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[1]沈興潮,宋才淵,呂帥潔,等.膝關節(jié)腔注射外周血干細胞和富血小板血漿聯合口服補腎活血湯治療膝骨關節(jié)炎[J].中醫(yī)正骨,2019,31(06):45-48.
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膝關節(jié)腔注射外周血干細胞和富血小板血漿聯合口服補腎活血湯治療膝骨關節(jié)炎()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數:
2019年06期
頁碼:
45-48
欄目:
臨床報道
出版日期:
2019-06-20

文章信息/Info

作者:
沈興潮1宋才淵2呂帥潔3厲駒3童培建3夏炳江1
(1.紹興市中醫(yī)院,浙江 紹興 312000; 2.杭州市富陽中醫(yī)骨傷醫(yī)院,浙江 杭州 311400; 3.浙江中醫(yī)藥大學附屬第一醫(yī)院,浙江 杭州 310006)
關鍵詞:
骨關節(jié)炎 富血小板血漿 外周血干細胞移植 補腎活血湯
摘要:
目的:觀察膝關節(jié)腔注射外周血干細胞和富血小板血漿(platelet rich plasma,PRP)聯合口服補腎活血湯治療膝骨關節(jié)炎(knee osteoarthritis,KOA)的臨床療效和安全性。方法:2014年 6月至2016年6月收治19例KOA患者。男3例,女16例; 年齡 45~67歲,中位數56歲; 均為單膝病變,左膝9例、右膝10例; 按照Kellgren-Lawrence影像學分級標準,Ⅰ級2例、Ⅱ級9例、Ⅲ級3例、Ⅳ級5例; 中醫(yī)辨證均為肝腎兩虛證; 病程6~36個月,中位數17個月。抽取自體靜脈血制備PRP,采集自體外周血干細胞懸浮液,提純后備用。第1周膝關節(jié)腔內注射10 mL外周血干細胞提純液和5 mL PRP,第2周和第3周分別僅注射5 mL PRP,共注射3次。同時口服補腎活血湯,每天1 劑,連續(xù)服用1個月。分別于治療前及治療開始后1個月、3個月、6個月測定患者的西安大略和麥克馬斯特大學(Western Ontario and McMaster Universities,WOMAC)骨關節(jié)炎指數,并于治療前及治療開始后6個月行膝關節(jié)MRI檢查,應用CaLs軟骨評分系統進行軟骨評分。觀察治療及隨訪過程中不良反應和并發(fā)癥的發(fā)生情況。結果:1例在外周血干細胞采集過程中出現抽搐,要求停止治療; 1例治療期間因外傷致腰椎骨折,停止治療。其余17例患者均完成治療及隨訪觀察,隨訪時間6~12個月,中位數9個月。隨訪過程中無不良反應和并發(fā)癥發(fā)生。17例患者治療前及治療開始后1個月、3個月、6個月的WOMAC骨關節(jié)炎指數分別為(35.18±12.67)分、(19.76±9.29)分、(17.65±11.26)分、(19.71±14.90)分; 治療開始后6個月的CaLs軟骨評分高于治療前[(1.13±0.88)分,(1.43±0.75)分,t=2.553,P=0.023]。結論:膝關節(jié)腔注射外周血干細胞和PRP聯合口服補腎活血湯治療KOA,可有效改善患者的臨床癥狀,修復受損軟骨,而且具有較高的安全性。

參考文獻/References:

[1] 國家中醫(yī)藥管理局醫(yī)政司.22個專業(yè)95個病種中醫(yī)診療方案(合訂本)[M].北京:中國中醫(yī)藥出版社,2012:131-132. [2] PATEL S,DHILLON M S,AGGARWAL S,et al.Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis:a prospective,double-blind,randomized trial[J].Am J Sports Med,2013,41(2):356-364. [3] 蔣協遠,王大偉.骨科臨床療效評價標準[M].北京:人民衛(wèi)生出版社,2005:275-276. [4] ALIZAI H,VIRAYAVANICH W,JOSEPH G B,et al.Cartilage lesion score:comparison of a quantitative assessment score with established semiquantitative MR scoring systems[J].Radiology,2014,271(2):479-487. [5] VAHEDI P,JAROLMASJED S,SHAFAEI H,et al.In vivo articular cartilage regeneration through infrapatellar adipose tissue derived stem cell in nanofiber polycaprolactone scaffold[J].Tissue Cell,2019,57:49-56. [6] SOFIA V,NASRUL E,MANJAS M,et al.The influence of wharton jelly mesenchymal stem cell toward matrix metalloproteinase-13 and RELA synoviocyte gene expression on osteoarthritis[J].Open Access Maced J Med Sci,2019,7(5):701-706. [7] CHAHAL J,GMEZ-ARISTIZBAL A,SHESTOPALOFF K,et al.Bone marrow mesenchymal stromal cells in patients with osteoarthritis results in overall improvement in pain and symptoms and reduces synovial inflammation[J/OL].Stem Cells Transl Med,2019[2019-01-16].https://stemcellsjournals.onlinelibrary.wiley.com/doi/full/10.1002/sctm.18-0183. [8] KHALIFEH SOLTANI S,FOROGH B,AHMADBEIGI N,et al.Safety and efficacy of allogenic placental mesenchymal stem cells for treating knee osteoarthritis:a pilot study[J].Cytotherapy,2019,21(1):54-63. [9] 彭艷.富血小板血漿激活PI3K/AKT/NF<kappa>B信號通路促進骨髓間充質干細胞再生及修復功能的相關研究[D].廣州:南方醫(yī)科大學,2013. [10] 唐曉波,王健,董佩龍.自體富血小板血漿誘導兔脂肪干細胞成軟骨分化的實驗研究[J].中國矯形外科雜志,2014,22(11):1025-1033. [11] 鐘達,廖前德,盧吉平,等.不同體積分數富血小板血漿對犬骨髓間充質干細胞增殖的影響[J].中國組織工程研究與臨床康復,2009,13(49):9727-9730. [12] 劉偉,陳劍,宋佳,等.利用自體富血小板血漿構建凝膠生物細胞支架的實驗研究[J].中國實驗診斷學,2013,17(11):1937-1940. [13] VINOD E,VINOD FRANCIS D,MANICKAM AMIRTHAM S,et al.Allogeneic platelet rich plasma serves as a scaffold for articular cartilage derived chondroprogenitors[J].Tissue Cell,2019,56:107-113. [14] CHEN Y C,HSU Y M,TAN K P,et al.Intraarticular injection for rabbit knee osteoarthritis:effectiveness among hyaluronic acid,platelet-rich plasma,and mesenchymal stem cells[J].Journal of the Taiwan Institute of Chemical Engineers,2018,91:138-145. [15] KOH Y G,KWON O R,KIM Y S,et al.Comparative outcomes of open-wedge high tibial osteotomy with platelet-rich plasma alone or in combination with mesenchymal stem cell treatment:a prospective study[J].Arthroscopy,2014,30(11):1453-1460. [16] 張穎,張蕾蕾,孫瑞波,等.補腎活血法對人骨髓間充質干細胞成骨能力的影響及miR-93-5p對其的抑制作用[J].中華中醫(yī)藥雜志,2018,33(2):667-671. [17] 吳剛,童培建.補腎活血湯含藥血清干預體外培養(yǎng)大鼠骨髓間充質干細胞成軟骨分化及補腎活血湯聯合骨髓間充質干細胞治療大鼠膝骨關節(jié)炎的實驗研究[J].中醫(yī)正骨,2018,30(1):6-11.

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備注/Memo

備注/Memo:
基金項目:浙江省中醫(yī)藥科技計劃項目(2019ZQ016) 通訊作者:童培建 E-mail:[email protected](收稿日期:2019-02-16 本文編輯:李曉樂)
更新日期/Last Update: 1900-01-01