膝痹汤外洗治疗重度膝骨关节炎的疗效观察

Curative Effect of Xibitang in Treating Severe Knee Osteoarthritis

目的:评价膝痹汤外洗治疗重度膝骨关节炎(KOA)的临床效果。方法:采用随机对照的研究方法,纳入2017年7月-2018年3月本院收治的重度KOA患者60例,按照随机数字表法将其分为试验组与对照组,各30例。两组均接受生活健康教育、指导患者进行股四头肌功能锻炼、硫酸氨基葡萄糖口服的基础治疗,对照组接受海桐皮汤外洗,试验组接受膝痹汤外洗,1剂/d,早晚2次,20 min/次,2周为1个疗程。采用WOMAC骨性关节炎指数量表及ISOA膝骨关节炎严重程度指数量表在治疗前后进行评分,并根据评分下降比例评价疗效。结果:治疗2周后,根据ISOA量表评价,试验组的总有效率高于对照组,差异有统计学意义(X^2=4.32,P=0.04)。试验组治疗1、2周后的症状与体征评分、总分与治疗前评分差值均优于对照组,差异均有统计学意义(P<0.05);试验组治疗2周后的最大步行距离评分与治疗前评分差值优于对照组,差异有统计学意义(P<0.05)。治疗期间两组均无不良反应的发生。结论:膝痹汤外洗可有效改善重度KOA病情,且短期疗效稳定,安全性较高。

Objective：To evaluate the clinical effect of Xibitang in the treatment of severe knee osteoarthritis（KOA）.Method：60 cases of severe KOA admitted to our hospital from July 2017 to March 2018 were included in the randomized controlled study,according to the random number table method,they were divided into the experimental group and the control group,30 cases each in each group.Both groups received education of life health and guided the patients to perform functional exercise of quadriceps and oral Glucosamine Sulfate.The control group accepted the external washing by Haitongpitang,and the experimental group accepted Xibitang,1 dose per day,2 times at morning and night,20 min each time,2 weeks for 1 course of treatment.The WOMAC osteoarthritis index scale and ISOA knee osteoarthritis severity index scale were used before and after treatment,and the curative effect was evaluated according to the proportion of decreased score.Result：After 2 weeks of treatment,according to the ISOA scale,the total effective rate of the experimental group was higherthan that of the control group,the difference was statistically significant（ X2=4.32,P=0.04）.The scores of symptoms and signs,total scores and pre-treatment scores of the experimental group were better than those of the control group after 1 week and 2 weeks of treatment,the differences were statistically significant（P〈0.05）;the differences between the maximum walking distance score and the pre-treatment score in the experimental group were better than those in the control group after 2 weeks of treatment,the differences were statistically significant （P〈0.05）.There were no adverse reactions in the two groups during the period of treatment.Conclusion：The Xibitang external washing can improve the severe KOA condition,and the short-term curative effect is stable and safe.