乌头汤联合双醋瑞因治疗膝关节骨性关节炎寒湿痹阻证37例临床观察

Clinical observation on 37 cases of knee osteoarthritis with blockage due to cold-damp syndrome treated by Wutou Tang(乌头汤) combined with diacerein capsules

目的观察乌头汤联合双醋瑞因治疗膝关节骨性关节炎(KOA)寒湿痹阻证的临床疗效。方法将74例KOA寒湿痹阻证患者按照就诊顺序分为对照组和治疗组,各37例。对照组给予双醋瑞因胶囊治疗,治疗组在对照组治疗方法的基础上给予乌头汤治疗。8周后比较2组的临床疗效、不良反应发生率,以及治疗前后中医证候积分、西安大略和麦克马斯特大学骨关节炎(WOMAC)指数、视觉模拟评分法(VAS)评分。结果对照组总有效率为54.1%(20/37),治疗组为86.5%(32/37),2组比较差异有统计学意义(P<0.05);治疗后2组中医证候积分、WOMAC指数及VAS评分均明显降低,与同组治疗前比较差异有统计学意义(P<0.01),且治疗组降低更明显,与对照组治疗后比较差异均有统计学意义(P<0.01);对照组不良反应发生率为10.81%(4/37),治疗组为8.11%(3/37),2组比较差异无统计学意义(P>0.05)。结论乌头汤联合双醋瑞因可明显改善KOA寒湿痹阻证患者膝关节疼痛、晨僵及功能活动,缓解临床症状,值得临床推广应用。

Objective To observe the clinical efficacy of Wutou Tang(乌头汤)combined with diacerein capsules in the treatment of knee osteoarthritis(KOA)with blockage due to cold-damp syndrome.Methods Seventyfour cases of KOA with blockage due to cold-damp syndrome were divided into control group and treatment group by visiting order,with 37 cases in each group.The control group was given diacerein capsules,on this basis,the treatment group was given Wutou Tang.After 8 weeks,the clinical efficacy,incidence of adverse reactions,along with TCM symptom scores,the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),visual analogue scale(VAS)scores before and after treatment between the 2 groups were compared.Results The total effective rate of the control group was 54.1%(20/37),that of the treatment group was 86.5%(32/37),and the difference was statistically significant between the 2 groups(P<0.05).After treatment,TCM symptom scores,WOMAC and VAS scores of the 2 groups all significantly decreased,and the difference was statistically significant as compared with the same group before treatment(P<0.01),moreover,the decrease was more significant in the treatment group,and the difference was statistically significant as compared with the control group after treatment(P<0.01).The incidence of adverse reactions in the control group was 10.81%(4/37),that of the treatment group was 8.11%(3/37),and the difference was not statistically significant between the 2 groups(P>0.05).Conclusion Wutou Tang combined with diacerein capsules can markedly alleviate knee joint pain,morning stiffness and functional activities in KOA patients with blockage due to cold-damp syndrome,and improve clinical symptoms,which is worthy of further clinical promotion and application.