六味地黄丸治疗肾阴虚型原发性膝骨关节炎的临床影像学改变

The clinical and imaging changes of Liuwei Dihnang Pill in the treatment of primary knee osteoarthritis with kidney yin deficiency type

目的探讨六味地黄丸治疗肾阴虚型原发性膝骨关节炎患者的临床影像学变化。方法30例肾阴虚型原发性膝骨关节炎患者随机分为对照组和观察组,每组各15例。对照组仅在膝骨关节炎急性疼痛发作期给予西乐葆口服治疗,观察组除在疼痛期使用西乐葆之外,并长期口服六味地黄丸治疗。随访1年,比较两组患者在治疗前和治疗6、12个月的膝关节功能评分、中医症状评分以及膝关节影像学变化。结果两组患者治疗前后的膝关节功能评分差值及中医症状评分差值比较,差异均有统计学意义(P<0.05)。X线检查,两组膝骨关节炎的进展情况比较,差异有统计学意义(P<0.05)。治疗12个月后,观察组膝关节MRI检查显示在关节游离体、骨质增生、积液、滑膜增厚、半月极损伤以及软骨损伤等方面的改变均有明显统计学意义(P<0.05),其中以骨质增生、积液、滑膜增厚的改变例数更为直观。结论六味地黄丸治疗肾阴虚型原发性膝骨关节炎的效果良好,可以显著改善膝关节功能评分及临床症状,在临床影像学表现的变化也有所体现。

Objective To investigate the clinical imaging changes of Liuwei Dihuang Pill in the treatment of primary knee osteoarthritis with kidney yin deficiency type.Methods Thirty patients with primary knee osteoarthritis of kidney yin deficiency were randomly divided into control group and observation group,with 15 cases in each group.The control group was only given celebrex orally during the acute pain episode of knee osteoarthritis,while the observation group was given celebrex orally during the acute pain episode in addition to the long-term treatment of Liuwei Dihuang Pill.The patients were followed up for 1 year,and the knee function score,TCM symptom score and knee imaging changes were compared between the two groups before treatment and 6 and 12 months after treatment.Results The difference of knee function score and TCM symptom score before and after treatment in two groups was statistically significant(P<0.05).X-ray examination showed that there was staristical significance in the progression of knee osteoarthritis between the two groups(P<0.05).After 12 months of treatment,MRI examination of the knee joint in the observation group showed significant statistical significance in the changes of joint free body,hyperosteogeny,effusion,synovial thickening,meniscus injury and cartilage injury(P<0.05),among which the numbers of changes in hyperosteogeny,effusion and synovial thickening were more obvious.Conclusion Liuwei Dihuang Pill has a good effect on the treatment of primary knee osteoarthritis with kidney-yin deficiency,which can significantly improve the knee function score and clinical symptoms,and the changes in clinical imaging manifestations are also reflected.