推拿手法联合加味扶元荣骨汤对膝骨关节炎患者膝关节功能、步态功能的影响

Effect of Massage Manipulations Combined with Modified Fuyuan Ronggu Decoction on Knee Joint Function and Gait Function in Patients with Knee Osteoarthritis

目的:探究推拿手法联合加味扶元荣骨汤对膝骨关节炎患者膝关节功能、步态功能的影响。方法:选取2019年1月-2021年1月某院收治的膝骨关节炎患者127例,随机分为扶元荣骨汤组63例和联合治疗组64例,扶元荣骨汤组采用加味扶元荣骨汤治疗,联合治疗组采用推拿手法联合加味扶元荣骨汤治疗,对比两组中医证候评分、Leqensne、BBS评分及6MWT水平变化,酶联免疫吸附实验法检测骨代谢指标(OPG、BGP)、炎症反应指标(IL-1β、IL-17)、氧化应激指标(NO、LPO)水平,流式细胞仪检测CD8^(+)、CD4^(+)水平,对比两组治疗效果。结果:治疗后,与扶元荣骨汤组比较,联合治疗组腰膝酸软、关节酸胀、行走关节痛等证候评分较低(P<0.05)。治疗后,联合治疗组Leqensne评分低于扶元荣骨汤组,BBS评分、6MWT水平高于扶元荣骨汤组(P<0.05)。治疗后,联合治疗组OPG、BGP、CD4^(+)水平高于扶元荣骨汤组,IL-1β、IL-17、NO、LPO、CD8^(+)水平低于扶元荣骨汤组(P<0.05)。联合治疗组治疗有效率高于扶元荣骨汤组(P<0.05)。结论:膝骨关节炎患者使用推拿手法联合加味扶元荣骨汤治疗,中医证候减轻,膝关节功能、步态功能得到提升,骨代谢状况改善,炎症反应、氧化应激反应减轻,免疫功能得到提升,治疗效果显著。

Objective:To explore the effect of massage manipulations combined with modified Fuyuan Ronggu decoction on knee joint function and gait function of patients with knee osteoarthritis.Methods:127 patients with knee osteoarthritis in a hospital from January 2019 to January 2021 were selected and randomly divided into Fuyuan Ronggu decoction group(63 cases)and combined treatment group(64 cases).Patients in Fuyuan Ronggu decoction group were treated with modified Fuyuan Ronggu decoction,while patients in combined treatment group were treated with massage manipulations combined with modified Fuyuan Ronggu decoction.TCM syndrome score,leqensne,BBS score and 6MWT level were compared between the two groups.The levels of bone metabolism indexes(OPG,BGP),inflammatory reaction indexes(IL-1β,IL-17),oxidative stress indexes(NO,LPO),and the levels of CD8^(+)and CD4^(+)were detected by enzyme-linked immunosorbent assay.The treatment effects of the two groups were compared.Results:After treatment,compared with the Fuyuan Ronggu decoction group,the combined treatment group had lower syndrome scores of waist and knee soreness,joint soreness,and walking joint pain(P<0.05).After treatment,leqensne score of combined treatment group was lower than that of Fuyuan Ronggu decoction group,BBS score and 6MWT level were higher than those of Fuyuan Ronggu decoction group(P<0.05).After treatment,the levels of OPG,BGP and CD4^(+)in the combined treatment group were higher than those in the Fuyuan Ronggu decoction group,and the levels of IL-1β,IL-17,NO,LPO and CD8^(+)in the combined treatment group were lower than those in the Fuyuan Ronggu decoction group(P<0.05).The effective rate of the combined treatment group was higher than that of the Fuyuan Ronggu decoction group(P<0.05).Conclusion:Massage manipulations combined with modified Fuyuan Ronggu decoction in the treatment of knee osteoarthritis patients can reduce TCM syndromes,improve knee joint function and gait function,improve bone metabolism,reduce inflammatory reaction and oxidative stress reaction,and improve immune function,with remarkable therapeutic effect.