活血化瘀止痛贴贴敷疗法联合体外冲击波治疗髌腱炎的临床研究

Clinical Study on the External Application of Huoxue Huayu Zhitong Analgesic Adhesive Plaster Combined with Extracorporeal Shock Wave for the Treatment of Patellar Tendinopathy

【目的】观察中山市中医院院内制剂活血化瘀止痛贴(由延胡索、桃仁、丹参、三七、赤芍、川芎等中药组成)贴敷疗法联合体外冲击波(ESWT)治疗髌腱炎的临床疗效。【方法】将80例髌腱炎患者随机分为治疗组和对照组,每组各40例。2组患者均给予口服非甾体消炎药的常规治疗,在此基础上,对照组给予ESWT治疗,治疗组在对照组的基础上给予活血化瘀止痛贴贴敷治疗,疗程为4周。观察2组患者治疗前后疼痛目测类比评分、维多利亚运动评估研究院髌腱肌腱病量表疼痛评分(VISA-P)和闭目单腿站立时间的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面:治疗4周后,治疗组的总有效率为92.5%(37/40),对照组为72.5%(29/40);组间比较,治疗组的疗效明显优于对照组(P<0.05)。(2)观察指标方面:治疗后,2组患者的疼痛目测类比评分均较治疗前明显降低(P<0.05),VISA-P评分均较治疗前明显升高(P<0.05),闭目单腿站立时间均较治疗前明显延长(P<0.05);组间比较,治疗组对疼痛目测类比评分的降低作用和对VISA-P评分的升高作用以及对闭目单腿站立时间的延长作用均明显优于对照组(P<0.05)。(3)安全性方面:治疗过程中,2组患者均无明显不良反应发生,患者的血、尿、大便常规和肝肾功能等安全性指标也均无异常变化。【结论】活血化瘀止痛贴贴敷疗法联合ESWT治疗髌腱炎效果显著,能够有效缓解疼痛,促进患膝关节功能恢复,其疗效优于单纯ESWT治疗。

Objective To observe the clinical efficacy of the hospital preparation of Huoxue Huayu Zhitong Analgesic Adhesive Plaster(mainly composed of Corydalis Rhizoma,Persicae Semen,Salviae Miltiorrhizae Radix,Notoginseng Radix et Rhizoma,Paeoniae Radix Rubra,and Chuanxiong Rhizoma,with the functions of activating blood,removing blood stasis and relieving pain)in Zhongshan Hospital of Traditional Chinese Medicine combined with extracorporeal shock wave therapy(ESWT)for the treatment of patellar tendinopathy(PT).Methods Eighty patients with PT were randomly divided into the treatment and the control groups,with 40 patients in each group.Both groups of patients were given conventional treatment with oral use of non-steroid antiinflammatory drugs(NSAID).And additionally,the control group was given ESWT,and the treatment group was given external use of Huoxue Huayu Zhitong Analgesic Adhesive Plaster together with ESWT for a period of 4 weeks.The changes in the visual analogue scale(VAS)scores of pain,the pain scores tested by Victorian Institute for Sport Assessment Patellar Tendinopathy Scale(VISA-P)and the time of standing on one leg with eyes closed in the two groups were observed before and after treatment.After treatment,the clinical efficacy and safety of the patients in the two groups were evaluated.Results(1)After 4 weeks of treatment,the overall effective rate of the treatment group was 92.5%(37/40)and that of the control group was 72.5%(29/40).The intergroup comparison showed that the efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(2)After treatment,pain VAS scores were significantly decreased,the VISA-P scores were significantly increased,and the time of standing on one foot with eyes closed was significantly prolonged in both groups as comparised with those before treatment(P<0.05).The intergroup comparison showed that the effects on reducing the pain VAS scores,decreasing VISA-P scores and prolonging the time of standing on one foot with eyes closed in the treatment group were significantly stronger than those in the control group(P<0.05).(3)During the treatment,no adverse actions such as allergy occurred,nor abnormal changes of safety parameters of routine test of blood,urine and stool or liver and kidney function examination were found in the two groups.Conclusion The combination of external application of Huoxue Huayu Zhitong Analgesic Adhesive Plaster with ESWT is effective in treating PT by effectively relieving pain and promoting functional recovery of the affected knee,and its efficacy is superior to that of the ESWT alone.