消瘀接骨散外敷联合中药内服对膝骨关节炎患者临床疗效的影响

Clinical Efficacy of Xiaoyu Jiegu Powder Combined with Chinese Herbs for Patients with Knee Osteoarthritis

目的观察消瘀接骨散外敷配合中药内服治疗膝骨关节炎患者(KOA)的临床疗效的影响。方法60例均为2018年1月—2019年10月安徽中医药大学第一附属医院风湿免疫科诊断明确的KOA患者,采用随机数字表法分为观察组30例(消瘀接骨散外敷配合中药内服+氨基葡萄糖口服)、对照组30例(氨基葡萄糖口服)。治疗4周后观察2组治疗前后血沉(ESR)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、IL-4、IL-10、基质金属蛋白酶-9(MMP-9)、西安大略和麦克马斯特调查量表(WOMAC)评分、关节炎严重程度(Lequesne MG)评分、VAS评分、生活质量量表(SF-36)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分。结果与治疗前比较,两组ESR、CRP、TNF-α、IL-1β、MMP-9、WOMAC评分、Lequesne MG评分、VAS、SAS评分明显降低,IL-4、IL-10、一般健康状况(GH)、生理功能(PF)、躯体疼痛(BP)、社会功能(SF)的评分明显升高(P<0.05,P<0.01);与对照组治疗后比较,观察组ESR、CRP、TNF-α、IL-1β、MMP-9、WOMAC评分、Lequesne MG评分、VAS、SAS评分下降更明显,IL-4、IL-10、生理职能(RP)、精力(VT)升高更明显(P<0.05,P<0.01)。结论消瘀接骨散外敷配合中药内服能够改善KOA患者实验室指标,减轻临床症状,提高生活质量。

Objective To observe the clinical efficacy of Xiaoyu Jiegu Powder(XYJGP) combined with Chinese herbs for knee osteoarthritis(KOA) patients. Methods Totally 60 KOA patients diagnosed at Department of Rheumatic Immunology in First Affiliated Hospital, Anhui University of Traditional Chinese Medicine from January 2018 to October 2019 were recruited. They were equally assigned to the observation group(external application of XYJGP combined with oral administration of glucosamine and Chinese herbs) and the control group(oral administration of glucosamine). After 4 weeks of treatment, erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-4, IL-10, matrix metalloproteinase-9(MMP-9), Western Ontario and McMaster Osteoarthritis Index(WOMAC), Lequesne MG, the MOS item short from health survey(SF-36), VAS score, anxiety scale(SAS), and depression scale(SDS) score were observed in the two groups. Results Levels of ESR, CRP, TNF-α, IL-1β, MMP-9, WOMAC score, Lequesne MG score, VAS, SAS significantly decreased, levels of IL-4, IL-10, general health(GH), physical function(PF), body pain(BP), social function(SF) significantly increased in the two groups, with statistical difference with before treatment(P<0.05, P<0.01). Compared with the control group after treatment, levels of ESR, CRP, TNF-α, IL-1β, MMP-9, WOMAC score, Lequesne MG score, VAS, SAS decreased more significantly, the levels of IL-4, IL-10, RP and VT increased more significantly(P<0.05, P<0.01). Conclusion External application of XYJGP combined with oral administration of Chinese herbs improved laboratory indices, alleviated clinical symptoms, and elevated KOA patients′ quality of life.