桂枝附子汤加味治疗膝骨关节炎的临床疗效及安全性

Clinical efficacy and safety of Guizhi Fuzi Decoction in treating knee osteoarthritis

目的观察桂枝附子汤加味对膝骨关节炎(KOA)患者的临床疗效及安全性。方法选取2016年1月至2019年1月我院中医科门诊的60例KOA患者,按照随机数字表法分为治疗组和对照组,每组各30例。治疗组给予桂枝附子汤加味水煎服,对照组给予氨基葡萄糖片口服。两组均以塞来昔布胶囊作为应急用药。治疗前后分别评估两组WOMAC骨关节炎指数、50 m行走后膝关节VAS评分、ESR、CRP。结果58例患者完成了研究,其中治疗组30例,对照组28例。治疗后治疗组的总有效率为81.33%,明显高于对照组的71.43%,差异有统计学意义(P<0.05)。治疗后两组50 m行走后膝关节疼痛VAS评分、WOMAC骨关节炎指数、关节肿胀VAS评分、关节压痛VAS评分及ESR、CRP水平治疗前相比均显著降低(P<0.05或P<0.01)。治疗后,治疗组50 m行走后膝关节疼痛VAS评分、WOMAC骨关节炎指数、关节肿胀VAS评分和关节压痛VAS评分均明显低于对照组(P<0.05或P<0.01)。治疗后,治疗组ESR及CRP水平显著低于对照组,差异有统计学意义(P<0.05)。治疗组副作用的发生率为3.33%,明显低于对照组的10.00%,差异有统计学意义(P<0.05)。结论桂枝附子汤加味能显著改善KOA临床症状、降低KOA外周血ESR和CRP水平,与氨基葡萄糖片相比具有更好的疗效和安全性。

Objective To observe the clinical efficacy and safety of Guizhi Fuzi Decoction on patients with knee osteoarthritis(KOA).Methods A total of 60 KOA patients in the outpatient clinic of the Department of Traditional Chinese Medicine and Rheumatology in our hospital from January 2016 to January 2019 were divided into the treatment group and the control group according to a random number table,with 30 cases in each group.The treatment group was given Guizhi Fuzi Decoction plus flavored water for decoction,and the control group was given glucosamine tablets orally.Celecoxib capsules were used as emergency medication in both groups.Before and after treatment,the WOMAC osteoarthritis index,knee joint pain VAS score after 50 m walking,erythrocyte sedimentation rate,and C-reactive protein(CRP)of the two groups were evaluated.Results 58 patients completed the study,including 30 in the treatment group and 28 in the control group.The total effective rate in the treatment group after treatment was 81.33%,which was significantly higher than that of(71.43%)in the control group,and the difference was statistically significant(P<0.05).After treatment,the knee joint pain VAS score after 50 m walking,WOMAC osteoarthritis index,joint swelling VAS score,joint tenderness VAS score and ESR,CRP between the treatment group and the control group were significantly lower than those before treatment(P<0.05 or P<0.01).After treatment,the knee joint pain VAS score after 50 m walking,WOMAC osteoarthritis index,joint swelling VAS score and joint tenderness VAS score in the treatment group were significantly lower than those in the control group(P<0.05 or P<0.01).After treatment,the ESR and CRP levels in the treatment group were significantly lower than those in the control group,with significant difference(P<0.05).The total incidence of side effects in the treatment group was 3.33%,significantly lower than that of 10.00%in the control group,with significant difference(P<0.05).Conclusion Guizhi Fuzi Decoction can significantly improve the clinical symptoms of KOA,reduce the levels of ESR and CRP in peripheral blood of KOA,and has better efficacy and safety than glucosamine tablets.