富血小板血浆联合膝痹1号方治疗寒湿痹阻型膝骨关节炎临床研究

A Clinical Study of Intra-Articular Injection of Platelet-Rich Plasma Combined with Oral Application of Xibi No.1 Prescription(膝痹1号方)for Treatment of Knee Osteoarthritis with Cold-Dampness Syndrome

目的 观察富血小板血浆(PRP)联合膝痹1号方治疗寒湿痹阻型膝骨关节炎的临床疗效。方法 将90例寒湿痹阻型膝骨关节炎患者随机分为A、B、C组,A组予以PRP关节腔内注射联合膝痹1号方治疗,B组单纯PRP关节腔注射治疗,C组膝痹1号方治疗。于治疗前及治疗1、3、6个月比较3组膝关节疼痛视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数量表评分、Lysholm量表评分、临床疗效。结果 治疗后,三组VAS评分比较,差异有统计学意义(P<0.05);与治疗前比较,三组VAS评分均降低(P<0.05);治疗3、6个月,A组VAS评分均低于B组(P<0.05);治疗6个月,A组VAS评分低于C组(P<0.05)。治疗后,三组WOMAC评分比较,差异有统计学意义(P<0.05);治疗1、3、6个月,A、C组WOMAC评分均低于治疗前(P<0.05),B组治疗6个月WOMAC评分低于治疗前(P<0.05);与B组比较,治疗后3、6个月,A组WOMAC评分均低于B组(P<0.05);与C组比较,治疗3、6个月,A组WOMAC评分均低于同期C组(P<0.05)。治疗后,三组Lysholm评分比较,差异有统计学意义(P<0.05);治疗3、6个月,三组Lysholm评分均高于治疗前(P<0.05);与B组比较,治疗3、6个月,A组Lysholm评分均高于同期B组(P<0.05);与C组比较,治疗3、6个月,A组Lysholm评分均明显高于同期C组(P<0.05)。A组治疗后临床总有效率86.67%,B组总有效率76.67%,C组总有效率73.33%,三组比较,差异有统计学意义(P<0.05)。结论 采用PRP关节腔注射联合膝痹1号方与单纯PRP关节腔注射、膝痹1号方治疗寒湿痹阻型膝骨关节炎,均能缓解膝关节疼痛和促进膝关节功能恢复,但联合治疗的疗效优于单一治疗。

Objective To observe the clinical effect of joint cavity injection of platelet-rich plasma(PRP)combined with Xibi No.1 Prescription(膝痹1号方)in the treatment of knee osteoarthritis with cold-dampness Bi syndrome.Methods Ninety ca-ses of knee osteoarthritis were randomly divided into group A,B and C.Group A was treated with PRP intra-articular injection combined with Xibi No.1 Prescription,group B was treated with PRP intra-articular injection alone and group C was treated with Xibi No.1 Prescription.Visual Analogue Scale(VAS)scores of the knee pain,Western Ontario and McMaster University(WOMAC)Osteoarthritis Index Scale scores and Lysholm scale scores were compared among the three groups before treatment and at 1,3 and 6 months of treatment,and the clinical efficacy was evaluated.Results After treatment,there was a statistically significant difference in VAS scores among the three groups(P<0.05).Compared with those before treatment,the VAS scores of all three groups decreased(P<0.05).After 3 and 6 months of treatment,the VAS scores of Group A were lower than those of Group B(P<0.05).After 6 months of treatment,the VAS score of Group A was lower than that of Group C(P<0.05).After treatment,there was a statistically significant difference in WOMAC scores among the three groups(P<0.05).After 1,3 and 6 months of treatment,the WOMAC scores of group A and C were lower than those before treatment(P<0.05),while the WOMAC scores of group B were lower than those before treatment(P<0.05).Compared with those of Group B,at 3 and 6 months after treatment,the WOMAC score of Group A was lower than that of Group B(P<0.05).Compared with those of Group C,after 3 and 6 months of treatment,the WOMAC score of Group A was lower than that of Group C during the same period(P<0.05).Af-ter treatment,there was a statistically significant difference in Lysholm scores among the three groups(P<0.05).After 3 and 6 months of treatment,the Lysholm scores of all three groups were higher than those before treatment(P<0.05).Compared with those of Group B,after 3 and 6 months of treatment,Group A had higher Lysholm scores than Group B during the same period(P<0.05).Compared with those of Group C,after 3 and 6 months of treatment,the Lysholm scores of Group A were significantly higher than those of Group C during the same period(P<0.05).After treatment,the total clinical effective rate of Group A was 86.67%,of Group B was 76.67%and of Group C was 73.33%.The difference among the three groups was statistically signifi-cant(P<0.05).Conclusion The use of PRP joint cavity injection combined with Xibi No.1 Prescription,as well as simple PRP joint cavity injection and Xibi No.1 Prescription,can alleviate knee joint pain and promote knee joint function recovery in the treatment of cold-dampness obstruction type of knee osteoarthritis.However,the combined treatment is more effective than sin-gle treatment.