中药Ⅱ号方外敷配合运动疗法治疗风寒湿痹阻型膝骨性关节炎临床研究

Clinical research on knee osteoarthritis of wind-cold-damp blockage treated with the external application of Chinese medicine Ⅱ formula and kinetotherapy

目的探究平乐正骨中药Ⅱ号方配合运动锻炼治疗膝骨性关节炎(KOA)的临床疗效。方法 135例患者按入院先后顺序随机分为治疗组(68例)和对照组(67例)。对照组给予口服硫酸氨基葡萄糖、塞来昔布胶囊治疗,指导患者运动锻炼。治疗组患者运用院内自制中药Ⅱ号方外敷,同样指导患者运动锻炼。观察两组患者治疗后临床疗效及西安大略麦马斯特大学骨性关节炎指数量表(WOMAC)评分、血清中相关炎症因子[白细胞介素1β(IL-1β)、转化生长因子-β(TGF-β)]水平情况。结果经过4周治疗后,治疗组总有效率为87. 69%,对照组为83. 54%,两组总有效率比较差异有统计学意义(P <0. 05)。两组患者治疗后4周WOMAC评分均显著下降,与治疗前比较差异有统计学意义(P <0. 01),且治疗组下降幅度高于对照组(P <0. 05)。两组治疗4周,治疗组与对照组炎症因子IL-1β、TGF-β水平均高于本组治疗前,差异有统计学意义(P <0. 01),且治疗组升高水平高于对照组(P <0. 05)。结论平乐正骨中药Ⅱ号方配合运动锻炼治疗KOA能明显改善患者临床症状,值得临床推广应用。

Objective To explore the clinical therapeutic effects on knee osteoarthritis(KOA)treated with pingle zhengguo Chinese medicine Ⅱ formula and kinetotherapy.Methods A total of 135 patients were randomized into a treatment group(68 cases)and a control group(67 cases)according to the hospital admission sequence.In the control group,glucosamine sulfate and celecoxib capsules were prescribed for oral administration.Additionally,the physical exercise was provided under guidance.In the treatment group,the self-prepared pingle zhengguo Chinese medicine Ⅱ formula was adopted for the external application.Additionally,the physical exercise was provided under guidance.The clinical effects,WOMAC scores and the related inflammatory factors in serum(IL-1β and TGF-β)were observed after treatment in the two groups.Results After 4-week treatment,the total effective rate was 87.69% in the treatment group and was 83.54% in the control group,indicating the significant difference in comparison(P<0.05).After 4-week treatment,WOMAC scores were all reduced in the two groups,indicating the significant differences as compared with the scores before treatment(P<0.01).The reducing amplitude in the treatment group was larger than the control group(P<0.05).After 4-week treatment,the levels of IL-1β and TGF-β were all higher than the levels before treatment in comparison within the same group(P<0.01).The increases in the treatment group were larger than the control group(P<0.05).Conclusion The combined treatment with pingle zhengguo Chinese medicine Ⅱ formula and kinetotherapy obviously relieves the clinical symptoms in KOA patients.This treatment deserves to be promoted in clinical application.