补肾活血方联合曲安奈德治疗腰椎骨性关节炎42例临床观察

Clinical Observation on Tonifying Kidney and Activating Blood Recipe Combined with Triamcinolone Acetonide in the Treatment of Lumbar Osteoarthritis for 42 Cases

目的评价补肾活血方加减联合曲安奈德治疗腰椎骨性关节炎(肾虚瘀阻型)的临床效果及对患者关节液中巨噬细胞集落刺激因子(GM-CSF)、一氧化氮(NO)水平的影响。方法将入选的属于肾虚瘀阻型的83例腰椎骨性关节炎患者随机分为2组。对照组41例,采用4 mL曲安奈德+2%利多卡因混合生理盐水穴位注射治疗,观察组42例联合补肾活血方加减治疗,4周为一疗程,比较2组临床疗效。结果治疗后观察组关节液中GM-CSF、NO水平低于对照组,治疗结束后,观察组脊柱评分(JOA评分)高于对照组,VAS评分(疼痛视觉评分)低于对照组;观察组总有效率95.24%(40/42)高于对照组的75.61%(31/41),以上差异均具有统计学意义(均P<0.05)。结论补肾活血方加减联合曲安奈德治疗腰椎骨性关节炎(肾虚瘀阻型)效果显著,可有效改善脊柱功能,值得推广。

Objective To investigate the effect of tonifying kidney and activating blood recipe combined with triamcinolone acetonide in the treatment of lumbar osteoarthritis （kidney deficiency stasis type） and the effect on the level of macrophage colony stimulating factor （GM-CSF） and nitric oxide （NO） in the joint fluid. Methods From February 2016 to February 2018, 83 patients with osteoarthritis of the lumbar spine in our hospital and the TCM syndrome type belonging to the kidney deficiency stasis type were included in the study and grouped according to the random digital table method. 41 cases in the control group were treated with acupoint injection of 4ml triamcinolone ＋2% lidocaine mixed with saline mixed physiological saline. The observation group was treated with kidney invigorating and blood activating prescription. 4 weeks as a course of treatment, and the clinical effect of two groups was compared. Results After treatment, the level of GM-CSF and NO in the articular fluild of the observation group was lower than that of the control group （P〈0.05）, the spinal score （JOA score） in the observation group was higher than that of the control group, the VAS score （pain visual score） in the observation group was lower （P〈0.05）, and the total effective rate of the observation group was 95.24%（40/42）, which was higher than 75.61%（31/41） of the control group, and the difference was statistically significant （P〈0.05）. Conclusion The effect of tonifying kidney and activating blood recipe combined with triamcinolone acetonide combined with triamcinolone acetonide in the treatment of lumbar osteoarthritis （kidney deficiency stasis type） is significant, it can effectively improve the function of the spine, and it is worth popularizing.