补肾祛寒治尪汤联合金乌骨通胶囊治疗肾虚血瘀型膝骨关节炎疗效观察

Efficacy Observation of Bushen Quhan Zhiwang Decoction Combined with Jinwugutong Capsules in the Treatment of Kidney Deficiency and Blood Stasis-type Knee Osteoarthritis

目的:观察补肾祛寒治尪汤联合金乌骨通胶囊治疗肾虚血瘀型膝骨关节炎的疗效及对骨代谢指标和复发率的影响。方法:106例肾虚血瘀型膝骨关节炎患者随机分为2组。对照组53例给予金乌骨通胶囊治疗,研究组53例在对照组基础上加用补肾祛寒治尪汤治疗。治疗6周后评价两组疗效与不良反应发生率,比较两组患者治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、骨代谢指标含量及炎症因子水平变化。随访1年观察两组复发情况。结果:研究组临床总有效率为92.45%,显著优于对照组的71.70%(P<0.05)。两组治疗后WOMAC量表中日常生活受限、关节僵硬和关节疼痛评分,及血清肿瘤坏死因子-α(TNF-α)和白细胞介素-1(IL-1)水平均较治疗前显著下降,血清骨保护素(OPG)和骨钙素(BGP)含量则较前显著升高(P<0.05);且研究组上述指标均显著优于对照组(P<0.05)。研究组的不良反应发生率及复发率均明显低于对照组(P<0.05)。结论:补肾祛寒治尪汤联合金乌骨通胶囊治疗肾虚血瘀型膝骨关节炎疗效显著,能有效改善患者症状,调节骨代谢指标,减轻炎症反应,减少复发,同时不良反应较少,安全性高。

Objective:To observe the therapeutic effect of Bushen Quhan Zhiwang decoction combined with Jinwugutong capsules on kidney deficiency and blood stasis-type knee osteoarthritis and the influences on the bone metabolism indices and recurrence rate.Methods:Totally 106 cases of patients with kidney deficiency and blood stasis-type knee osteoarthritis were randomly divided into two groups.The 53 cases in the control group were treated with Jinwugutong capsules,and the 53 cases in the study group were treated with Bushen Quhan Zhiwang decoction on the basis of controll group.The efficacy and incidence of adverse drug reactions of the two groups were evaluated after 6 weeks of treatment,the scores of Western Ontario McMaster University Osteoarthritis Index(WOMAC),bone metabolism index content and inflammatory factor levels in the two groups before and after treatment were compared,and the recurrence of the two groups were observed follow up for one year.Results:The total effective rate of the study group after treatment was 92.45%,which was significantly better than that(71.70%)of the control group(P<0.05).After treatment,the scores of limited daily life,ankylosis and arthralgia in the WOMAC scale,and the levels of serum tumor necrosis factor-α(TNF-α)and interleukin-1(IL-1)of the two groups were significantly lower than those before treatment(P<0.05),while the contents serum osteoprotegerin(OPG)and bone gla protein(BGP)were significantly increased than those before treatment(P<0.05);and the above indices in the study group were significantly better than those in the control group(P<0.05).The incidence of adverse reactions and the recurrence rate of the study group were both significantly lower than these of the control group(P<0.05).Conclusion:Bushen Quhan Zhiyi decoction combined with the symptions of patients,regulate Jinwugutong capsules has a significant effect on kidney deficiency and nlood stasis-type knee osteoarthritis with less adverse reactions and high safety.It can effectively improve the bone metabolism indexes,reduce inflammatory reaction and recurrence,with less adverse reactions and high safety.