壮筋养血汤对距骨骨软骨损伤的疗效研究

Research of the therapeutic effect of Zhuangjin Yangxue decoction on osteochondral lesion of the talus

目的探讨壮筋养血汤对Hepple分型Ⅰ、Ⅱ型距骨骨软骨损伤(osteochondral lesion of the talus,OLT)的临床疗效。方法选取2021年2月至2022年12月在杭州市萧山区中医院就诊的62例OLT患者为研究对象,根据随机数字表法将患者分为观察组和对照组,每组各31例。对照组采用常规西药治疗,观察组在对照组基础上联合壮筋养血汤治疗。比较两组患者治疗前后的血清基质金属蛋白酶13(matrix metalloproteinase 13,MMP-13)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、踝关节视觉模拟评分法(visual analogue scale,VAS)评分、美国足踝外科学会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分、中医证候积分及软骨修复组织磁共振观察(magnetic resonance observation of cartilage repair tissue,MOCART)评分。结果治疗后5周、3个月,两组患者的MMP-13、TNF-α、VAS评分、中医证候积分均显著低于本组治疗前,AOFAS踝-后足功能评分、MOCART评分均显著高于本组治疗前(P<0.05);观察组患者的MMP-13、TNF-α、中医证候积分均显著低于对照组,MOCART评分显著高于对照组(P<0.05)。治疗后5周,观察组患者的VAS评分显著低于对照组,AOFAS踝-后足功能评分显著高于对照组(P<0.05)。结论壮筋养血汤治疗Hepple分型Ⅰ、Ⅱ型OLT的近期疗效良好,其具有抗炎镇痛、改善关节功能和促进软骨修复的作用。

Objective To investigate the clinical efficacy of Zhuangjin Yangxue decoction on Hepple stageⅠandⅡof osteochondral lesion of the talus(OLT).Methods From February 2021 to December 2022,a total of 62 cases of OLT were seleted from the Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine.According to random number table method,the patients were divided into observation group and control group,with 31 cases in each group.The control group was treated with Western medicine,and the observation group received an additional treatment of Zhuangjin Yangxue decoction alongside with Western medicine.Serum matrix metalloproteinase 13(MMP-13),tumor necrosis factor-α(TNF-α),ankle visual analogue scale(VAS)score,American Orthopedic Foot and Ankle Society(AOFAS)ankle-hind foot function score,TCM syndrome score and magnetic resonance observation of cartilage repair tissue(MOCART)score before and after treatment were compared between two groups.Results After 5 weeks and 3 months of treatment,MMP-13,TNF-α,VAS score and TCM syndrome score in two groups were significantly lower than before treatment,and AOFAS ankle-hind foot function score and MOCART score were significantly higher than before treatment(P<0.05).MMP-13,TNF-αand TCM syndrome scores in observation group were significantly lower than those in control group,and MOCART score was significantly higher than that in control group(P<0.05).After 5 weeks of treatment,VAS score of observation group was significantly lower than that of control group,and AOFAS ankle-hind foot function score was significantly higher than that of control group(P<0.05).Conclusion Zhuangjin Yangxue decoction shows a good short-term efficacy in treating Hepple stageⅠandⅡof OLT,with anti-inflammatory and analgesic effects,improved joint function,and promotion of cartilage repair.