骨痹汤熏蒸联合经筋推拿治疗早中期膝骨关节炎临床研究

Clinical Study of Gubi Decoction Fumigation Combined with Meridian Massage in the Treatment of Knee Osteoarthritis in the Early and Middle Stages

目的探讨骨痹汤熏蒸联合经筋推拿治疗早中期膝骨关节炎的临床疗效。方法选取河北省石家庄市中医院推拿科2018年10月至2020年10月收治的早中期膝骨关节炎患者100例,按随机数字表法分为观察组和对照组,各50例。对照组患者予塞来昔布胶囊口服,每日2次,每次0.2 g;观察组患者在对照组基础上予骨痹汤熏蒸联合经筋推拿治疗,每日1次,14 d为1个疗程。两组均治疗1个月。结果观察组自愿退出1例、失访2例,对照组自愿退出2例,均予以剔除。观察组总有效率为91.49%,显著高于对照组的72.92%(P <0.05);治疗后,观察组患者视觉模拟评分量表(VAS)、WOMAC骨性关节评分量表(WOMAC)、Lequene和Mery膝骨关节炎严重度指数评分量表(Lequene&Mery)评分,中医证候积分(肿胀、疼痛、僵硬、跛行),炎性因子(基质金属蛋白酶9、单核细胞趋化蛋白1、肿瘤坏死因子-α)水平均显著低于对照组(P <0.05);观察组和对照组不良反应发生率相当(12.77%比8.33%, P> 0.05)。结论骨痹汤熏蒸联合经筋推拿治疗早中期膝骨关节炎疗效显著,能减轻患者的症状,降低中医证候积分,改善机体的炎性反应状态,且治疗安全性良好。

Objective To investigate the clinical efficacy of Gubi Decoction fumigation combined with meridian massage in the treatment of knee osteoarthritis in the early and middle stages.Methods A total of 100 patients with knee osteoarthritis in the early and middle stages admitted to the Department of Massage in the Shijiazhuang Hospital of Traditional Chinese Medicine from October 2018 to October 2020 were selected and randomly divided into the observation group and the control group,50 cases in each group.The patients in the control group were given Celecoxib Capsules orally,twice a day,0.2 g each time.On the basis of the control group,the patients in the observation group were treated with Gubi Decoction fumigation combined with meridian massage once a day for 14 d.Both groups were treated for one month.Results One case voluntarily withdrew and two cases were lost to follow-up in the observation group,while two cases withdrew in the control group,all of them were excluded.The total effective rate of the observation group was91.49%,which was significantly higher than 72.92%of the control group(P<0.05).After treatment,the scores of visual analogue scale(V AS),WOM AC scale,Lequene and Mery severity index scale(Lequene&Mery),TCM syndromes including swelling,pain,stiffness and claudication,and the levels of inflammatory factors[matrix metalloproteinase-9(MMP-9),monocyte chemoattractant protein-1(MCP-1),tumor necrosis factor-α(TNF-α)]in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(12.77%vs.8.33%,P>0.05).Conclusion Gubi Decoction fumigation combined with meridian massage is effective and safe in the treatment of knee osteoarthritis in the early and middle stages.It can improve the symptoms of patients,reduce the score of TCM syndromes and improve the inflammatory reaction of the body.