肾气丸加味治疗膝骨关节炎的疗效观察

Effect of Modified Shenqi Pills in Treating Patients with Knee Osteoarthritis

目的:探讨肾气丸加味治疗膝骨关节炎的临床疗效。方法:将116例膝骨关节炎患者采用随机数字表法分为对照组和治疗组各58例,对照组给予硫酸氨基葡萄糖胶囊+塞来昔布胶囊+玻璃酸钠注射液联合治疗,治疗组在对照组治疗的基础上加用肾气丸加味治疗,连续治疗4周。分析比较两组的临床疗效、西安大略和麦马斯特大学骨关节炎指数可视化量表(WOMAC)、膝关节视觉模拟评分法(VAS)评分、Lesquesne评分、膝关节活动度和健康状况调查简表(SF-36)生活质量评分以及血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)的水平。结果:治疗组的总有效率明显高于对照组,两组疗效比较差异有统计学意义(P<0.05);治疗后,两组患者的WOMAC、VAS、Lesquesne评分和血清TNF-α、CRP、IL-1β水平均较治疗前降低,且治疗组改善程度优于对照组,差异有统计学意义(P<0.05);两组患者的膝关节活动度、SF-36评分均较治疗前升高,且治疗组改善程度更明显,差异有统计学意义(P<0.05)。结论:肾气丸加味治疗膝骨关节炎可以改善膝关节功能、缓解疼痛、改善生活质量,可能与抑制炎症因子表达有关。

Objective:To study the effects of modified Shenqi Pills(肾气丸)on patients with knee osteoarthritis.Methods:One hundred and sixteen patients with knee osteoarthritis were randomly divided into the control group and the treatment group,58 cases in each group.The control group received combined therapy of glucosamine sulfate+celecoxib+sodium hyaluronate injection,while the treatment group received modified Shenqi Pills and the treatment in the control group.The treatment lasted for 4 weeks.The clinical efficacy,Western Ontario and McMaster University Osteoarthritis Index Visualization Scale(WOMAC),visual analogue scale(VAS)score,Lesquesne score,knee joint mobility and 36-item short form health survey(SF-36)score,quality of life score,and levels of serum tumors necrosis factor-α(TNF-α),C-reactive protein(CRP),and interleukin-1β(IL-1β)were compared between both groups.Results:The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).After the treatment,the WOMAC,VAS,Lesquesne scores and serum TNF-α,CRP,and IL-1βlevels in both groups were lower than those before treatment,but in the treatment group reduced more significantly,with statistical difference(P<0.05).The knee joint activity and SF-36 scores of the two groups were higher than those before the treatment,but in the treatment group increased more significantly,with statistical difference(P<0.05).Conclusions:Modified Shenqi Pills could improve knee function,relieve pain and improve quality of life,which might be related to the inhibition of inflammatory factor expression in patients with knee osteoarthritis.