宣痹止痛膏治疗风寒湿痹型膝骨性关节炎的临床疗效及机制初探

Clinical Efficacy and Mechanism of Xuanbi Zhitong Ointment in Treating Knee Osteoarthritis with Wind-Cold and Dampness

目的:观察宣痹止痛膏治疗风寒湿痹型膝骨性关节炎的临床疗效及初步探讨其作用机制。方法:将100例患者随机分为治疗组50例和对照组50例。治疗组采用宣痹止痛膏;对照组采用双氯芬酸二乙酰乳胶剂外用。治疗4周后观察两组治疗前后疼痛视觉模拟评分(VAS)、活动度、Lequesne指数评分、WOMAC评分变化,并运用肌骨超声观察两组治疗前后膝关节滑膜厚度和关节积液深度,同时抽取治疗前后关节液,采用ELISA法检测IL-1β、TNF-α及CollagenⅡ并进行组间对比。结果:两组治疗后VAS评分、Lequesne指数评分、WOMAC评分较治疗前均降低,差异有统计学意义(P<0.05),活动度较治疗前均增加,差异有统计学意义(P<0.05),且治疗组优于对照组,差异有统计学意义(P<0.05);膝关节滑膜厚度、关节积液深度数值较治疗前均降低,差异有统计学意义(P<0.05),且治疗组优于对照组,差异有统计学意义(P<0.05);关节液中IL-1β、TNF-α含量均降低,差异有统计学意义(P<0.05),CollagenⅡ含量升高,差异有统计学意义(P<0.05),且治疗组优于对照组,差异有统计学意义(P<0.05)。结论:宣痹止痛膏治疗风寒湿痹型膝关节骨性关节炎的临床疗效确切,其作用机制初步可能与降低炎性因子IL-1β、TNF-α,增加CollagenⅡ蛋白的含量,促进关节软骨的增殖修复有关。

Objective:To observe the clinical efficacy of Xuanbi Zhitong ointment on knee osteoarthritis with wind-cold and dampness.Methods:100 patients with this disease were randomly divided into treatment group(50 cases)and control group(50 cases).The treatment group was used Xuanbi Zhitong ointment,the control group was used diclofenac diacetyl emulsion externally.Visual analogue scale(VAS),range of motion,Lequesne index scores and WOMAC scores of both groups were observed before and after treatment.The thickness of synovial membrane of the knee joint and the depth of joint effusion were observed by musculoskeletal ultrasound,and joint fluid was extracted before and after treatment.IL-1β,TNF-α and CollagenⅡ were detected by ELISA and compared between groups.Results:VAS scores,Lequesne index scores and WOMAC scores in the two groups after treatment were lower than those before treatment(P<0.05),and the activity was increased as compared with that before treatment(P<0.05),and the treatment group was superior to the control group(P<0.05).The values of knee joint synovial membrane thickness and joint effusion depth were lower than those before treatment(P<0.05),and the treatment group was superior to the control group(P<0.05).The contents of IL-1β and TNF-α in the joint fluid were decreased(P<0.05),and the content of CollagenⅡ was increased(P<0.05),and the treatment group was superior to the control group(P<0.05).Conclusion:Xuanbi Zhitong ointment has definite clinical efficacy on the treatment of knee osteoarthritis with wind-cold and dampness,and its mechanism may be related to reducing inflammatory factors IL-1β and TNF-α,increasing CollagenⅡ protein content and promoting the proliferation and repair of articular cartilage.