舒筋活血汤治疗老年膝骨关节炎的效果分析

Analysis of the Effect of Shujin Huoxue Decoction in Elderly Knee Osteoarthritis

目的探究舒筋活血汤联合膝关节置换术对老年膝骨关节炎患者白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)及膝关节功能的影响。方法以行膝关节置换术的老年膝骨关节炎68例患者为研究对象,随机分为观察组和对照组,各34例。2组均采用膝关节置换术+常规治疗,观察组加用舒筋活血汤+针灸治疗。比较2组炎症因子指标、视觉模拟(VAS)评分、美国特种外科医院(HSS)膝关节评分及膝关节活动度(ROM)评分。结果术后2周,观察组血管内皮细胞生长因子(VEGF)水平低于对照组(P<0.05),而IL-6 、TNF-α水平无显著差异(P>0.05);术后4周,观察组IL-6 、TNF-α、VEGF水平均低于对照组(P<0.05);术后2周、4周,观察组VAS评分均低于对照组,HSS评分均高于对照组(P<0.05);术后2周、4周,观察组ROM评分均大于对照组(P<0.05)。结论在膝关节置换术和常规治疗基础上加用舒筋活血汤与针灸,可以有效改善老年膝骨关节炎患者治疗效果,降低IL-6、TNF-α水平,缓解疼痛,改善膝关节活动度。

Objective To investigate the effects of Shujin Huoxue decoction combined with knee arthroplasty on interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and knee joint function in elderly patients with knee osteoarthritis.Methods 68 patients with knee osteoarthritis were randomly enrolled in the observation group (n=34) and the control group (n=34).Both groups were treated with knee arthroplasty plus conventional therapy.The observation group was treated with Shujin Huoxue Decoction + acupuncture.The inflammatory factor index,visual analog (VAS) score,the score of US Special Surgery Hospital (HSS) knee score,and the score of knee joint activity (ROM) were compared.Results At 2 weeks postoperatively,the level of vascular endothelial growth factor (VEGF) in the observation group was lower than that in the control group (P<0.05),but there was no significant difference in the levels of IL-6 and TNF-α (P>0.05).The levels of IL-6,TNF-α and VEGF in the observation group were lower than those in the control group (P<0.05).At 2 weeks and 4 weeks postoperatively,the scores of VAS of the observation group were lower than those of the control group,and the scores of HSS were higher than the control group (P<0.05).At 2 weeks and 4 weeks postoperatively,the scores of ROM of the observation group were higher than those of the control group (P<0.05).Conclusion Adding Shujin huoxue decoction and acupuncture on the basis of knee joint replacement and conventional treatment can effectively improve the treatment effect of elderly patients with knee osteoarthritis,reduce the levels of IL-6 and TNF-α,relieve pain and improve knee joint.