中药外治法在膝骨性关节炎中的临床疗效研究

Study on clinical curative effect of TCM external treatment on knee osteoarthritis

目的:通过分析使用芜湖市中医医院熏洗方结合活血膏治疗膝骨性关节炎患者的临床效果,研究中药外治法在该病中的应用效果。方法:选取60例膝骨性关节炎患者,2018年10月-2019年12月在芜湖市中医医院确诊治疗的患者,随机均分为两组(按随机数字表法)。对照组选择口服双氯芬酸钠缓释片治疗,双氯芬酸钠缓释片推荐剂量为每日1次,每次75 mg,最大剂量为150 mg,分2次服用。观察组采用中药外治法治疗,即使用中药熏蒸结合活血膏进行治疗。活血膏(院内制剂),用法:取活血膏40 g涂在消毒纱布上外敷于患处,每次8~12 h,每日1次。用法:将熏蒸药物放入治疗机中提前加热,加入3 L洁净自来水先浸泡半小时后再煮沸,将蒸汽温度调至患者可接受范围内,再对患者的膝关节进行熏蒸,每次30 min,每日1次。采用McMaster大学关节炎量表(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)表格对两组病例进行评分,记录两组临床治疗前后评分,并比较治疗后疗效。结果:治疗总有效率:观察组93.30%(28/30),对照组80.00%(24/30),比较后显示观察组明显高于对照组,两组差异比较后存在统计学意义(P<0.05)。经过治疗后,观察组治疗后WOMAC积分表中疼痛程度、僵硬程度及关节活动情况评分均显著低于对照组,两组积分比较有统计学差异(P<0.05)。结论:中药熏蒸结合活血膏外敷应用临床膝关节骨性关节炎的治疗后,疗效较显著,对于改善患者症状及生活质量有着较为明显的作用。

Objective: To analyze the clinical effect of using in-hospital fumigation combined with Huoxue ointment(活血膏) in the treatment of knee osteoarthritis patients, and to study the effect of traditional Chinese medicine on the disease. Methods: 60 patients with osteoarthritis of the knee were selected and diagnosed and treated in Anhui University of Chinese Medicine Affiliated Wuhu Hospital of Traditional Chinese Medicine from October 2018 to December 2019. They were randomly divided into two groups(according to the random number table method). The control group received oral diclofenac sodium sustained-release tablets for treatment. The recommended dose of diclofenac sodium sustained-release tablets was 1 time/d, 75 mg each time, and the maximum dose was 150 mg,which was taken twice a day. The observation group was treated with Chinese medicine external treatment, that was, Chinese medicine fumigation combined with Huoxue ointment for treatment. Huoxue ointment(in-hospital preparation) usage: applying 40 g of Huoxue ointment on sterile gauze to the affected area, 8-12 h/time, 1 time/d. The traditional Chinese medicine fumigation and washing prescription(the experience prescription of this hospital) was the main one. Usage: Put the fumigation medicine into the treatment machine, heat it in advance, add 3 L of clean tap water, soak for half an hour, then boil, adjust the steam temperature to the acceptable range of the patient, and then fumigate the patient’s knee joint, 30 min/time, 1 time/d. The Womac table was used to score the cases of the two groups, the scores of the two groups before and after clinical treatment were recorded, and the efficacy after treatment was compared. Results: The total effective rate of treatment was 93.30%(28/30) in the observation group and 80.00%(24/30) in the control group. After comparison, the observation group was significantly higher than the control group, and the difference between the two groups was statistically significant(P<0.05). After treatment, the degree of pain, stiffness, and joint activity in the Western ontario and mcmaster universities osteoarthritis index(WOMAC) score table of the observation group were significantly lower than those of the control group, and the scores of the two groups were statistically different(P<0.05). Conclusion: Traditional Chinese medicine fumigation combined with Huoxue ointment external application has a significant effect in the treatment of clinical knee osteoarthritis, and it has a more obvious effect on relieving patients’ symptoms and improving quality of life.