骨痛散治疗膝骨性关节炎临床观察

Clinical Observation on Gutong Powder in the Treatment of Knee Osteoarthritis

目的探讨膝骨性关节炎(KOA)患者应用骨痛散加减的效果。方法纳入2019年6月-2021年12月收治于九江市中医医院的68例KOA患者,采用随机数字表法分为2组,各34例。对照组予以氨基葡萄糖治疗,观察组加用骨痛散加减治疗,均连续治疗4周。对2组临床疗效、中医证候积分、炎症因子水平[白介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)和基质金属蛋白酶-3(MMP-3)]、膝关节功能、血液流变学指标及不良反应进行比较。结果与对照组比,临床总有效率观察组较高,中医证候积分及TNF-α、IL-1β、MMP-3水平观察组较低,僵硬、疼痛、日常活动能力评分及红细胞聚集指数、全血黏度(高切和低切)、血浆黏度观察组较低,差异有统计学意义(P<0.05)。治疗期间2组未见明显不良反应。结论KOA患者应用骨痛散加减治疗可缓解临床症状,降低炎症因子水平,改善膝关节功能,促进血液循环,且具有良好的安全性,值得借鉴。

Objective To investigate the effect of Gutong powder in the treatment of knee osteoarthritis(KOA).Methods A total of 68 KOA patients admitted to Jiujiang Hospital of Traditional Chinese Medicine from June 2019 to December 2021 were enrolled and divided into two groups by random number table method,with 34 cases in each group.The control group was treated with glucosamine hydrochloride capsule,and the observation group was treated with Gutong powder for 4 consecutive weeks.The clinical effect,traditional Chinese medicine(TCM)syndrome score,inflammatory factor levels[interleukin-1β(IL-1β),tumor necrosis factor(TNF-α)and matrix metalloproteinase-3(MMP-3)],knee function,hemorheology indexes and adverse reactions were compared between the two groups.Results Compared with the control group,the total clinical effective rate in the observation group was higher,the TCM syndrome score,TNF-α,IL-1βand MMP-3 levels were lower,the scores of stiffness,pain,daily activity,erythrocyte aggregation index,whole blood viscosity(high and low cut)and plasma viscosity were lower,with statistical difference(P<0.05).During the treatment period,there were no obvious adverse reactions in the two groups.Conciusion The application of modified Gutong powder in KOA patients can relieve clinical symptoms,reduce inflammation,improve knee function and hemorheology,and has good safety,which is worthy of reference.