补肾养血方治疗老年膝关节骨关节炎的效果

Effect of Bushen Yangxue prescription on senile knee osteoarthritis

目的观察补肾养血方加减治疗老年膝关节骨关节炎(KOA)的效果。方法选取该院2019年10月至2022年12月收治的106例老年中重度KOA患者为研究对象,根据用药方案分为两组。两组均给予关节镜下清理治疗,对照组术后24h在关节腔内注射玻璃酸钠治疗。养血方组在对照组基础上给予补肾养血方加减治疗,比较两组治疗效果。结果与治疗前比较,两组膝关节伸直活动度治疗后下降,膝关节屈曲活动度治疗后升高,但治疗后无统计学差异(P>0.05)。与治疗前比较,两组血清白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)、CC趋化因子配体18(CCL18)治疗后下降,且养血方组低于对照组(P<0.05);两组血清转化生长因子β1(TGF-β1)治疗后升高,且养血方组高于对照组(P<0.05)。与治疗前比较,两组滑膜厚度、关节腔积液厚度治疗后下降,且养血方组低于对照组(P<0.05);与治疗前比较,两组中医症状积分、视觉模拟(VAS)平分、骨关节炎指数量表(WOMAC)评分治疗后下降,且养血方组低于对照组(P<0.05);两组下肢Fugl-Meyer(FMA)评分治疗后升高,且养血方组高于对照组(P<0.05)。两组不良反应发生率比较,未见统计学差异(P>0.05)。结论补肾养血方加减治疗老年中重度KOA可促进炎症的吸收,改善膝关节活动度,促进膝关节功能恢复。

Objective To observe the effect of Bushen Yangxue prescription on senile knee osteoarthritis(KOA).Methods A total of 106 elderly patients with moderate and severe KOA admitted to our hospital from October 2019 to December 2022 were selected as the study objects and divided into two groups according to medication regimen.Both groups were given arthroscopic cleaning treatment,and the control group was injected with sodium hyaluronate 24 hours after operation.Yangxue prescription group was treated with Bushen Yangxue prescription on the basis of control group,and the therapeutic effect of the two groups was compared.Results Compared with before treatment,knee extension motion decreased after treatment,and knee flexion motion increased after treatment,but there was no statistical difference after treatment(P>0.05).Compared with before treatment,serum interleukin-17(IL-17),tumor necrosis factor-α(TNF-α)and CC chemokine ligand 18(CCL18)in 2 groups were decreased after treatment,and Yangxue prescription group was lower than control group(P<0.05).Serum transforming growth factorβ1(TGF-β1)was increased in both groups after treatment,and Yangxue formula group was higher than control group(P<0.05).Compared with before treatment,the synovial thickness and joint effusion thickness of the two groups decreased after treatment,and the Yangxue prescription group was lower than the control group(P<0.05).Compared with before treatment,TCM symptom score,visual analogue scale(VAS)score and osteoarthritis index scale(WOMAC)score of two groups were decreased after treatment,and Yangxue prescription group was lower than control group(P<0.05).The lower limb Fugl-Meyer(FMA)score of the two groups was increased after treatment,and the Yangxue formula group was higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Bushen Yangxue decoction can promote the absorption of inflammation,improve the motion of knee joint and promote the recovery of knee joint function in the treatment of senile moderate and severe KOA.