张氏消瘀通络熏条灸法联合百草伤膏外敷治疗膝骨关节炎合并骨髓水肿临床研究

Clinical Study on ZHANG’s Moxibustion Method of Dissipating Blood Stasis to Free Collateral Vessels with Fumigation Medicated Rolls Combined with External Application of Baicaoshang Adhesive Plaster for Knee Osteoarthritis Complicated with Bone Marrow Edem

目的:观察张氏消瘀通络熏条灸法联合百草伤膏外敷治疗膝骨关节炎(KOA)合并骨髓水肿(BME)的临床疗效。方法:选取90例寒湿痹阻型KOA合并BME的患者,按照随机数字表法分为观察组和对照组各45例,对照组口服盐酸氨基葡萄糖胶囊治疗,观察组给予张氏消瘀通络熏条灸法联合百草伤膏外敷治疗。2组均以4周为1个疗程,治疗3个疗程。治疗前后评定中医证候积分、膝关节疼痛视觉模拟评分法(VAS)评分、Lysholm膝关节评分、BME评分,比较2组的临床疗效。结果:治疗3个疗程后,观察组临床疗效总有效率为95.56%,对照组为80.00%,2组比较,差异有统计学意义(P<0.05)。2组中医证候积分、VAS评分、BME评分均较治疗前降低,Lysholm膝关节评分均较治疗前增加,差异均有统计学意义(P<0.05);观察组中医证候积分、VAS评分、BME评分均低于对照组,Lysholm膝关节评分高于对照组,差异均有统计学意义(P<0.05)。结论:张氏消瘀通络熏条灸法联合百草伤膏外敷能显著改善寒湿痹阻型KOA合并BME患者的膝关节症状,还能促进关节水肿吸收,提高膝关节功能。

Objective:To observe the clinical effect of ZHANG’s moxibustion method of dissipating blood stasis to free the collateral vessels with fumigation medicated rolls combined with external application of Baicaoshang Adhesive Plaster on knee osteoarthritis(KOA)complicated with bone marrow edema(BME).Methods:A total of 90 patients with KOA of cold-damp obstruction type complicated with BME were prospectively selected and divided into the observation group and the control group according to the random number table method,with 45 cases in each group.The control group was given Glucosamine Hydrochloride Capsules orally,and the observation group was treated with ZHANG’s moxibustion method of dissipating blood stasis to free the collateral vessels with fumigation medicated rolls combined with external application of Baicaoshang Adhesive Plaster.Both groups were treated for 3 courses,4 weeks being a course.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndromes,Visual Analogue Scale(VAS)of knee joint pain,Lysholm knee joint,and BME were evaluated,and the clinical effects were compared between the two groups.Results:After three courses of treatment,the total clinical effective rate was 95.56% in the observation group and 80.00% in the control group,the difference being significant(P<0.05).The scores of TCM syndromes,VAS,and BME in the two groups were decreased when compared with those before treatment,and the scores of Lysholm knee joint were increased,differences being significant(P<0.05);the scores of traditional Chinese medicine syndromes,VAS,and BME in the observation group were lower than those in the control group,and the score of Lysholm knee was higher than that in the control group,differences being significant(P<0.05).Conclusion:ZHANG’s moxibustion method of dissipating blood stasis to free the collateral vessels with fumigation medicated rolls combined with external application of Baicaoshang Adhesive Plaster can significantly relieve the knee joint pain in patients with KOA of cold-damp obstruction syndrome type complicated with BME,improve the symptoms,promote the absorption of knee joint edema,and enhance the knee joint function.