筋骨痹通方联合关节腔注射治疗膝关节骨性关节炎的临床观察

Clinical Observationof Jingu Bitong Decoction Combined with Intraarticular Injection on Treatment of Knee Osteoarthritis

目的探讨关节腔注射玻璃酸钠注射液联合筋骨痹通方内服及中药离子导入治疗膝关节骨性关节炎的临床疗效。方法 100例膝关节骨性关节炎患者按照随机数字表法分为观察组和对照组,每组50例。对照组患者予以关节腔注射玻璃酸钠注射液,观察组患者予以关节腔注射玻璃酸钠注射液联合筋骨痹通方内服及中药离子导入治疗。连续治疗5周后,比较2组患者治疗前后Lequesne指数、WOMAC评分、VAS评分和TNF-α、IL-1、MMP-3和CRP水平变化,并进行临床疗效评价。结果治疗后,2组患者Lequesne指数、WOMAC和VAS评分均较治疗前明显下降(P<0.05),且观察组改善程度显著优于对照组(P<0.05);2组患者TNF-α、IL-1、MMP-3和CRP水平均较治疗前明显改善,且观察组改善程度显著优于对照组(P<0.05);观察组总有效率为96.0%,显著高于对照组的84.0%(P<0.05)。结论关节腔注射玻璃酸钠注射液联合筋骨痹通方内服及中药离子导入治疗膝关节骨性关节炎,能够明显减轻关节疼痛,增加关节活动度,改善关节功能,降低外周血清炎性细胞因子水平,提高临床疗效。

Objective To investigate the clinical effect of intraarticular injection of sodium hyaluronate combined with internal administration of Jingu Bitong decoction and iontophoresis of traditional Chinese medicine in the treatment of knee osteoarthritis.Methods One hundred cases of knee osteoarthritis patients were divided into observation group and control group according to random number table method with50cases in each group.The patients in the control group were injected with sodium hyaluronate injection into the articular cavity,while the patients in the observation group were treated by injected with sodium hyaluronate injection combined with internal administration of Jingu Bitong decoction and iontophoresis of traditional Chinese medicine.After5weeks of continuous treatment,the changes of Lequesne index,WOMAC score,VAS score and the levels of TNF-α,IL-1,MMP-3and CRP were compared between the two groups before and after treatment,and the clinical efficacy was evaluated.Results After treatment,the Lequesne index,WOMAC and VAS scores of the two groups were significantly lower than those before treatment(P<0.05),and the improvement degree of the observation group was significantly better than that of the control group(P<0.05).The levels of TNF-α,IL-1,MMP-3and CRP of the two groups were significantly improved than those before treatment(P<0.05),and the improvement drgree of the observation group was significantly better than that of the control group(P<0.05).The total effective rate in the observation group was96.0%,which was significantly higher than that in the control group(84.0%)(P<0.05).Conclusion Intraarticular injection of sodium hyaluronate combined with internal administration of Jingu Bitong decoction and iontophoresis of traditional Chinese medicine,can significantly reduce joint pain,increase joint motion,and improve joint function,reduce the level of inflammatory cytokines in peripheral blood and improve the clinical efficacy.