小针刀、四妙散加减联合洛索洛芬钠片治疗膝骨性关节炎的疗效

Effect of small needle knife,Simiao powder plus and minus combined with loxolofen sodium tablets on knee osteoarthritis

目的 观察小针刀、四妙散加减联合洛索洛芬钠片治疗膝骨性关节炎(湿热痹阻证)的效果。方法 将本院收治的126例膝骨性关节炎患者按照随机数字表法分为对照组和观察组患者各63例。对照组患者给予洛索洛芬钠片口服治疗,观察组在对照组基础上给予小针刀联合四妙散加减内外合治,2周为1个疗程,连续治疗2个疗程。比较两组治疗方案的临床效果,进行膝关节功能、疼痛程度及骨关节炎指数评价,检测血清中骨代谢指标、炎症相关指标变化。结果 与对照组77.78%(49/63)的有效率进行组间比较,观察组的有效率92.06%(58/63)显著升高(χ^(2)=5.020,P<0.05);与对照组进行组间比较,观察组患者治疗后的膝关节功能改善更明显,HSS评分显著升高,疼痛减轻更明显,VAS评分显著降低,骨关节炎指数WOMAC评分下降更明显(P<0.05);观察组患者治疗后的血清骨代谢BGP、BALP水平显著升高,TRACP-5b、CTX-I水平显著降低(P<0.05);观察组患者治疗后机体炎症减轻更明显,血清中炎症因子IL-1、MMP-13水平显著降低(P<0.05)。结论 小针刀、四妙散加减联合洛索洛芬钠片治疗膝骨性关节炎(湿热痹阻证)的效果确切,在提高膝关节功能、减轻疼痛程度、改善骨关节炎指数等方面有更好的效果,原因可能与改善骨代谢、抗炎作用有关,凸显出中医内外合治骨关节病变的优势,值得进行临床推广。

Objective To observe the effect of small needle knife,addition and subtraction of Simiao powder and loxolofen sodiumtablet in the treatment of knee osteoarthritis(dampness-heat obstruction syndrome).Methods The 126 patients with knee osteo-arthritis in our hospital were divided into control group and observation group with 63 cases each according to the random number table method.Patients in the control group were treated orally with loxolofen sodium tablets,while patients in the observation group were treated with small needle knife combined with Simiao powder plus or minus for internal and external combined treatment on the basis of the control group,2 weeks for 1 course of treatment,and 2 courses of treatment continuously.The clinical effects of the two treatment schemes were compared,the knee joint function,pain degree and osteoarthritis index were evaluated,and changes in serum bone metabolism and inflammation-related indicators were detected.Results Compared with 77.78%(49/63)of the control group,the effective rate of 92.06%(58/63)of the observation group was significantly higher(χ^(2)=5.020,P0.05).Compared with the control group,after treatment,the knee joint function of patients in the observation group improved significantly,HSS score significantly increased,pain relief was more obvious,VAS score significantly decreased,and osteoarthritis index WOMAC score decreased significantly(P0.05).In the observation group,the serum bone metabolism BGP and BALP levels were significantly increased after treatment,while TRACP-5b and CTX-I levels were significantly decreased(P0.05).In the observation group,the body inflammation was significantly reduced after treatment,and the serum levels of inflammatory cytokines IL-1 and MMP-13 were significantly reduced(P0.05).Conclusion The effect of small needle knife,Simiao powder plus and minus combined with loxolofen sodium tablet in the treatment of knee osteoarthritis(dampness-heat obstruction syndrome)is exact,which has better effect on improving knee joint function,reducing pain degree,improving osteoarthritis index and other aspects.The reason may be related to improving bone metabolism and anti-inflammatory effect,highlighting the advantages of internal and external treatment of osteoarthritis in traditional Chinese medicine,which is worthy of clinical promotion.