补肾活血方联合热敷散治疗气滞血瘀型膝骨性关节炎临床观察

Clinical Observation on Kidney-invigorating Blood-activating Prescription and Hot Compress Powder in Treating Knee Osteoarthritis of Qi-Stagnation Blood Stasis Pattern

目的:探讨补肾活血方联合热敷散治疗气滞血瘀型膝骨性关节炎(knee osteoarthritis,KOA)的临床疗效。方法:选取96例气滞血瘀型KOA患者,随机分为对照组和观察组,每组48例。观察组给予补肾活血方联合热敷散治疗,对照组采用硫酸氨基葡萄糖胶囊联合双氯芬酸钠缓释胶囊治疗,两组均连续治疗4周。比较两组治疗前后临床疗效、美国膝关节协会评分(American knee society score,AKSS)、疼痛视觉模拟评分(visual analogue score,VAS)、膝关节功能评分[参照西安大略和麦克马斯特大学(Western Ontario and McMaster University,WOMAC)骨关节炎指数进行评分]、生活质量评分[参照关节炎生活质量测量量表2-短卷(arthritis quality of life measurement scale 2-short volume,AIMS2-SF)进行评分],测定治疗前后血清肿瘤坏死因子α(tumor necrosis factor,TNF-α)、白细胞介素6(interleukin-6,IL-6)、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平,记录不良反应,评估临床疗效。结果:总有效率观察组为91.67%(44/48),优于对照组的72.92%(35/48)(P<0.05);观察组治疗后AKSS评分、AIMS2-SF评分与本组治疗前、对照组治疗后比较均明显升高(P<0.05);观察组治疗后VAS评分、WOMAC评分与本组治疗前、对照组治疗后比较均明显下降(P<0.05);两组治疗后炎症因子血清浓度均较治疗前明显下降(P<0.05),且观察组较对照组下降更加显著(P<0.05)。结论:补肾活血方联合热敷散治疗气滞血瘀型KOA疗效确切,可明显改善膝关节功能,减轻临床症状,提高患者生活质量。

Objective:To discuss clinical effects of kidney-invigorating blood-activating prescription and hot compress powder in treating knee osteoarthritis(KOA)of Qi stagnation and blood stasis pattern.Methods:All 96 patients were randomized into the control group and the observation group,48 cases in each group.The observation group were treated by kidney-invigorating blood-activating prescription and hot compress powder,and the control group by glucosamine sulfate capsules and diclofenac sodium sustained release capsules,both groups were treated for four weeks continuously.To compare clinical effects,AKSS and VAS before and after treating,knee function score(according to WOMAC),quality of life scores(evaluated by consulting AIMS2-SF),to measure the levels of TNF-α,IL-6 and hs-CRP before and after treating,to record adverse reaction,and assess clinical effects.Results:Total effective rate of the observation group was 91.67%(44/48),superior to 72.92%(35/48)of the control group(P<0.05);AKSS scores and AIMS2-SF of the observation group after treating were higher than these before treating,than these of the control group after treating distinctly(P<0.05);VAS scores and WOMAC scores of the observation group were lower than these before treating,than these of the control group after treating notably(P<0.05);serum concentrations of inflammatory factors lowered in both groups after treating compared with these before treating(P<0.05),the decrease of the observation group were more significant compared with that of the control group(P<0.05).Conclusion:Kidney-invigorating blood-activating prescription and hot compress powder could gain definite effects in treating KOA of Qi stagnation and blood stasis pattern,it could apparently improve knee joint function,relieve clinical symptoms and raise quality of life.