身痛逐瘀汤联合透化系统治疗瘀血闭阻型膝骨性关节炎疗效观察

Observation on the therapeutic effect of Shentong Zhuyu Decoction combined with permeabilization system on knee osteoarthritis of type of blood stasis blocking

目的观察身痛逐瘀汤联合透化系统治疗瘀血闭阻型膝骨性关节炎的临床疗效及对血清细胞因子水平的影响。方法将2017年1月—2018年12月上海市奉贤区中医医院诊治的90例瘀血闭阻型膝骨性关节炎患者按随机数字表法分为透化组、中药组和联合组各30例。在常规药物和康复治疗基础上,透化组给予活血温经通络中药透化系统治疗,中药组给予身痛逐瘀汤口服,联合组给予活血温经通络中药透化系统治疗及身痛逐瘀汤口服。3组均以2周为1个疗程,连续治疗1个疗程。比较3组治疗前后中医主要症状评分、疼痛VAS评分、骨关节炎指数评分(WOMAC)和血清细胞因子[前列腺素E2(PGE2)、基质金属蛋白酶-3(MMP-3)和肿瘤坏死因子-α(TNF-α)]水平,并统计3组疗效。结果3组治疗后中医主要症状评分、VAS评分、WOMAC评分及血清PGE2、MMP-3、TNF-α水平均较治疗前明显降低(P均<0.05),且联合组治疗后上述指标均明显低于透化组和中药组(P均<0.05),透化组和中药组上述指标比较差异均无统计学意义(P均>0.05)。联合组的治疗总有效率明显高于透化组和中药组(P<0.05),透化组和中药组治疗总有效率比较差异无统计学意义(P>0.05)。结论身痛逐瘀汤联合透化系统可有效改善瘀血闭阻型膝骨性关节炎患者的中医症状,减轻患者疼痛,治疗效果更好,可能与明显降低相关炎性因子水平、抑制炎性反应有关。

Objective It is to observe the clinical efficacy of Shentong Zhuyu Decoction combined with permeabilization system on knee osteoarthritis of type of blood stasis blocking and its effect on serum cytokine levels.Methods Ninety patients with knee osteoarthritis of type of blood stasis blocking treated in the Traditional Chinese Medicine Hospital of Fengxian District from January 2017 to December 2018 were divided into a permeabilization group,a traditional Chinese medicine group and a combined group by random number table,30 cases in each group.On the basis of conventional drugs and rehabilitation treatment,the permeation group was treated with the Chinese medicine of Huoxue Wenjing Tongluo from permeation system,the Chinese medicine group was treated with Shentong Zhuyu Decoction orally,and the combined group was given the Chinese medicine of Huoxue Wenjing Tongluo from permeation system and Shentong Zhuyu Decoction orally.2 weeks as a course of treatment,all groups were continuously treated for a course of treatment.The symptom scores,pain VAS scores,osteoarthritis index scores(WOMAC)and the levels of serum cytokines[prostaglandin E2(PGE2),matrix metalloproteinase-3(MMP-3)and tumor necrosis factor-α(TNF-α)]before and after treatment were observed in the three groups,and the efficacy of 3 groups was evaluated.Results The main symptom scores,VAS scores,WOMAC scores,and the levels of serum PGE2,MMP-3,and TNF-αin the three groups were significantly lower after treatment than those before treatment(all P<0.05),and the above indicators after treatment were significantly lower in the combined group than those in the other two groups(P<0.05).There was no significant difference in the above indexes between the permeabilization group and the Chinese medicine group(both P>0.05).The total effective rate of the combined group was significantly higher than that of the permeabilized group and the traditional Chinese medicine group(P<0.05).There was no significant difference in the total effective rate between the permeated group and the traditional Chinese medicine group(P>0.05).Conclusion Shentong Zhuyu Decoction combined with permeabilization system can effectively improve the symptoms of traditional Chinese medicine,relieve the patient's pain and has a better therapeutic effect in patients with knee osteoarthritis of type of blood stasis blocking,the effect may be related to significantly reducing the levels of related inflammatory factors and inhibiting inflammation.