应用磁共振T2-mapping评价养血柔肝方延缓膝关节软骨退变的研究

Magnetic Resonance T2-mapping Evaluation of Yangxue Rougan R ecipe for Delaying Knee Articular Cartilage Degeneration

目的复方中药防治膝骨关节炎是临床常用的方法,它能减缓关节疼痛、僵硬等症状,但对关节软骨的保护效果仍不明确。磁共振技术中T2mapping成像能对关节软骨进行定量客观的评估,因此本研究应用T2-mapping成像定量评价养血柔肝方延缓早中期膝骨关节炎患者关节软骨退变的疗效。方法符合早中期膝骨关节炎诊断的受试者随机分为2组(A组:养血柔肝方组34名;B组:硫酸氨基葡萄糖组33名)。分别在入组时、第4周、第8周、第12周评估WOMAC评分,入组时及12周后评价受试者膝关节软骨T2值和全膝关节磁共振成像积分(WORMS)。结果养血柔肝方治疗12周后股骨软骨T2值(-1.51ms,P=0.021),髌骨软骨T2值(-3.12ms,P=0.006)均明显下降;反映全膝关节情况的WORMS评分(Z=4.33,P<0.0001)也明显下降。并且与硫酸氨基葡萄糖组相比,养血柔肝方在改善患者WOMAC评分上也有显著效果(A组-7.12 VS B组-3.68,P=0.04)。结论养血柔肝方能较好地改善早中期膝骨关节炎患者疼痛、僵硬等症状,延缓软骨损伤,具有良好的软骨保护作用。

Objective Compound Chinese medicine for prevention and treatment of knee osteoarthritis is a commonly used method in clinical practice.It can relieve symptoms such as joint pain,but the protective effect on articular cartilage is still unclear.Magnetic resonance imaging in T2mapping imaging can quantitatively and objectively evaluate articular cartilage.Therefore,T2-mapping imaging was used to quantitatively evaluate the efficacy of Yangxue Rougan Recipe in delaying articular cartilage degener-ation in patients with knee osteoarthritis.Methods The subjects who met the diagnosis of knee osteoarthritis in the early and mid-dle stages were randomly divided into two groups(group A:34 in Yangxue Rougan prescription group;group B:33 in glu-cosamine sulfate group).The WOMAC scores were evaluated at enrollment,week 4,week 8 and week 12,respectively,and the knee joint cartilage T2 values and total knee magnetic resonance imaging scores(WORMS)were evaluated at the time of enroll-ment and after 12 weeks.Results T2 values of femoral cartilage(-1.51ms,P=0.021)after 12 weeks of treatment with Yan-gxue Rougan R ecipe,T2 values of tibial cartilage(-3.12ms,P=0.006)were significantly decreased;WORMS scores reflec-ting total knee joint condition(Z=4.33,P<0.0001)also decreased significantly.Compared with the glucosamine sulfate group,Yangxue Rougan Recipe also had a significant effect on decreasing the WOMAC score of patients(group A-7.12 VS B group-3.68,P=0.04).Conclusion Yangxue Rougan Recipe can improve the symptoms of pain and other symptoms in pa-tients with knee osteoarthritis in early and middle stages,delay cartilage damage,and has good cartilage protection.