中西医结合治疗与护理干预老年肾虚血瘀型膝骨性关节炎临床观察

Clinical Observation of Integrated Chinese and Western Medicine Therapy Combined with Nursing for Knee Osteoarthritis in Senile Patients of Kidney Deficiency and Blood Stasis Type

目的:观察中西医结合治疗与护理干预老年肾虚血瘀型膝骨性关节炎(KOA)患者的临床疗效。方法:将100例老年肾虚血瘀型KOA患者随机分为对照组和医-护组各50例。2组均予基础治疗(口服盐酸氨基葡萄糖片,关节内注射玻璃酸钠注射液)和补肾活血荣筋汤内服,医-护组配合中医特色护理措施。2组连续观察8周。比较2组患者治疗前后的西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分、疼痛视觉模拟评分法(VAS)评分及临床疗效。结果:治疗后,医-护组总有效率为98.00%,高于对照组的84.00%,差异有统计学意义(P <0.05)。2组WOMAC骨关节炎指数量表关节疼痛、关节僵硬、日常活动受限评分均较治疗前降低(P <0.01);医-护组各项评分均低于对照组(P <0.01)。治疗4、8周,2组VAS评分均较治疗前下降(P <0.01);医-护组VAS评分均低于对照组(P <0.01)。结论:以基础治疗联合补肾活血荣筋汤内服,配合中医特色护理措施干预老年肾虚血瘀型KOA患者临床疗效明显。

Objective： To observe the clinical effect of integrated Chinese and western medicine therapy combined with nursing for knee osteoarthritis（KOA） in senile patients of kidney deficiency and blood stasis type. Methods： Divided 100 cases of senile patients with KOA of kidney deficiency and blood stasis type into the control group and the medicine and nursing group randomly, 50 cases in each group. The two groups received basic treatment of sodium hyaluronate by intra-articular injection and oral administration of glucosamine hydrochloride tablets and Bushen Huoxue Rongjin tang, while the medicine and nursing group additionally received nursing with Chinese medicine characteristics. The two groups were treated for eight weeks continuously. Compared scores of the Western Ontario and McMaster Universities （WOMAC） osteoarthritis index, scores of visual analogue scale（VAS） and the clinical effect in the two groups before and after treatment. Results. After treatment, the total effective rate was 98.00% in the medicine and nursing group, higher than that of 84.00% in the treatment group, the difference being significant（P 〈 0.05）. Scores of WOMAC indexes including ankylosis, arthralgia and restricted daily activities in the two groups were decreased when compared with those before treatment（P 〈 0.01）, and the scores in the medicine and nursing group were lower than those in the control group（P 〈 0.01）. After treatment of four and eight weeks, VAS scores in the two groups were decreased when compared with those before treatment（P 〈 0.01）, and the VAS scores in the medicine and nursing group were lower than those in the control group（P 〈 0.01）. Conclusion： Based on the basis treatment and the oral administration of Bushen Huoxue Rongjin tang, the intervention of integrated Chinese and western medicine therapy combined with nursing has obvious effect in treating KOA in senile patients of kidney deficiency and blood stasis type.