活血利水消肿方内服联合中药外敷治疗膝骨关节炎(湿热痹阻型)疗效观察

Clinical Effect of Huoxue Lishui Xiaotuo Decoction Combined with External Application of Traditional Chinese Medicine in the Treatment of Knee Osteoarthritis(Damp-heat Obstruction Type)

目的:观察活血利水消肿方内服联合中药外敷治疗膝骨关节炎(湿热痹阻型)的临床疗效。方法:选取2023年1月—12月就诊于安徽省中医院的60例膝骨关节炎(湿热痹阻型)患者,随机分为2组,对照组给予塞来希布胶囊口服联合扶他林(双氯芬酸二乙胺乳胶剂)外涂,治疗组给予活血利水消肿方内服联合五味骨疽拔毒散外敷治疗,2组持续治疗4周。分别于治疗前后比较2组患者的临床疗效、膝关节周径、视觉模拟量表(VAS)评分、骨关节炎指数(WOMAC)评分、血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果:治疗组有效率高于对照组,差异有统计学意义。治疗后2组患者患侧膝关节周径、WOMAC评分、VAS评分、血清IL-6水平、血清TNF-α水平均降低且均低于对照组,差异有统计学意义。结论:活血利水消肿方内服联合五味骨疽拔毒散外敷治疗湿热痹阻型膝骨关节炎具有较好的疗效。该治疗方案能有效改善患者膝关节功能,减轻膝关节疼痛,降低炎性因子水平,显著提高患者的生活质量,为中医治疗湿热痹阻型膝骨关节炎提供有利的临床实践经验。

Objective:To observe the clinical efficacy of Huoxue Lishui Xiaozhong prescription combined with external application of Chinese medicine in the treatment of knee osteoarthritis(damp-heat obstruction type).Methods:A total of 60 patients with knee osteoarthritis(damp-heat obstruction type)who visited Anhui Provincial Hospital of Traditional Chinese Medicine from January to December 2023 were randomly divided into two groups.The control group was given oral Celexib capsules combined with external application of Voltaren(diclofenac diethylamine emulsion),and the treatment group was given oral Huoxue Lishui Xiaozhong prescription combined with external application of Wuwei Guju Badu powder.The two groups were treated for 4 weeks.The clinical efficacy,knee joint circumference,visual analog scale(VAS)score,osteoarthritis index(WOMAC)score,serum interleukin 6(IL-6),and tumor necrosis factorα(TNF-α)levels of the two groups were compared before and after treatment.Results:The effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant.After treatment,the knee circumference,WOMAC score,VAS score,serum IL-6 level,and serum TNF-αlevel of the two groups of patients were reduced and lower than those of the control group,with statistically significant differences.Conclusion:Huoxue Lishui Xiaozhong Fang oral administration combined with Wuwei Guju Badu San external application has a good effect in the treatment of damp-heat blockage type knee osteoarthritis.This treatment regimen can effectively improve the patient’s knee joint function,relieve knee joint pain,reduce the level of inflammatory factors,and significantly improve the patient’s quality of life,providing favorable clinical practice experience for the treatment of damp-heat blockage type knee osteoarthritis with traditional Chinese medicine.