中医外治疗法联合富血小板血浆治疗膝关节骨关节炎的临床观察

Clinical Observation on Traditional Chinese Medicine External Therapy Combined with Platelet Rich Plasma in the Treatment of Knee Osteoarthritis

目的:探讨中医外治疗法联合富血小板血浆(PRP)治疗膝关节骨关节炎的临床效果。方法:使用随机数字表法将2020年1月—2022年5月菏泽市中医医院收治的80例膝关节骨关节炎患者分为观察组及对照组,各40例。对照组行PRP治疗,观察组在对照组基础上加用中医外治疗法。对比两组的治疗总有效率、美国纽约特种外科医院(HSS)膝关节评分、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数、视觉模拟评分法(VAS)、骨代谢指标、血清因子指标。结果:观察组治疗总有效率(95.00%)高于对照组(80.00%),差异有统计学意义(P<0.05)。治疗前,两组HSS膝关节评分、WOMAC骨关节炎指数评分、VAS评分、软骨寡聚基质蛋白(COMP)、骨钙素(OCN)、骨保护素(OPG)、Ⅱ型胶原C端肽(CTX-Ⅱ)、白细胞介素-17(IL-17)、白细胞介素-1β(IL-1β)、沉默信息调节因子1(SIRT1)水平比较,差异均无统计学意义(P>0.05);治疗后,两组的HSS膝关节评分及OCN、OPG、SIRT1水平均升高,观察组均高于对照组,WOMAC、VAS评分及COMP、CTX-Ⅱ、IL-17、IL-1β水平均降低,观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:中医外治疗法联合PRP可有效改善膝关节骨关节炎患者的膝关节功能和骨代谢,减轻炎症反应,调节SIRT1水平,效果显著。

Objective:To investigate the clinical effect of traditional Chinese medicine external therapy combined with platelet rich plasma(PRP)in the treatment of knee osteoarthritis.Method:A total of 80 patients with knee osteoarthritis treated in Heze Hospital of Traditional Chinese Medicine from January 2020 to May 2022 were divided into observation group and control group using random number table method,with 40 cases in each group.The control group was treated with PRP treatment,and the observation group was treated with traditional Chinese medicine external therapy on the basis of the control group.The total effective rate,hospital for special surgery(HSS)knee joint score,Western Ontario and McMaster University(WOMAC),visual analogue score(VAS),bone metabolism indexes and serum factor indexes were compared between the two groups.Result:The total effective rate of the observation group(95.00%)was higher than that of the control group(80.00%),the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in HSS knee joint score,WOMAC osteoarthritis index score,VAS score and the levels of cartilage oligomeric matrix protein(COMP),osteocalcin(OCN),osteoprotegerin(OPG),C-terminal peptide of typeⅡcollagen(CTX-Ⅱ),interleukin-17(IL-17),interleukin-1β(IL-1β)and silence information regulator 1(SIRT1)between the two groups(P>0.05).After treatment,the HSS knee joint scores and the levels of OCN,OPG and SIRT1 in both groups were increased,and those in the observation group were higher than those in the control group,the levels of WOMAC,VAS,COMP,CTX-Ⅱ,IL-17,IL-1βin both groups were decreased,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Traditional Chinese medicine external therapy combined with PRP can effectively improve knee joint function and bone metabolism in patients with knee joint osteoarthritis,reduce inflammatory reaction,and regulate SIRT1 level,with significant effects.