活血消肿汤对膝关节骨性关节炎患者的治疗机制分析

Analysis of Therapeutic Mechanism of Huoxue Xiaozhong Decoction(活血消肿汤)for Patients with Knee Osteoarthritis

目的分析活血消肿汤对膝关节骨性关节炎(knee osteoarthritis,KOA)患者的治疗机制。方法2018年1月-2021年5月该院收治的KOA患者156例随机分为对照组和观察组。对照组采用关节镜下关节清理术进行治疗,术后观察3个月,观察组在对照组的基础上采用活血消肿汤进行治疗,共治疗3个月。统计两组治疗3个月后的疗效,比较两组治疗前和治疗3个月后炎性因子水平、膝关节功能(Lysholm)评分、疼痛及关节活动情况。结果治疗3个月后,观察组总有效率为91.03%(71/78),显著高于对照组(78.21%,61/78),P<0.05。治疗3个月后,两组血沉(ESR)及血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)水平及视觉模拟评分(VAS)低于治疗前,观察组低于对照组(P<0.05)。治疗3个月后,两组Lysholm各项评分高于治疗前,观察组高于对照组(P<0.05)。治疗3个月后,两组关节活动度、最大屈曲度大于治疗前,观察组大于对照组(P<0.05)。结论活血消肿汤联合关节镜下关节清理术治疗KOA患者,可有效缓解膝关节疼痛程度,改善患者膝关节功能,具有较好的治疗效果,或许与其可有效降低患者机体炎症反应有关。

Objective To analyze the mechanism of Huoxue Xiaozhong Decoction(活血消肿汤)combined with arthroscopic debridement in the treatment of patients with knee osteoarthritis(KOA).Methods A total of 156 patients with KOA admitted to the hospital from January 2018 to May 2021 were selected as the research objects,and they were divided into the control group(78 cases)and the observation group(78 cases)by random number table method.The control group was treated with arthroscopic arthrodebridement for 3 months after operation,and the observation group was treated with Huoxue Xiaozhong Decoction on the basis of the control group for 3 months.The curative effect after 3 months of treatment of the two groups was counted,and the levels of inflammatory factors,score of Lysholm,pain and joint activity before and after 3 months of treatment were compared between the two groups.Results After 3 months of treatment,the total effective rate in the observation group(91.03%,71/78)was significantly higher than that(78.21%,61/78)in the control group(P<0.05).After 3 months of treatment,the levels of erythrocyte sedimentation rate(ESR)and the levels of serum hypersensitive C-reactive protein(hs-CRP)and procalcitonin(PCT)and the score of visual analog scale(VAS)in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).After 3 months of treatment,the range of motion and maximum flexion were greater in both groups than those before treatment,and those of the observation group were greater than those of the control group(P<0.05).ConclusionHuoxue Xiaozhong Decoction combined with arthroscopic joint debridement in the treatment of patients with KOA can effectively relieve the degree of pain and improve the knee function,and has a good therapeutic effect,which may be related to the effective reduction of inflammatory response in patients.