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[1]林棟棟,彭力平,肖偉,等.消瘀散軟膏外敷聯(lián)合臭氧關(guān)節(jié)腔注射治療膝骨關(guān)節(jié)炎[J].中醫(yī)正骨,2015,27(03):17-21.
　LIN Dongdong,PENG Liping,XIAO Wei,et al.A combination therapy of external application of Xiaoyu San(消瘀散)ointment and intra-articular injection of ozone for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):17-21.
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消瘀散軟膏外敷聯(lián)合臭氧關(guān)節(jié)腔注射治療膝骨關(guān)節(jié)炎()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年03期
頁碼:
17-21
欄目:
臨床研究
出版日期:
2015-03-30

文章信息/Info

Title:
A combination therapy of external application of Xiaoyu San(消瘀散)ointment and intra-articular injection of ozone for the treatment of knee osteoarthritis
作者:
林棟棟; 彭力平; 肖偉; 徐文銘
廣東省深圳市中醫(yī)院,廣東 深圳 518033
Author(s):
LIN Dongdong; PENG Liping; XIAO Wei; XU Wenming
Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen 518033,Guangdong,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  中藥外敷;  注射; 關(guān)節(jié)內(nèi);  消瘀散;  臭氧
Keywords:
osteoarthritis; knee;  external applications(TCD);  injections; intra-articular;  Xiaoyu San;  ozone
摘要:
目的:探討消瘀散軟膏外敷聯(lián)合臭氧關(guān)節(jié)腔注射治療膝骨關(guān)節(jié)炎的臨床療效和安全性。方法:膝骨關(guān)節(jié)炎患者120例,隨機分為3組,每組40例。聯(lián)合治療組采用消瘀散軟膏外敷聯(lián)合臭氧關(guān)節(jié)腔注射治療,消瘀散組單純采用消瘀散軟膏外敷治療,臭氧組單純采用臭氧關(guān)節(jié)腔注射治療; 共治療3周。分別于治療前、治療1周后及治療3周后采用疼痛視覺模擬評分法(visual analogue scale,VAS)、美國西安大略和麥克馬斯特大學骨關(guān)節(jié)炎指數(shù)評分(the western Ontario and McMaster universities osteoarthritis index,WOMAC)及Lequesne和Mery膝關(guān)節(jié)骨性關(guān)節(jié)炎嚴重度指數(shù)評分,對患膝疼痛及功能情況進行評價; 治療3周后,參照《中藥新藥治療骨性關(guān)節(jié)炎的臨床研究指導原則》療效評定標準評價療效; 并在治療期間觀察有無與治療相關(guān)的不良反應,檢測血、尿常規(guī)及肝腎功能。結(jié)果:治療前后各時間點間患膝VAS評分比較,差異有統(tǒng)計學意義,存在時間效應(F=76.212,P=0.000); 3組患者間患膝VAS評分比較,差異有統(tǒng)計學意義,存在分組效應(F=15.669,P=0.000); 治療前,3組患者間患膝VAS評分比較,差異無統(tǒng)計學意義[(7.81±0.84)分,(8.02±0.71)分,(7.65±0.55)分; F=0.472,P=0.697]; 治療1周后和治療3周后,聯(lián)合治療組患膝VAS評分低于消瘀散組和臭氧組[(3.30±0.45)分,(5.87±0.84)分,(5.73±0.67)分,F=20.033,P=0.000;(1.84±0.84)分,(4.82±0.43)分,(4.23±0.45)分; F=25.210,P=0.000]。時間因素與分組因素存在交互效應(F=43.220,P=0.041)。治療前后各時間點間患膝WOMAC評分比較,差異有統(tǒng)計學意義,存在時間效應(F=28.302,P=0.028); 3組患者間患膝WOMAC評分比較,差異有統(tǒng)計學意義,存在分組效應(F=12.892,P=0.001); 治療前,3組患者間患膝WOMAC評分比較,差異無統(tǒng)計學意義[(141.81±8.22)分,(149.24±14.32)分,(145.56±10.37)分; F=0.750,P=0.493]; 治療1周后和治療3周后,聯(lián)合治療組患膝WOMAC評分低于消瘀散組和臭氧組[(115.21±4.18)分,(128.34±10.37)分,(120.89±12.28)分,F=12.896,P=0.001;(74.17±10.84)分,(97.28±7.91)分,(81.32±12.34)分,F=20.872,P=0.000]; 時間因素和分組因素之間存在交互效應(F=4.698,P=0.006)。治療前后各時間點間患膝Lequesne評分比較,差異有統(tǒng)計學意義,存在時間效應(F=30.302,P=0.031); 3組患者間患膝Lequesne評分比較,差異有統(tǒng)計學意義,存在分組效應(F=8.892,P=0.012); 治療前,3組患者間患膝Lequesne評分比較,差異無統(tǒng)計學意義[(17.94±2.97)分,(16.74±2.68)分,(16.38±2.72)分; F=0.452,P=0.587]; 治療1周后和治療3周后,聯(lián)合治療組患膝Lequesne評分低于消瘀散組和臭氧組[(8.61±3.05)分,(12.28±2.65)分,(10.80±2.68)分,F=5.371,P=0.021;(3.23±1.92)分,(8.68±2.17)分,(5.48±2.39)分; F=4.246,P=0.037]; 時間因素和分組因素之間存在交互效應(F=40.176,P=0.010)。治療3周后,聯(lián)合治療組臨床控制6例、顯效17例、有效16例、無效1例,消瘀散組臨床控制1例、顯效12例、有效21例、無效6例,臭氧組臨床控制2例、顯效11例、有效24例、無效3例,聯(lián)合治療組臨床療效優(yōu)于消瘀散組和臭氧組(R^-聯(lián)合治療組=48.18,R^-消瘀散組=68.30,R^-臭氧組=65.02; χ2=9.281,P=0.010)。3組患者治療期間均未出現(xiàn)皮疹、惡心、嘔吐等不良反應,血、尿常規(guī)及肝腎功能檢查均正常。結(jié)論:消瘀散軟膏外敷聯(lián)合臭氧關(guān)節(jié)腔注射治療膝骨關(guān)節(jié)炎,可有效緩解癥狀、改善關(guān)節(jié)功能,療效優(yōu)于單純消瘀散外敷和單純臭氧注射,且安全可靠。
Abstract:
Objective:To explore the clinical curative effects and safety of external application of Xiaoyu San(消瘀散)ointment combined with intra-articular injection of ozone in the treatment of knee osteoarthritis(KOA).Methods:One hundred and twenty patients with KOA were randomly divided into 3 groups,40 cases in each group.The patients were treated with external application of Xiaoyu San ointment combined with intra-articular injection of ozone(combination therapy group)external application of Xiaoyu San ointment(Xiaoyu San group)and intra-articular injection of ozone(ozone group)respectively for 3 weeks.The pain degree and function of knee were evaluated by using the visual analogue scale(VAS),the western Ontario and McMaster universities osteoarthritis index(WOMAC)and Lequesne and Mery knee osteoarthritis severity index before the treatment and at 1 and 3 weeks after the treatment respectively.The curative effects were evaluated according to the criterion in Guiding principles of clinical research on new Chinese medicine for osteoarthritis.The treatment-related adverse reactions were observed,meanwhile,the blood RT,urine RT,and hepatorenal function were examined.Results:There was statistical difference in knee VAS scores between different time points(F=76.212,P=0.000)and between different groups(F=15.669,P=0.000),in other words,there was time effect and grouping effect.There was no statistical difference in knee VAS scores between the three groups before the treatment(7.81+/-0.84,8.02+/-0.71,7.65+/-0.55 points; F=0.472,P=0.697).The VAS scores were lower in the combination therapy group compared to the Xiaoyu San group and ozone group after 1-week treatment and 3-week treatment(3.30+/-0.45,5.87+/-0.84,5.73+/-0.67 points; F=20.033,P=0.000; 1.84+/-0.84,4.82+/-0.43,4.23+/-0.45 points; F=25.210,P=0.000).There was interaction between time factor and grouping factor(F=43.220,P=0.041).There was statistical difference in knee WOMAC scores between different time points,in other words,there was time effect(F=28.302,P=0.028).There was statistical difference in knee WOMAC scores between the three groups,in other words,there was grouping effect(F=12.892,P=0.001).There was no statistical difference in knee WOMAC scores between the three groups before the treatment(141.81+/-8.22,149.24+/-14.32,145.56+/-10.37 points; F=0.750,P=0.493).The WOMAC scores were lower in the combination therapy group compared to the Xiaoyu San group and ozone group after 1-week treatment and 3-week treatment(115.21+/-4.18,128.34+/-10.37,120.89+/-12.28 points,F=12.896,P=0.001; 74.17+/-10.84,97.28+/-7.91,81.32+/-12.34 points,F=20.872,P=0.000).There was interaction between time factor and grouping factor(F=4.698,P=0.006).There was statistical difference in knee Lequesne scores between different time points,in other words,there was time effect(F=30.302,P=0.031).There was statistical difference in knee Lequesne scores between the three groups,in other words,there was grouping effect(F=8.892,P=0.012).There was no statistical difference in knee Lequesne scores between the three groups before the treatment(17.94+/-2.97,16.74+/-2.68,16.38+/-2.72 points; F=0.452,P=0.587).The Lequesne scores were lower in the combination therapy group compared to the Xiaoyu San group and ozone group after 1-week treatment and 3-week treatment(8.61+/-3.05,12.28+/-2.65,10.80+/-2.68 points,F=5.371,P=0.021; 3.23+/-1.92,8.68+/-2.17,5.48+/-2.39 points; F=4.246,P=0.037).There was interaction between time factor and grouping factor(F=40.176,P=0.010).After 3-week treatment,6 patients were clinical controlled,17 good,16 fair and 1 poor in the combination therapy group; and 1 patients were clinical controlled,12 good,21 fair and 6 poor in the Xiaoyu San group; while 2 patients were clinical controlled,11 good,24 fair and 3 poor in the ozone group.The combination therapy group surpassed the Xiaoyu San group and ozone group in the clinical curative effect(R^-combination therapy group=48.18,R^-Xiaoyu San group=68.30,R^-ozone group=65.02; χ2=9.281,P=0.010).No adverse reactions including skin rash,nausea and vomitingr were found; and the blood RT,urine RT,and hepatorenal function were normal.Conclusion:The combination therapy of external application of Xiaoyu San ointment and intra-articular injection of ozone can effectively relieve the symptoms and improve the knee function in the treatment of KOA,and its curative effect is better than that of monotherapy of external application of Xiaoyu San ointment and intra-articular injection of ozone,and it is safe for treatment of KOA.

參考文獻/References:

[1] 李藝彬,吳昭克,朱勇.針灸治療膝骨性關(guān)節(jié)炎臨床研究現(xiàn)狀[J].中醫(yī)正骨,2013,25(2):74-75.
[2] 高丕明,羅小兵,何栩,等.運動干預防治膝骨關(guān)節(jié)炎的研究進展[J].中醫(yī)正骨,2014,26(9):70-74.
[3] 魏漢賢,許俊榆,吳海斌,等.臭氧關(guān)節(jié)腔內(nèi)注射聯(lián)合充髓通絡湯離子導入治療膝骨關(guān)節(jié)炎[J].中醫(yī)正骨,2014,26(4):70-71.
[4] 王勇堅.振動療法聯(lián)合活血益腎方口服治療膝骨關(guān)節(jié)炎[J].中醫(yī)正骨,2013,25(12):54-55.
[5] Kellgren JH,Lawrence JS.Radiological assessment of osteo-arthrosis[J].Ann Rheum Dis,1957,16(4):494-502.
[6] 倪家驤,樊碧發(fā),薛富善.臨床疼痛治療技術(shù)[M].北京:科學技術(shù)文獻出版社,2003:170.
[7] Bellamy N,Buchanan WW,Goldsmith CH,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J].J Rheumatol,1988,15(12):1833-1840.
[8] 蔣協(xié)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,2005:202-203.
[9] 鄭筱萸.中藥新藥臨床研究指導原則[M].北京:中國醫(yī)藥科技出版社,2002:349-353.
[10] 唐曉棟,樊成虎.消定膏治療膝關(guān)節(jié)骨性關(guān)節(jié)炎臨床觀察[J].亞太傳統(tǒng)醫(yī)藥,2013,9(6):150-151
[11] 孫艷,陳立忠,王海燕,等.增液潤節(jié)湯和美洛昔康片治療膝骨關(guān)節(jié)炎的對比研究[J].中醫(yī)正骨,2014,26(1):21-23.
[12] 彭力平,孫德毅,林松青,等.消瘀散外敷治療急性軟組織損傷的實驗研究[J].中國中醫(yī)骨傷科雜志,2008,16(5):16-18.
[13] 林松青,彭力平.消瘀散治療急性軟組織損傷的臨床療效研究[J].中醫(yī)正骨,2009,21(4):10-11
[14] 王建偉,張亞峰,馬勇,等.關(guān)節(jié)腔內(nèi)低濃度臭氧注射治療膝骨性關(guān)節(jié)炎近期療效觀察[J].遼寧中醫(yī)藥大學學報,2010,12(4):17-19.
[15] 張家富,戰(zhàn)祥青,胡宏偉,等.臭氧聯(lián)合玻璃酸鈉治療膝骨性關(guān)節(jié)炎的療效觀察[J].中國矯形外科雜志,2010,18(5):362-365.

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[18]帥波,沈霖,楊艷萍,等.加味青娥丸治療膝骨關(guān)節(jié)炎的作用機制研究[J].中醫(yī)正骨,2015,27(07):15.
　SHUAI Bo,SHEN Lin,YANG Yanping,et al.Study on the mechanism of action of Jiawei Qing'e Wan(加味青娥丸)for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):15.
[19]梅其杰,袁長深,段戡,等.壯藥骨痹方燙熨聯(lián)合運動療法治療膝骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2015,27(07):27.
　MEI Qijie,YUAN Changshen,DUAN Kan,et al.Clinical study of the curative effect of hot compressing and rubbing with packet of Gubi Fang(骨痹方)combined with exercise therapy in the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):27.
[20]王丹輝,張燕,劉麗娟,等.重組人Ⅱ型腫瘤壞死因子受體-抗體融合蛋白 關(guān)節(jié)腔注射聯(lián)合中藥薰洗治療膝骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2015,27(07):31.
　WANG Danhui,ZHANG Yan,LIU Lijuan,et al.Clinical study on intra-articular injection of TypeⅡrecombinant human tumor necrosis factor receptor-Fc fusion protein combined with Chinese herbal steaming and washing therapy for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):31.

備注/Memo

備注/Memo:
2014-09-29收稿 2014-11-26修回
通訊作者:彭力平 E-mail:[email protected]
更新日期/Last Update: 2015-03-30