补肾蠲痹汤治疗肝肾两虚型膝骨关节炎临床研究

Clinical Study on Bushen Juanbi Decoction for Knee Osteoarthritis of Liver and Kidney Deficiency Type

目的:观察补肾蠲痹汤治疗肝肾两虚型膝骨关节炎的临床疗效。方法:选取2019年3月—2021年3月固始县中医院收治的38例肝肾两虚型膝骨关节炎患者作为研究对象。患者予以补肾蠲痹汤治疗。比较临床疗效及患者治疗前后西安大略和麦克马斯特大学骨关节炎调查量表(WOMAC)评分、36项简明健康调查问卷(SF-36)评分及血清矮小相关转录因子2(RUNX-2)、成纤维细胞生长因子23(FGF-23)、Y染色体性别决定区相关高迁移率组基因9(SOX-9)含量。结果:患者失访1例,脱落1例,最终纳入统计患者36例。治疗后,36例患者中显效12例,有效17例,无效7例,总有效率为80.56%。与治疗前比较,患者治疗后WOMAC评分及血清RUNX-2、FGF-23含量均明显降低(P<0.05),SF-36各维度评分及血清SOX-9含量明显升高(P<0.05)。结论:补肾蠲痹汤治疗肝肾两虚型膝骨关节炎疗效较好,能有效缓解患者临床症状,提高患者生活质量,其作用机制与下调RUNX-2、FGF-23表达,促进SOX-9释放有关。

Objective:To observe the clinical effect of Bushen Juanbi Decoction for knee osteoarthritis of liver and kidney deficiency type.Methods:A total of 38 cases of patients with knee osteoarthritis of liver and kidney deficiency type,who were treated from March 2019 to March 2021 in Gushi County Hospital of Traditional Chinese Medicine,were selected as the study subjects.Patients were treated with Bushen Juanbi Decoction.Before and after treatment,the clinical effect and the scores of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and 36-Item Short Form Health Survey(SF-36),and the contents of Runt-related transcription factor 2(RUNX-2),fibroblast growth factor 23(FGF-23),and sex-determining region Y-related high-mobility group-box 9(SOX-9)in serum were compared.Results:One patient was lost in follow-up,one patient fell off,and 36 patients were finally included in the statistics.After treatment,12 of the 36 patients showed significant difference,17 were effective,and 7 were ineffective,with the total effective rate being 80.56%.Compared with those before treatment,the WOMAC scores and the contents of RUNX-2 and FGF-23 in serum were significantly decreased(P<0.05),and the scores of SF-36 and the contents of SOX-9 in serum were significantly increased(P<0.05).Conclusion:Bushen Juanbi Decoction has a good curative effect in treating knee osteoarthritis of liver and kidney deficiency type,which can effectively relieve the clinical symptoms and improve the quality of life of patients.Its mechanism is related to down-regulating the expression of RUNX-2 and FGF-23 and promoting the release of SOX-9.