五痹汤合桃红四物汤加减联合温针灸治疗膝骨性关节炎的疗效观察

Observation on the Curative Effect of Wubi Decoction Combined with Taohong Siwu Decoction Combined with Warming Needle Moxibustion on Knee Osteoarthritis

目的:观察五痹汤合桃红四物汤加减联合温针灸治疗膝关节骨性关节炎(KOA)的临床效果。方法:选取2018年1月至2018年12月聊城市中医医院收治的KOA患者124例作为研究对象,按照随机数字表法分为对照组和观察组,每组62例。对照组给予常规西药治疗,观察组在对照组基础上给予五痹汤合桃红四物汤加减方联合温针灸。比较2组临床效果,观察膝关节疼痛、僵硬、功能改善情况,检测骨代谢指标、炎症介质、血液流变学指标。结果:观察组临床有效率91.94%(57/62),与对照组的77.41%(48/62)比较明显升高(P<0.05);治疗后,观察组患者膝关节疼痛、僵硬、功能改善优于对照组,痛感VAS、关节僵硬程度WOMAC评分显著低于对照组,膝部关节功能Lyshom评分显著高于对照组,2组比较,差异有统计学意义(均P<0.05);观察组患者血清骨代谢TRACP-5b、CTX-I指标、炎症介质TNF-α、MMP-9、COX-2水平、血液流变学指标显著低于对照组,BGP、BALP水平则显著高于对照组,差异有统计学意义(均P<0.05)。结论:五痹汤合桃红四物汤加减方联合温针灸有利于缓解膝骨性关节炎关节疼痛,减轻关节僵硬,提高膝关节功能,其机制可能与改善骨代谢、减轻炎症反应、改善局部血液微循环有关。

Objective:To observe the clinical effect of Wubi Decoction combined with Taohong Siwu Decoction combined with warming needle moxibustion on knee osteoarthritis.Methods:A total of 124 cases of knee osteoarthritis patients admitted to Liaocheng Traditional Chinese Medicine Hospital from January to December 2018,were randomly divided into a control group and an observation group,with 62 cases in each group.Patients in the control group were given conventional symptomatic treatment with Western medicine,while those in the observation group were treated with flexible internal decoction of Wubi Decoction and Taohong Siwu Decoction combined with warming needle moxibustion for one month on the basis of the control group.The clinical effects of the 2 groups were compared,knee joint pain,stiffness and functional improvement were observed,and changes in bone metabolism indexes,inflammatory factors and hemorheology indexes were detected.Results:The clinical effective rate of the observation group and the control group was 91.94%(57/62)and 77.41%(48/62)respectively,the clinical efficacy of the observation group was better(P<0.05).After treatment,the patients in the observation group had better knee joint pain,stiffness and functional improvement than those in the control group.The VAS scores of pain sensation and WOMAC scores of joint stiffness were significantly lower than those in the control group,and the Lyshom scores of knee joint function were significantly higher than those in the control group(P<0.05).The serum levels of bone metabolism TRACP-5b,CTX-I,inflammatory factors TNF-α,MMP-9,COX-2 and indexes of hemorheology in the observation group were significantly lower than those in the control group,while the levels of BGP and BALP were significantly higher than those in the control group(P<0.05).Conclusion:Wubi Decoction and Taohong Siwu Decoction combined with warming needle moxibustion are beneficial to alleviate joint pain of knee osteoarthritis,reduce joint stiffness and improve knee joint function.The mechanism may be related to improving bone metabolism,reducing inflammation and improving local blood microcirculation.