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[1]喻秋萍,唐萌芽,陳金洪.口服補腎活血方聯(lián)合關(guān)節(jié)腔內(nèi)注射玻璃酸鈉 治療膝骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2016,28(02):23-27.
　YU Qiuping,TANG Mengya,CHEN Jinhong.Clinical study on oral application of Bushen Huoxue Fang(補腎活血方)combined with intra-articular injection of sodium hyaluronate for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(02):23-27.
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口服補腎活血方聯(lián)合關(guān)節(jié)腔內(nèi)注射玻璃酸鈉 治療膝骨關(guān)節(jié)炎的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年02期
頁碼:
23-27
欄目:
臨床研究
出版日期:
2016-02-20

文章信息/Info

Title:
Clinical study on oral application of Bushen Huoxue Fang(補腎活血方)combined with intra-articular injection of sodium hyaluronate for the treatment of knee osteoarthritis
作者:
喻秋萍; 唐萌芽; 陳金洪
浙江省杭州市富陽中醫(yī)骨傷醫(yī)院,浙江 富陽 311400
Author(s):
YU Qiuping; TANG Mengya; CHEN Jinhong
Fuyang TCM Orthopedic-Traumatological Hospital,Fuyang 311400,Zhejiang,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  中藥療法;  注射; 關(guān)節(jié)內(nèi);  透明質(zhì)酸;  治療; 臨床研究性
Keywords:
osteoarthritis; knee;  drug therapy(TCD);  injections; intra-articular;  hyaluronic acid;  therapies; investigational
摘要:
目的:觀察口服補腎活血方聯(lián)合關(guān)節(jié)腔內(nèi)注射玻璃酸鈉治療膝骨關(guān)節(jié)炎的臨床療效。方法:將90例膝骨關(guān)節(jié)炎患者隨機分 為2組,每組45例,分別采用口服補腎活血方聯(lián)合關(guān)節(jié)腔內(nèi)注射玻璃酸鈉、單純關(guān)節(jié)腔內(nèi)注射玻璃酸鈉治療。玻璃酸鈉注射每次2 mL,每周1次; 補腎活血方口服每日1劑; 4周為1個療程,共治療3個療程。分別于治療前及治療3個療程后比較2組患者膝關(guān)節(jié)疼 痛視覺模擬量表(visual analogue scale,VAS)評分、西安大略和麥克馬斯特大學(Western Ontario and McMaster universities,WOMAC)骨關(guān)節(jié)炎指數(shù)量表評分以及白細胞介素-1(interleukin-1,IL-1)、腫瘤壞死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反應蛋白(hypersensitive C-reactive protein,hs-CRP)的血清含量。結(jié)果:①膝關(guān)節(jié)疼痛VAS評分 及WOMAC評分。治療前2組患者膝關(guān)節(jié)疼痛VAS評分及WOMAC評分比較,組間差異均無統(tǒng)計學意義[(4.6±1.7)分, (4.5±1.5)分,t=0.465,P=0.643;(53.1±13.6)分,(52.8±14.8)分,t=0.104,P=0.918]。治療3個療程后,口服補 腎活血方聯(lián)合關(guān)節(jié)腔內(nèi)注射玻璃酸鈉組膝關(guān)節(jié)疼痛VAS評分及WOMAC評分均低于關(guān)節(jié)腔內(nèi)注射玻璃酸鈉組[(1.8±1.1)分, (2.5±1.4)分,t=2.461,P=0.016;(25.0±10.2)分,(32.8±14.1)分,t=3.000,P=0.004],2組患者膝關(guān)節(jié)疼痛VAS評 分及WOMAC評分均低于治療前(t=6.626,P=0.000; t=9.551,P=0.001; t=6.580,P=0.000; t=11.054,P=0.000)。②炎性因子血清 含量。治療前2組患者IL-1、TNF-α、hs-CRP的血清含量比較,組間差異均無統(tǒng)計學意義[(356.8±14.4)μg·g- 1,(360.9±12.7)μg·g-1,t=1.412,P=0.161;(258.9±15.7)pg·mL-1, (260.0±14.1)pg·mL-1,t=0.354,P=0.724;(25.0±2.5)mg·L-1,(24.0±2.5) mg·L-1,t=1.850,P=0.068]。治療3個療程后,口服補腎活血方聯(lián)合關(guān)節(jié)腔內(nèi)注射玻璃酸鈉組IL-1、TNF-α、hs- CRP的血清含量均低于關(guān)節(jié)腔內(nèi)玻璃酸鈉注射組[(286.0±18.1)μg·g-1,(310.4±15.7)μg·g- 1,t=6.831,P=0.000;(166.0±17.8)pg·mL-1,(219.6±15.4)pg·mL- 1,t=15.273,P=0.000;(11.7±2.5)mg·L-1,(18.4±3.0)mg·L-1,t=11.589,P=0.000] 。2組患者IL-1、TNF-α、hs-CRP的血清含量均低于治療前(t=20.525,P=0.000; t=16.729,P=0.000; t=26.270,P=0.000; t=12.980,P=0.000; t=25.277,P=0.000; t=9.560,P=0.000)。結(jié)論:口服補腎活血方聯(lián)合關(guān)節(jié)腔內(nèi)注射玻璃酸鈉可以減輕膝關(guān) 節(jié)炎癥,緩解或消除膝關(guān)節(jié)疼痛,改善膝關(guān)節(jié)功能,其療效優(yōu)于單純關(guān)節(jié)腔內(nèi)注射玻璃酸鈉,值得臨床推廣應用。
Abstract:
Objective:To observe the clinical curative effect of oral application of Bushen Huoxue Fang(補腎活血 方,BSHXF)combined with intra-articular injection of sodium hyaluronate for treatment of knee osteoarthritis (KOA).Methods:Ninety patients with KOA were randomly divided into 2 groups,45 cases in each group,and were treated with intra-articular injection of sodium hyaluronate(2 ml at a time,once a week)combined and non- combined with oral application of BSHXF(one dose at a time)respectively for consecutive three course of treatment,4 weeks for each course.The knee pain visual analogue scale(VAS)scores,Western Ontario and McMaster universities(WOMAC)osteoarthritis index scale scores and the serum contents of interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)and hypersensitive C-reactive protein(hs-CRP)were compared between the 2 groups before treatment and after three-course of treatment respectively.Results:There was no statistical difference in knee pain VAS scores and WOMAC scores between the 2 groups before treatment(4.6+/-1.7 vs 4.5+/-1.5 points,t=0.465,P=0.643; 53.1+/-13.6 vs 52.8+/-14.8 points,t=0.104,P=0.918).The knee pain VAS scores and WOMAC scores were lower in the combination therapy group compared to monotherapy group after three-course of treatment(1.8+/-1.1 vs 2.5+/-1.4 points,t=2.461,P=0.016; 25.0+/-10.2 vs 32.8+/-14.1 points,t=3.000,P=0.004).The knee pain VAS scores and WOMAC scores of the 2 groups were lower after three- course of treatment compared to pre-treatment(t=6.626,P=0.000; t=9.551,P=0.001; t=6.580,P=0.000; t=11.054,P=0.000).There was no statistical difference in the serum contents of IL-1,TNF-α and hs-CRP between the 2 groups before treatment(356.8+/-14.4 vs 360.9+/-12.7 μg/g,t=1.412,P=0.161; 258.9+/-15.7 vs 260.0+/-14.1 pg/ml,t=0.354,P=0.724; 25.0+/-2.5 vs 24.0+/-2.5 mg/L,t=1.850,P=0.068).The serum contents of IL-1,TNF-α and hs-CRP were lower in the combination therapy group compared to monotherapy group after three-course of treatment(286.0+/-18.1 vs 310.4+/-15.7 μg/g,t=6.831,P=0.000; 166.0+/-17.8 vs 219.6+/-15.4 pg/ml,t=15.273,P=0.000; 11.7+/-2.5 vs 18.4+/-3.0 mg/L,t=11.589,P=0.000).The serum contents of IL-1,TNF-α and hs-CRP of the 2 groups were lower after three-course of treatment compared to pre-treatment(t=20.525,P=0.000; t=16.729,P=0.000; t=26.270,P=0.000; t=12.980,P=0.000; t=25.277,P=0.000; t=9.560,P=0.000).Conclusion:Combination of oral application of BSHXF with intra-articular injection of sodium hyaluronate can reduce the knee inflammation and relieve or eliminate the knee pain and improve the knee function.Moreover,it surpasses the monotherapy of intra-articular injection of sodium hyaluronate in the curative effect,so it is worthy of popularizing in clinic.

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更新日期/Last Update: 2016-04-30