骨伤1号方联合塞来昔布治疗寒湿痹阻证膝骨关节炎的临床观察

Clinical Observation on Orthopedics No.1 Prescription Combined with Celecoxib in Treating Knee Osteoarthritis with Middle Stage of Cold-dampness Syndrome

目的:探讨骨伤1号方联合塞来昔布治疗寒湿痹阻证膝骨关节炎(KOA)的疗效及对血清细胞因子的影响。方法:将72例患者按随机数字表法分为对照组和观察组,各36例。两组患者均给予口服塞来昔布胶囊基础治疗,0.2 g/次,1次/d。观察组在西医治疗基础上,中药骨伤1号方免煎颗粒熏洗治疗,每次1袋,1次/日,每周熏洗5次,两组患者均治疗4周。观察两组患者用药前后视觉模拟疼痛评分(VAS),美国膝关节协会评分(KSS),血清白细胞介素-1β(IL-1β),肿瘤坏死因子-α(TNF-α),转化生长因子-β_(1)(TGF-β_(1))水平变化情况并评估临床疗效。结果:与本组治疗前比较,治疗后两组患者VAS评分明显降低(P<0.01),KSS评分明显增高(P<0.01),且观察组临床效果改善更佳。与本组治疗前比较,治疗后两组患者血清中IL-1β,TNF-α水平明显下降(P<0.01),且治疗后观察组低于对照组(P<0.05);两组患者TGF-β_(1)水平较本组治疗前显著升高(P<0.01)。结论:骨伤1号方联合塞来昔布治疗寒湿痹阻证KOA,可有效缓解KOA患者的临床症状,改善关节功能,提高生活质量,同时能降低血清炎性因子IL-1β,TNF-α水平,并增加TGF-β_(1)水平。

Objective: To study the clinical efficacy of orthopedics No. 1 prescription combined with celecoxib in the treatment of knee osteoarthritis(KOA)with middle stage of cold-dampness syndrome and investigate its effect on serum cytokines levels. Method: The 72 patients were randomly divided into control group and observation group,with 36 cases each. Patients in both groups were given basic treatment with oral celecoxib capsules(0.2 g/time,1 time/day). On the basis of western medicine treatment,patients in observation group were treated with orthopedics No. 1 prescription decoction-free granules by fumigation,1 bag/time,1 time/day,5 times/week. Both groups received treatment for 4 weeks. The visual analog pain score(VAS),American knee society knee score(KSS),serum interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),and transforming growth factor-β_(1)(TGF-β_(1))levels were observed before and after treatment,and their clinical efficacy was evaluated. Result: After treatment,VAS score significantly decreased in both groups(P<0.01),and KSS score significantly increased(P<0.01), with better clinical effect in observation group. After treatment,serum IL-1β and TNF-α levels decreased significantly in both groups(P<0.01),and the levels in observation group were lower than those in control group after treatment(P<0.05). TGF-β_(1) content was significantly higher than that before treatment in two groups(P<0.01). Conclusion: Orthopedics No. 1 prescription combined with celecoxib for the treatment of KOA with middle stage of cold-dampness syndrome can effectively relieve the clinical symptoms of patients with KOA,improve joint function,improve quality of life,reduce the contents of inflammatory factors IL-1β and TNF-α in serum,and increase the expression of TGF-β_(1) level.