祛风活络丸与制香片联合应用治疗骨关节炎

Clinical observation on treatment of osteoarthritis with Qufeng Huoluo pills/Zhixiang tablets administered alone or in combination

目的探讨祛风活络丸与制香片联合应用治疗骨关节炎是否具有临床协同疗效。方法选取2017年10月~2019年5月我院诊治的骨关节炎患者160例,采用随机数字表法分为祛风活络丸组、制香片组、祛风活络丸/制香片联合应用组和硫酸氨基葡萄糖组,每组各40例,治疗3个月后,对患者的疗效及不良反应进行评价与统计,观察各组X线片和核磁共振表现、WOMAC骨关节炎指数和Lequesne疼痛与功能指数;并采用金正均法计算q值,评价祛风活络丸/制香片联合应用是否具有协同作用。结果与单独给药组比较,祛风活络丸/制香片联合给药组患者X线片结果显示关节间隙狭窄减轻,骨赘减少,KL分级降低,MRI结果显示关节囊积液和水肿减少,软骨缺损减轻,Recht分级降低;WOMAC骨关节炎指数(P<0.05)和Lequesne疼痛与功能指数显著降低(P<0.01);采用金正均法计算q值(q=1.25),联合用药具有协同作用。同时,与硫酸氨基葡萄糖相比,联合用药组疗效相当但不良反应更少(P<0.05)。结论祛风活络丸与制香片联合应用治疗骨关节炎临床疗效优于单独给药,具有协同作用,与硫酸氨基葡萄糖疗效相当且副作用更少,可在临床推广应用。

Objective To explore synergistic clinical effect of the combination of Qufeng Huoluo pills and Zhixiang tablets for treatment of osteoarthritis.Methods 160 patients diagnosed with osteoarthritis and treated in our hospital from October 2017 to May 2019 were randomly divided into four groups,and were treated with Qufeng Huoluo Pills,Zhixiang Tablets,Qufeng Huoluo Pills/Zhixiang Tablets and Glucosamine Sulfate Capsules,respectively.After 3 months’of treatment,the clinical efficacy and adverse reactions were evaluated and statistically analyzed by X-ray plain film signs,magnetic resonance images,Western Ontario McMaster index and Lequesne pain and function index.Results Compared with the single-drug group,the X-ray films signs of the combination group of Qifeng Huoluo Pills/Zhixiang Tablets showed narrower joint space and obvious reduction of callus with decreased KL grade.MRI results showed that joint capsule fluid,edema and cartilage defect were significantly alleviated with reduced Recht grade.The WOMAC osteoarthritis index(P<0.05)and the Lequesne pain and function index were significantly lower(P<0.01).The q(1.25)demonstrated that the combined administration had a synergistic effect.At the same time,compared with glucosamine sulfate,the combination group has comparable efficacy while fewer adverse reactions.Conclusion The clinical efficacy of Qifeng Huoluo pill/Zhixiang tablets in treatment of osteoarthritis is better than that of single administration.It has synergistic effect and is equivalent to the effect of glucosamine sulfate with fewer side effects.