 patients were randomly divided into treatment group with 50 patients and control group with 46 patients. The patients in the control group were given injection of 25 mg sodium hyaluronate into the knee articular cavity combined with isokinetic muscle-strength basic rehabilitation training, and those in the treatment group were given external application of Jiangu Zhuyu Decoction in addition to the treatment for the control group. Each course of treatment was 1 week, and both groups were treated for 5 courses. The two groups were compared in terms of Hospital for Special Surgery （HSS） score before and after treatment and clinical outcome after treatment. Results After treatment, the treatment group had significant increases in the scores of each item of knee joint function （P〈0.05）, while the control group had no significant improvements in myodynamia and knee stability and had significant increases in the scores of the other items （P〈0.05）; the treatment group had significantly greater increases in the scores of all items than the control group （P〈0.05）. There was a significant difference in the distribution of clinical outcomes between the two groups （P〈0.05）. Conclusion Intra-articular injection combined with external application of modified Jiangu Zhuyu Decoction can alleviate pain, improve knee joint function, and reduce clinical symptoms in the treatment of KOA.