治痹汤加减治疗老年膝关节骨性关节炎临床效果

Clinical Effect of Modified Zhibi Decoction(治痹汤加减)on Elderly KOA Patients

目的探讨治痹汤加减治疗老年膝关节骨性关节炎(knee osteoarthritis,KOA)患者的临床效果。方法选取2020年1月—2023年1月在医院治疗的老年KOA患者150例,将患者分为观察组(79例)和对照组(71例),对照组给予常规治疗,观察组在对照组基础上给予中医治痹汤加减治疗,观察两组治疗效果、生存质量等,检测治疗前后血清骨桥蛋白(osteopontin,OPN)、基质金属蛋白酶3(matrix metalloproteinase-3,MMP-3)、葡萄糖-6-磷酸异构酶(glucose-6-phosphate isomerase,GPI)、抗突变型瓜氨酸波形蛋白(anti mutant citrullinated vimentin,MCV)抗体水平。结果观察组治疗疗效优于对照组(P<0.05),其治疗总有效率为96.20%(76/79);观察组治疗后视觉模拟评分(visual analogue scale,VAS)评分和中医证候积分分别为(1.20±0.32)分和(3.40±1.00)分,明显低于对照组(P<0.05),而日本骨科协会(Japanese orthopaedic association,JOA)评分为(84.40±10.21)分,明显高于对照组(P<0.05);观察组治疗后SF-36量表生理机能、生理职能、躯体疼痛、总体健康和精神健康评分分别为(76.39±9.11)分、(80.02±8.81)分、(77.10±10.32)分、(75.50±9.92)分和(80.03±7.91)分,明显高于对照组(P<0.05);观察组治疗后血清OPN、MMP-3、GPI和抗MCV抗体分别为(27.72±6.60)mg/L、(120.01±31.17)mg/L、(0.04±0.01)mg/L和(4.92±1.02)U/mL,明显低于对照组(P<0.05);观察组和对照组不良反应发生率比较差异无统计学意义(P>0.05)。结论中医治痹汤加减治疗老年KOA患者有较好的临床效果,改善患者生存质量,明显降低患者血清OPN、MMP-3、GPI和抗MCV抗体水平。

Objective To investigate the clinical effect of Modified Zhibi Decoction(治痹汤加减)in the treatment of elderly patients with knee osteoarthritis(KOA).Methods A hundred and fifty elderly patients with KOA who were treated in the hospital from January 2020 to January 2023 were selected and divided into observation group(79 cases)and control group(71 cases).The control group was given conventional treatment,and the observation group was treated with Modified Zhibi Decoction on the basis of the control group.The treatment effect and quality of life of the two groups were observed.The serum osteopontin(OPN),matrix metalloproteinase-3(MMP-3),glucose-6-phosphate isomerase(GPI)and anti mutant citrullinated vimentin(MCV)antibodies were detected before and after treatment.Results The curative effect of the observation group was better than that of the control group(P<0.05),and the total effective rate was 96.20%(76/79).The visual analog scale(VAS)score and TCM symptom scores of the observation group after treatment were(1.20±0.32)points and(3.40±1.00)points,respectively,which were significantly lower than those of the control group(P<0.05),while the Japanese Orthopedics Association(JOA)score was(84.40±10.21)points,which was significantly higher than that of the control group(P<0.05).After treatment,the MOS item short from health survey(SF-36)scores of physiological function,role-physical,physical pain,general health and mental health of the observation group were(76.39±9.11)points,(80.02±8.81)points,(77.10±10.32)points,(75.50±9.92)points and(80.03±7.91)points,respectively,which were significantly higher than those of the control group(P<0.05).After treatment,the levels of serum osteopontin(OPN),matrix metalloproteinase-3(MMP-3),glucose-6-phosphate isomerase(GPI)and anti mutant citrullinated vimentin(MCV)antibody in the observation group were(27.72±6.60)mg/L,(120.01±31.17)mg/L,(0.04±0.01)mg/L and(4.92±1.02)U/mL,respectively,which were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions between the observation group and the control group was not statistically significant(P>0.05).Conclusion Modified Zhibi Decoction has better clinical effect in the treatment of elderly patients with KOA,improve the survival treatment and significantly reduce the levels of serum OPN,MMP-3,GPI and anti MCV antibody.