中医辨证分期康复疗法对老年骨性关节炎患者的功能恢复及血清IL-6、IL-18、CRP水平的影响

Effects of TCM syndrome differentiation and staging rehabilitation therapy on functional recovery and serum IL-6,IL-18,and CRP levels in elderly patients with osteoarthritis

目的探讨中医辨证分期康复疗法对老年骨性关节炎患者的功能恢复及血清白细胞介素-6(IL-6)、白细胞介素-18(IL-18)、C-反应蛋白(CRP)水平的影响,为患者临床治疗提供指导。方法选取2019年6月至2020年6月佛山市中医院骨科中心收治的60例老年骨性关节炎患者为研究对象,根据随机单双数法将所有患者分为对照组和观察组各30例。对照组患者予以西医疗法,观察组患者予以中医辨证分期康复疗法。治疗4周后,采用Lysholm膝关节评分评估两组患者膝关节功能恢复情况,比较两组患者的临床疗效及不良反应,以及治疗前后的血清IL-6、IL-18、CRP水平。结果治疗4周后,两组患者的Lysholm膝关节评分均明显提高,且观察组患者的Lysholm膝关节评分为(95.07±9.43)分,明显高于对照组的(90.51±9.02)分,差异均有统计学意义(P<0.05);观察组患者的治疗总有效率为96.67%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗4周后,两组患者的血清IL-6、IL-18、CRP水平均明显降低,且观察组患者的血清IL-6、IL-18、CRP水平分别为(173.59±17.36)pg/mL、(153.06±15.52)pg/mL、(5.11±0.52)mg/L,明显低于对照组的(212.33±21.45)pg/mL、(182.39±18.33)pg/mL、(7.39±0.78)mg/L,差异均有统计学意义(P<0.05);观察组患者的总不良反应发生率为10.00%,明显低于对照组的33.33%,差异有统计学意义(P<0.05)。结论中医辨证分期康复疗法治疗老年骨性关节炎能促进患者膝关节功能恢复,且有效降低其血清IL-6、IL-18、CRP等炎症因子水平,减少不良反应的发生,临床治疗效果显著且安全性高。

Objective To investigate the effect of TCM syndrome differentiation and staging rehabilitation therapy on functional recovery and serum interleukin-6(IL-6),interleukin-18(IL-18),and C-reactive protein(CRP)levels in elderly patients with osteoarthritis,and to provide guidance for clinical treatment of patients.Methods A total of 60 elderly patients with osteoarthritis admitted to the Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine from June 2019 to June 2020 were selected as the research objects.According to the random odd and even number method,the patients were divided into the control group and an observation group,with 30 patients in each group.Patients in the control group were treated with western medicine,and patients in the observation group were treated with TCM syndrome differentiation and staging rehabilitation therapy.After 4 weeks of treatment,Lysholm knee score was used to evaluate the knee function recovery of patients in the two groups,and the clinical efficacy,adverse reactions,and the serum levels of IL-6,IL-18 and CRP before and after treatment were compared between the two groups.Results After 4 weeks of treatment,the Lysholm knee scores of the two groups of patients were significantly improved,and the Lysholm knee score of the observation group was(95.07±9.43)points,which was significantly higher than(90.51±9.02)points of the control group(P<0.05);the total effective rate of treatment in the observation group was 96.67%,which was significantly higher than 80.00%in the control group(P<0.05);after 4 weeks of treatment,the serum IL-6,IL-18,and CRP levels of the two groups of patients were significantly reduced,and the serum IL-6,IL-18,and CRP levels of the observation group were(173.59±17.36)pg/mL,(153.06±15.52)pg/mL,(5.11±0.52)mg/L,respectively,which were significantly lower than corresponding(212.33±21.45)pg/mL,(182.39±18.33)pg/mL,(7.39±0.78)mg/L of the control group(all P<0.05);the total adverse reaction rate of the observation group was 10.00%,which was significantly lower than 33.33%of the control group(P<0.05).Conclusion TCM syndrome differentiation and staging rehabilitation therapy has a significant effect in the treatment of elderly osteoarthritis,which can promote the obvious recovery of patients'knee function,and effectively reduce the serum levels of IL-6,IL-18,CRP and other inflammatory factors,as well as decrease the occurrence of adverse reactions,and the clinical treatment effect is remarkable and high safety.