丁桂散结合壮骨健步膏治疗肝肾亏虚证膝骨关节炎的临床研究

Clinical Study on Dinggui Powder(丁桂散)Combined with Zhuanggu Jianbu Gao(壮骨健步膏)in the Treatment of Knee Osteoarthritis of Liver and Kidney Deficiency Syndrome

目的:观察丁桂散结合壮骨健步膏治疗肝肾亏虚证膝骨关节炎的临床疗效。方法:将60例肝肾亏虚证膝骨关节炎患者随机分为治疗组和对照组,每组30例,对照组患者予外敷氟比洛芬巴布膏结合口服壮骨健步膏治疗,治疗组患者予外敷丁桂散结合口服壮骨健步膏治疗,连续治疗4周。比较治疗前、治疗4周后及治疗结束后3个月VAS评分、WOMAC骨关节炎指数、总有效率、不良反应发生率。结果:治疗组总有效率为96.67%(29/30),对照组总有效率为90.00%(27/30),治疗组优于对照组(P<0.05)。所有患者治疗前后VAS评分、WOMAC骨关节炎指数比较,差异有统计学意义(P<0.05),即存在时间效应,两组均如此;治疗4周后及治疗结束3个月后,两组患者VAS评分、WOMAC骨关节炎指数均较治疗前明显改善(P<0.05),治疗结束后3个月VAS评分、WOMAC骨关节炎指数较治疗4周后均有上升,但仍低于治疗前(P<0.05)。两组患者VAS评分、WOMAC骨关节炎指数总体比较,差异有统计学意义(P<0.05),存在分组效应,治疗组低于对照组。治疗4周后,两组患者VAS评分、WOMAC骨关节炎指数比较,差异无统计学意义(P>0.05),治疗结束后3个月治疗组患者VAS评分、WOMAC骨关节炎指数较治疗4周后均低于对照组(P<0.05)。时间因素和分组因素对VAS评分、WOMAC骨关节炎指数的影响存在交互效应(P<0.05)。治疗组不良反应发生率低于对照组。结论:外敷丁桂散结合口服壮骨健步膏治疗肝肾亏虚证膝骨关节炎疗效显著,不良反应小,并且在远期疗效上有优势。

Objective:To observe the clinical effect of Dinggui powder combined with Zhuanggu Jianbu Gao in the treatment of knee osteoarthritis of liver and kidney deficiency syndrome.Methods:Totally 60 cases of knee osteoarthritis with liver and kidney deficiency syndrome were randomly divided into treatment and control groups,30 cases in each group.The control group was treated with flurbiprofen cataplasm combined with oral Zhuanggu Jianbu Gao,while the treatment group was treated with Dinggui powder combined with oral Zhuanggu Jianbu Gao,for four weeks.VAS score,WOMAC osteoarthritis index,total effective rate and incidence of adverse reactions were compared before treatment,after treatment and three months after treatment.Results:The total effective rate was 96.67%(29/30)in treatment group and 90.00%(27/30)in control group.The treatment group showed better efficacy than control group(P<0.05).There were significant differences in VAS score and WOMAC Osteoarthritis Index in all patients before and after treatment(P<0.05),and there was a time effect in the two groups.The VAS score and WOMAC osteoarthritis index were decreased,four weeks and three months after treatment(P<0.05);The VAS score and WOMAC osteoarthritis index were increas ed three months after treatment,but still lower than before treatment(P<0.05).There was significant difference in VAS score and WOMAC Osteoarthritis Index between the two groups(P<0.05);There was grouping effect,and the treatment group showed lower VAS score and WOMAC Osteoarthritis Index than control group.There was no significant difference in VAS score and WOMAC Osteoarthritis Index between the two groups,four weeks after treatment(P>0.05).The treatment group showed lower VAS score and WOMAC Osteoarthritis Index than control group,three months after treatment.Time factor and grouping factor showed interactive effect on VAS score and WOMAC Osteoarthritis Index(P<0.05).The treatment group showed lower incidence rate of adverse reactions than that control group.Conclusion:External application of Dinggui powder plus oral Zhuanggu Jianbu Gao showed significant therapeutic effect on knee osteoarthritis of liver and kidney deficiency syndrome,with less adverse reactions and there was advantage in long-term efficacy.