红花化瘀汤口服和熏蒸在膝骨关节炎治疗中的应用研究

Application of Oral Administration and Fumigation of Honghua Huayu Decoction in the Treatment of Knee Osteoarthritis

目的:观察红花化瘀汤口服和熏蒸在膝骨关节炎(KOA)治疗中的应用效果,旨在优化KOA的治疗方案。方法:选取2018年1月~2019年12月本院骨科确诊并接受治疗的120例KOA患者作为研究对象,按照随机数字表法分为口服组、熏蒸组、联合组,各40例。口服组使用红花化瘀汤口服治疗,熏蒸组使用红花化瘀汤熏蒸治疗;联合组使用红花化瘀汤口服联合熏蒸治疗,连续治疗2周后观察治疗效果。评估并比较3组临床疗效,比较两组治疗前和治疗后膝关节功能[采用西安大略大学和麦克马斯特大学(WOMAC)骨关节炎指数评分量表进行评估]及炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)、白细胞介素-18(IL-18)]水平。结果:联合组整体治疗效果优于口服组与熏蒸组,且总有效率高于口服组与熏蒸组(P<0.05);口服组与熏蒸组总有效率比较无统计学差异(P>0.05)。治疗后,3组疼痛、僵硬、日常活动及WOMAC总分均低于治疗前,且联合组低于口服组与熏蒸组(P<0.05);口服组与熏蒸组比较无统计学差异(P>0.05)。治疗后,3组TNF-α、IL-17、IL-18水平均低于治疗前,且联合组低于口服组与熏蒸组(P<0.05);口服组与熏蒸组比较无统计学差异(P>0.05)。结论:红花化瘀汤口服联合熏蒸治疗KOA的效果较好,更有利于改善炎症因子水平,促进膝关节功能恢复。

Objective:To observe the effect of oral administration and fumigation of Honghua Huayu Decoction in the treatment of knee osteoarthritis(KOA),in order to optimize the treatment scheme of KOA.Methods:120 patients with KOA diagnosed and treated in the department of orthopedics of our hospital from January 2018 to December 2019 were selected as the research subjects,and they were divided into oral group,fumigation group and combined group by random number table method,with 40 cases in each group.The oral group was treated with Honghua Huayu Decoction by oral administration,the fumigation group was treated with Honghua Huayu Decoction by fumigation,and the combined group was treated with Honghua Huayu Decoction by oral administration combined with fumigation.The therapeutic effect was observed after 2 weeks of continuous treatment.The clinical effects of the three groups were evaluated and compared.The knee function[assessed by the Western Ontario and McMaster Universities(WOMAC)osteoarthritis index scale]and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-17(IL-17),interleukin-18(IL-18)]levels were compared between the two groups before and after treatment.Results:The overall therapeutic effect of the combined group was better than that of the oral group and the fumigation group,and the total effective rate was higher than that of the oral group and the fumigation group(P<0.05).There was no significant difference in the total effective rate between the oral group and the fumigation group(P>0.05).After treatment,the pain,stiffness,daily activities and WOMAC total scores in the three groups were lower than those before treatment,and those in the combined group were lower than those in the oral group and fumigation group(P<0.05).There was no significant difference between the oral group and the fumigation group(P>0.05).After treatment,the levels of TNF-α,IL-17 and IL-18 in three groups were lower than those before treatment,and those in the combined group were lower than those in the oral group and fumigation group(P<0.05).There was no significant difference between the oral group and the fumigation group(P>0.05).Conclusion:Honghua Huayu Decoction by oral administration combined with fumigation has a better effect on KOA,which is more conducive to improve the level of inflammatory factors and promote the recovery of knee function.