中药外敷联合复方双氯芬酸钠治疗中重度骨关节炎临床疗效观察

Clinical efficacy of TCM external treatment combined with compound diclofenac sodium in treatment of moderate and severe osteoarthritis

目的观察中药外敷联合复方双氯芬酸钠治疗中重度骨关节炎(KOA)的临床疗效。方法将本院收治的142例被确诊的单侧中重度KOA患者随机分为观察组与对照组各71例。对照组给予复方双氯芬酸钠治疗,观察组在对照组治疗基础上采用中药外敷治疗。治疗前后分别采用Lysholm膝关节评分量表评价患者膝关节指标,视觉模拟评分法(VAS)进行疼痛程度评价;检测血清中白介素-6(IL-6)、肿瘤坏死因子(TNF-α)和C反应蛋白(CRP)水平,评估两组患者临床疗效,记录两组患者治疗期间的不良反应发生率。结果观察组临床疗效显著高于对照组(P<0.05);治疗后,观察组Lysholm评分明显高于对照组(P<0.05),中医症候积分与VAS评分明显低于对照组(P<0.05);观察组血清IL-6、TNF-α和CRP水平明显低于对照组(P<0.05);两组不良反应发生率情况比较无统计学意义(P>0.05)。结论中药外敷联合复方双氯芬酸钠可降低中重度KOA患者炎症因子水平,改善膝关节功能,治疗效果较好。

Objective To observe the clinical efficacy of TCM external treatment combined with compound diclofenac sodium in treatment of moderate and severe osteoarthritis(KOA).Methods 142 patients with unilateral moderate to severe KOA were randomly divided into observation group and control group,71 cases each.Control group was treated with compound diclofenac sodium;observation group was treated with TCM external treatment on the basis of control group.The Lysholm knee joint rating scale was used to evaluate the knee joint index and the Visual analogue scale(VAS) was used to evaluate the pain levels before and after treatment.The levels of interleukin-6(IL-6),tumor necrosis factor(TNF-α) and C-reactive protein(CRP) after treatment were detected,the efficacy of treatment was evaluated and the incidence of adverse reactions during treatment was recorded.Results The clinical efficacy in observation group was significantly better than that of control group(P<0.05);after treatment,the Lysholm score in observation group was significantly higher than that in control group(P<0.05),syndrome score and VAS score were significantly lower than that in control group(P<0.05);and the levels of IL-6,TNF-α and CRP were significantly lower than those in control group(P<0.05);there were no difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion TCM external treatment combined with compound diclofenac sodium can reduce the level of inflammatory factors in patients with moderate and severe KOA,it can improve the function of knee joint,and has a good therapeutic effect.