独活寄生汤联合膝关节松动术治疗肾虚髓亏型膝关节骨性关节炎的临床效果

Clinical effect of Duhuo Jisheng Decoction combined with knee joint mobilization on knee osteoarthritis of kidney deficiency and marrow insufficiency type

目的 观察独活寄生汤联合膝关节松动术治疗肾虚髓亏型膝关节骨性关节炎(KOA)的临床效果。方法 对64例肾虚髓亏型KOA患者,均采用独活寄生汤联合膝关节松动术治疗,连续治疗8周。观察患者治疗前、治疗8周时、治疗3个月时的膝关节功能Lysholm评分、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分、疼痛视觉模拟量表(VAS)评分及胫神经、腓总神经传导速度。结果 治疗8周时及治疗3个月时Lysholm各项评分及胫神经、腓总神经传导速度均高于治疗前,WOMAC骨关节炎指数各项评分及VAS评分均低于治疗前,且治疗3个月时以上指标均较治疗8周时改善更明显(均P<0.05)。结论 采用独活寄生汤联合膝关节松动术治疗肾虚髓亏型KOA疗效确切,可明显改善患者膝关节功能及胫神经、腓总神经传导速度,有效减轻患者疼痛症状。

Objective To observe the clinical effect of Duhuo Jisheng Decoction combined with knee joint mobilization on knee osteoarthritis(KOA)of kidney deficiency and marrow insufficiency type.Methods Sixty-four KOA patients with kidney deficiency and marrow insufficiency type were treated with Duhuo Jisheng Decoction combined with knee joint mobilization for consecutive 8 weeks.Lysholm score for knee function,Western Ontario and McMaster Universities(WOMAC)Osteoarthritis Index score,Visual Analogue Scale(VAS)score,and conduction velocities of tibial nerve and common peroneal nerve were observed in the patients before treatment,8 weeks after treatment,and 3 months after treatment.Results At 8 weeks or 3 months of treatment,Lysholm scores for all items as well as tibial nerve and common peroneal nerve conduction velocities were higher,along with lower WOMAC Osteoarthritis Index scores for all items and lower VAS score,as compared with those before treatment,moreover,the indices mentioned above at 3 months of treatment presented more notable improvement than those at 8 weeks of treatment(all P<0.05).Conclusion Duhuo Jisheng Decoction combined with knee joint mobilization has definite efficacy for KOA of kidney deficiency and marrow insufficiency type,which can significantly improve knee joint function as well as tibial nerve and common peroneal nerve conduction velocities,and achieve effective pain relieve in the patients.