从筋治骨理论指导治疗早中期膝痹病的临床研究

Clinical Study on Treatment of Early and Mid-term Knee Arthralgia Based on the Theory of Treating Bones from Tendons

目的基于从筋治骨、循筋治骨的治疗思路制定中医综合方案治疗早中期膝痹病的临床观察研究。方法将40例KOA(肝肾不足,筋脉瘀滞证)患者,随机抽签分为治疗组20例,对照组20例。治疗组予以邓氏舒筋蠲痹汤,水煎服,150 mL,每日2次后予院内制剂温通止痛贴每次1贴,24 h换药1次同时施以膝关节周围均衡理筋手法每日1次。连续治疗4周为1疗程。对照组予以双氯芬酸钠缓释片,75 mg/次,每日1次再予以双氯芬酸二乙胺乳胶剂涂敷于膝关节患处(以疼痛最剧烈部位为中心),每次3 cm,24 h涂药3次和TDP(神灯)治疗器理疗,每次30 min,每日1次。连续治疗4周为1疗程。在治疗疗程中比较2组治疗前WOMAC各症状、体征评分改变,并进行评价疗效。结果治疗组和对照组治疗前后WOMAC各症状、体征都有明显改善,治疗组除疼痛无明显差别其余各项症状、体征改善优于对照组(P<0.05)。结论从筋治骨,循筋治骨治疗思路制定中医综合方案治疗早中期膝痹病的治疗具有明显的疗效,为安全、有效的诊治措施。

Objective To develop a comprehensive clinical plan for the treatment of knee rickets in the early and middle stage through the treatment strategy of "treating bones from tendons", and to develop safe and effective foundations based on relevantknowledge and practice of KOA in ancient and modern Chinese medicine. Methods Forty patients with KOA (liver and kidney deficiency gluten stagnation and stasis syndrome) were randomly divided into treatment groups of 20 patients and control group of 20 patients. The treatment group was treated with Dengshi Shujin Jianbi decoction, 150 ml, 2 times a day and in-hospital preparation Wentong pain relief paste 1 patch each time, 24 hour dressing 1 time and balanced around the knee joints tendons techniques daily once. Four weeks of continuous treatment was a course of treatment. The control group was given diclofenac sodium sustained-release tablets, 75 mg/ time, once daily and applied diclofenac diethylamine latex on the affected part of the knee joint (centered on the most painful part), 3 cm each time, and applied for 24 hours. 3 and TDP (therapeutic) therapy physiotherapy, 30 minutes each time, once a day. Four weeks of continuous treatment was a course of treatment. In the course of treatment, the scores of WOMAC symptoms and physical signs before the two groups were compared, and the efficacy was evaluated. Results The symptoms and signs of WOMAC in the treatment group and the control group were significantly improved before and after treatment. The pain in the treatment group had no significant difference. The other symptoms and signs of the treatment group improved better than the control group. Conclusion The idea of " treating bones from tendons" is an effective and safe treatment for the KOA in the early and middle stages.