脉冲射频联合补肾活血方治疗肾虚血瘀型膝骨性关节炎的临床疗效观察

Clinical observation of pulsed radiofrequency combined with invigorating-kidney activating-blood prescription in the treatment of knee osteoarthritis of kidney deficiency and blood stasis type

目的观察脉冲射频联合补肾活血方治疗肾虚血瘀型膝骨性关节炎(KOA)的临床疗效。方法选取2021年1月至2022年5月天津中医药大学第一附属医院收治的80例肾虚血瘀型KOA患者为研究对象,采用随机数字表法分为对照组和治疗组,每组40例。对照组采用膝关节腔玻璃酸钠注射治疗,治疗组采用脉冲射频联合补肾活血方治疗。比较两组患者临床疗效,治疗前后视觉模拟量表(VAS)评分、西大略和麦克马斯特大学骨关节炎指数评分(WOMAC评分)、奎森肌力指数(Lequesnse指数)和血清炎性因子肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β及超敏C反应蛋白(hs-CRP)变化。结果治疗组总有效率92.50%,高于对照组的82.50%,差异有统计学意义(P<0.05)。治疗后两组患者VAS评分、WOMAC评分和Lequesnse指数,以及TNF-α、IL-1β、hs-CRP水平较治疗前均降低(P<0.05),且治疗组明显低于对照组(P<0.05)。结论脉冲射频联合补肾活血方治疗肾虚血瘀型KOA的临床疗效确切,可改善膝关节功能,降低血清TNF-α、IL-1β、hs-CRP水平。

Objective To observe the clinical efficacy of pulsed radiofrequency combined with invigorating-kidney activating-blood prescription in the treatment of knee osteoarthritis(KOA)with kidney deficiency and blood stasis.Methods A total of 80 patients with KOA of kidney deficiency and blood stasis type admitted to the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2021 to May 2022 were selected as the research objects.They were divided into control group and treatment group by random number table,with 40 cases in each group.The control group was treated with sodium hyaluronate injection in the knee joint cavity,and the treatment group was treated with pulsed radiofrequency combined with invigorating-kidney activating-blood prescription.The clinical efficacy,visual analogue scale(VAS)score,Western Ontario and McMaster University Osteoarthritis Index score(WOMAC score),Lequesnse muscle strength index(Lequesnse index)and serum inflammatory factors tumor necrosis factor(TNF)-α,interleukin(IL)-1βand high-sensitivity C-reactive protein(hs-CRP)were compared between the two groups before and after treatment.Results The total effective rate of the treatment group(92.50%)was higher than that of the control group(82.50%),and the difference was statistically significant(P<0.05).After treatment,the VAS scores,WOMAC score,Lequesnse index,and the levels of TNF-α,IL-1β,and hs-CRP in two groups were sig-nificantly lower than those before treatment(P<0.05),and these indexes in the treatment group were signif-icantly lower than those in the control group(P<0.05).Conclusion Pulsed radiofrequency combined with invigorating-kidney activating-blood prescription has a definite clinical effect on KOA of kidney deficiency and blood stasis type,which can improve knee joint function and reduce serum TNF-α,IL-1β,and hs-CRP levels.