关节镜手术联合蠲痹胶囊治疗膝骨性关节炎

Arthroscopic Surgery Combined with Juanbi Capsule in the Treatment of Knee Osteoarthritis

目的观察关节镜手术联合蠲痹胶囊对膝骨性关节炎(KOA)患者关节液中一氧化氮(NO)、超氧化物歧化酶(SOD)的影响及可能作用机理。方法将72例膝骨性关节炎患者按随机数字表法分为治疗组和对照组,各36例。对照组行关节镜手术治疗,治疗组在对照组基础上联合蠲痹胶囊口服治疗,观察患者术前与术后1周、4周的膝关节功能WOMAC评分、疼痛VAS评分以及膝关节液中NO、SOD表达含量。结果2组术后1周、4周的VAS评分、WOMAC评分与术前相比有显著差异(P <0.05),且组间差异具有统计学意义(P <0.05)。2组术后1周NO含量均明显减少,且组间比较有差异(P <0.05),SOD含量降低不显著,组间无明显差异(P> 0.05);术后4周,治疗组NO含量仍在下降,对照组NO含量逐渐升高,治疗组SOD含量显著升高,对照组变化不显著,2组相比有明显差异(P <0.05)。结论蠲痹胶囊联合关节镜手术能够明显降低KOA患者关节内NO的表达含量,中长期持续增强SOD活性,能够改善关节内环境,提高临床疗效。

Objective To observe the ef fects of Juanbi Capsule combined with arthroscopic surgery on nitricoxide(NO)and superoxide dismutase(SOD)in synovial fluid of patients with knee osteoarthritis(KOA)and its possible mechanism.Methods 72 patients with KOA were randomly divided into the treatment group(36 cases)and the control group(36 cases).The control group underwent arthroscopic surgery,and the treatment group was given Juanbi Capsule combined with arthroscopic surgery.The WOMAC scores of the knee joint function,the pain VAS score and the expression of NO and SOD in the knee joint fluid were observed before and 1 week and 4 weeks after operation.Results The VAS score and WOMAC score at 1 week and 4 weeks after operation were significantly dif ferent from those before operation(P<0.05).The dif ference between groups has statistical significance(P<0.05).NO content decreased significantly at 1 week after operation in both groups.The difference between groups has statistical significance(P<0.05).While SOD content was not significantly decreased,and there was no significant dif ference between the groups(P>0.05).At 4 weeks after operation,the NO content in the treatment group was still decreased,and the NO content in the control group was gradually increased.The SOD content in the treatment group was significantly increased,and the control group was not significantly changed.There was a significant dif ference between the two groups(P<0.05).Conclusion The combination of Juanbi Capsule and arthroscopic surgery can significantly reduce the expression of NO in the joints of KOA patients,continuously increase the activity of SOD in the medium and long term,and improve the internal environment of the joints to improve the clinical efficacy.