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[1]林濤,郭艷幸,吳麗芳,等.三伏貼聯(lián)合醫(yī)用臭氧膝關(guān)節(jié)腔注射治療膝骨關(guān)節(jié)炎陽虛寒凝證[J].中醫(yī)正骨,2019,31(02):22-25.
　LIN Tao,GUO Yanxing,WU Lifang,et al.External application of dog-days strapping combined with knee intra-articular injection of medical ozone for treatment of knee osteoarthritis with yang-deficiency and cold-congelation syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(02):22-25.
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三伏貼聯(lián)合醫(yī)用臭氧膝關(guān)節(jié)腔注射治療膝骨關(guān)節(jié)炎陽虛寒凝證()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年02期
頁碼:
22-25
欄目:
臨床研究
出版日期:
2019-02-20

文章信息/Info

Title:
External application of dog-days strapping combined with knee intra-articular injection of medical ozone for treatment of knee osteoarthritis with yang-deficiency and cold-congelation syndrome
作者:
林濤1; 郭艷幸2; 吳麗芳1; 吳超英1; 鄭梓灌1
(1.廈門醫(yī)學(xué)院附屬第二醫(yī)院,福建 廈門 361021; 2.河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽 471002)
Author(s):
LIN Tao1; GUO Yanxing2; WU Lifang1; WU Chaoying1; ZHENG Ziguan1
1.The Second Affiliated Hospital of Xiamen Medical College,Xiamen 361021,Fujian,China 2.Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  穴位貼敷法;  臭氧;  注射; 關(guān)節(jié)內(nèi)
Keywords:
osteoarthritis; knee;  acupoint sticking therapy;  ozone;  injections; intra-articular
摘要:
目的:探討三伏貼聯(lián)合醫(yī)用臭氧膝關(guān)節(jié)腔注射治療膝骨關(guān)節(jié)炎陽虛寒凝證的臨床療效。方法:納入膝骨關(guān)節(jié)炎陽虛寒凝證患者40例,隨機(jī)分為三伏貼聯(lián)合醫(yī)用臭氧組和塞來昔布聯(lián)合鹽酸氨基葡萄糖組,每組20例。三伏貼聯(lián)合醫(yī)用臭氧組,采用生白芥子、延胡索、甘遂、細(xì)辛、麝香、冰片、附子制成藥餅貼敷內(nèi)風(fēng)市、膝髎、膝海等穴,在初伏、中伏、末伏日分別貼敷1次,每次4～6 h,共貼3次; 并于初伏日前10 d至末伏日后10 d內(nèi),每周行醫(yī)用臭氧膝關(guān)節(jié)腔注射2次,共注射10次。塞來昔布聯(lián)合鹽酸氨基葡萄糖組,采用塞來昔布片和鹽酸氨基葡萄糖膠囊口服,每日2次,共服5周。治療期間2組患者均行康復(fù)功能鍛煉。分別于治療前和治療結(jié)束后,采用酶聯(lián)免疫吸附法檢測患膝關(guān)節(jié)液中腫瘤壞死因子-α(tumor necrosis factor-α,TNF-α)含量,采用疼痛視覺模擬量表(visual analogue scale,VAS)評分評價患膝疼痛情況,采用改良Lysholm膝關(guān)節(jié)評分標(biāo)準(zhǔn)評價患膝功能。結(jié)果:治療前2組患者患膝關(guān)節(jié)液中TNF-α含量、患膝疼痛VAS評分、患膝功能Lysholm評分比較,組間差異均無統(tǒng)計學(xué)意義[(89.51±11.76)μg·L-1,(87.48±10.61)μg·L-1,t=0.573,P=0.570;(7.52±0.56)分,(7.48±0.61)分,t=0.216,P=0.830;(74.62±7.38)分,(75.04±7.52)分,t=0.178,P=0.859]; 治療結(jié)束后,三伏貼聯(lián)合醫(yī)用臭氧組患膝關(guān)節(jié)液中TNF-α含量和患膝疼痛VAS評分低于塞來昔布聯(lián)合鹽酸氨基葡萄糖組,患膝功能Lysholm評分高于塞來昔布聯(lián)合鹽酸氨基葡萄糖組[(41.83±7.85)μg·L-1,(64.42±8.32)μg·L-1,t=8.832,P=0.000;(2.10±0.25)分,(4.02±0.32)分,t=21.145,P=0.000;(88.64±8.35)分,(82.12±8.28)分,t=2.480,P=0.018]。結(jié)論:對于膝骨關(guān)節(jié)炎陽虛寒凝證,采用三伏貼聯(lián)合醫(yī)用臭氧膝關(guān)節(jié)腔注射治療和采用塞來昔布片聯(lián)合鹽酸氨基葡萄糖膠囊口服治療,均能降低患膝關(guān)節(jié)液中TNF-α含量、緩解患膝疼痛、改善患膝功能,且前者療效優(yōu)于后者。
Abstract:
Objective:To explore the clinical curative effects of dog-days strapping combined with intra-articular injection of medical ozone for treatment of knee osteoarthritis(KOA)with yang-deficiency and cold-coagulation syndrome.Methods:Forty patients with yang-deficiency and cold-coagulation type KOA were enrolled in the study and were randomly divided into group A and group B,20 cases in each group.The patients in group A were treated with medical cakes made of raw white mustard seed,rhizoma corydalis,kansui root,asarum,musk,borneol and radix aconiti carmichaeli at the acupoints including Neifengshi(內(nèi)風(fēng)市),Xiliao(膝髎)and Xihai(膝海)on the 1st,2nd and last dog-day in summer respectively for consecutive 3 times,4-6 hours at a time.Moreover,the knee intra-articular injections of medical ozone were performed on patients in group A from the 10th day before the 1st dog-day to the 10th day after the last dog-day,twice a week for 10 times.The patients in group B were treated with oral applications of celecoxib tablets and glucosamine hydrochloride capsules,twice a day for consecutive 5 weeks.The functional rehabilitation exercises were performed on all patients in the 2 groups during the treatment period.The content of tumor necrosis factor-α(TNF-α)in knee synovial fluid was detected by using enzyme linked immunosorbent assay(ELISA),and the knee pain and knee function were evaluated by using visual analogue scale(VAS)and modified Lysholm knee scoring standards respectively before the treatment and after the end of the treatment.Results:There was no statistical difference in the content of TNF-α in knee synovial fluid,knee pain VAS scores and Lysholm knee function scores between the 2 groups before the treatment(89.51+/-11.76 vs 87.48+/-10.61 μg/L,t=0.573,P=0.570; 7.52+/-0.56 vs 7.48+/-0.61 points,t=0.216,P=0.830; 74.62+/-7.38 vs 75.04+/-7.52 points,t=0.178,P=0.859).The content of TNF-α in knee synovial fluid and the knee pain VAS scores were lower,and the Lysholm knee function scores were higher in group A compared to group B after the end of the treatment(41.83+/-7.85 vs 64.42+/-8.32 μg/L,t=8.832,P=0.000; 2.10+/-0.25 vs 4.02+/-0.32 points,t=21.145,P=0.000; 88.64+/-8.35 vs 82.12+/-8.28 points,t=2.480,P=0.018).Conclusion:For patients with yang-deficiency and cold-coagulation type KOA,both combination therapy of external application of dog-days strapping and knee intra-articular injection of medical ozone and combination therapy of oral applications of celecoxib tablets and glucosamine hydrochloride capsules can reduce the content of TNF-α in knee synovial fluid,relieve knee pain and improve knee function,moreover,the former surpasses the latter in clinical curative effects.

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備注/Memo

備注/Memo:
基金項目:廈門醫(yī)學(xué)院自然科學(xué)研究項目(K2015-01)(收稿日期:2018-11-30 本文編輯:楊雅)
更新日期/Last Update: 2019-02-20