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[1]郭會利,葉艷君,李盼盼,等.云克靜脈滴注聯(lián)合活血通絡(luò)方口服治療 距骨骨軟骨損傷的臨床研究[J].中醫(yī)正骨,2016,28(03):9-13.
　GUO Huili,YE Yanjun,LI Panpan,et al.Clinical study on intravenous drip of Yunke(云克)combined with oral application of Huoxue Tongluo Fang(活血通絡(luò)方)for treatment of talar osteochondral injury[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(03):9-13.
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云克靜脈滴注聯(lián)合活血通絡(luò)方口服治療 距骨骨軟骨損傷的臨床研究()
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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03期
頁碼:
9-13
欄目:
臨床研究
出版日期:
2016-03-20

文章信息/Info

Title:
Clinical study on intravenous drip of Yunke(云克)combined with oral application of Huoxue Tongluo Fang(活血通絡(luò)方)for treatment of talar osteochondral injury
作者:
郭會利; 葉艷君; 李盼盼; 郭樹農(nóng); 王軍輝; 郭水潔
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):
GUO Huili; YE Yanjun; LI Panpan; GUO Shunong; WANG Junhui; GUO Shuijie
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關(guān)鍵詞:
距骨;  踝關(guān)節(jié);  锝;  亞甲基二膦酸鹽;  中藥療法;  體層攝影術(shù); 發(fā)射型計算機; 單光子;  體層攝影術(shù); X線計算機;  圖像融合;  治療; 臨床研究性
Keywords:
talus;  ankle joint;  technetium;  methylenediphosphonate;  drug therapy(TCD);  tomography; emission-computed; single-photon;  tomography; X-ray computed;  image fusion;  therapies; investigational
摘要:
目的:觀察云克靜脈滴注聯(lián)合自擬活血通絡(luò)方口服治療距骨骨軟骨損傷的臨床療效。方法:將75例距骨骨軟骨損傷患者隨機分為3組,每組25例,分別采用單純靜脈滴注云克、單純口服自擬活血通絡(luò)方及云克靜脈滴注聯(lián)合自擬活血通絡(luò)方口服治療。云克注射液靜脈滴注每日1次,每分鐘40滴,連續(xù)治療30 d; 自擬活血通絡(luò)方口服每日1劑,連續(xù)口服30 d。治療結(jié)束后6個月采用自擬影像學(xué)評價標(biāo)準(zhǔn)、美國足與踝關(guān)節(jié)外科協(xié)會(American orthopaedic foot and ankle society,AOFAS)踝與后足功能評分標(biāo)準(zhǔn)及疼痛數(shù)字評價量表(numerical rating scale,NRS)評分法評定3組患者的臨床療效。結(jié)果:①踝關(guān)節(jié)NRS疼痛評分結(jié)果。治療前3組患者踝關(guān)節(jié)NRS疼痛評分比較,差異無統(tǒng)計學(xué)意義[(3.000±0.577)分,(3.160±0.624)分,(3.080±0.759)分,F=0.369,P=0.693]。治療結(jié)束后6個月,3組患者踝關(guān)節(jié)NRS疼痛評分比較,差異有統(tǒng)計學(xué)意義[(1.120±0.332)分,(1.640±0.757)分,(1.680±0.690)分,F=6.310,P=0.003]; 云克聯(lián)合活血通絡(luò)方組踝關(guān)節(jié)NRS疼痛評分低于云克組和活血通絡(luò)方組(P=0.004,P=0.002); 云克組與活血通絡(luò)方組比較,差異無統(tǒng)計學(xué)意義(P=0.821)。②踝關(guān)節(jié)AOFAS功能評分結(jié)果。云克聯(lián)合活血通絡(luò)方組1例患者自行退出試驗。治療結(jié)束后6個月,活血通絡(luò)方組顯效7例,有效10例,無效8例; 云克組顯效9例,有效10例,無效6例; 云克聯(lián)合活血通絡(luò)方組顯效15例,有效6例,無效3例。3組患者踝關(guān)節(jié)AOFAS功能評分比較,差異有統(tǒng)計學(xué)意義(χ2=6.316,P=0.043); 進(jìn)一步兩兩比較(校正α'=0.025),云克聯(lián)合活血通絡(luò)方組優(yōu)于活血通絡(luò)方組(u=162.000,P=0.003); 云克組與云克聯(lián)合活血通絡(luò)方組、活血通絡(luò)方組比較,差異均無統(tǒng)計學(xué)意義(u=218.000,P=0.045; u=251.000,P=0.232)。③影像學(xué)評價結(jié)果。3組均有患者拒絕影像學(xué)檢查,其中活血通絡(luò)方組2例、云克組2例、云克聯(lián)合活血通絡(luò)方組1例。治療結(jié)束后6個月,活血通絡(luò)方組顯效4例,有效10例,無效9例; 云克組顯效6例,有效9例,無效8例; 云克聯(lián)合活血通絡(luò)方組顯效11例,有效10例,無效3例。3組患者影像學(xué)評價結(jié)果比較,差異有統(tǒng)計學(xué)意義(χ2=6.588,P=0.037); 進(jìn)一步兩兩比較(校正α'=0.025),云克聯(lián)合活血通絡(luò)方組優(yōu)于活血通絡(luò)方組(u=99.000,P=0.018); 云克組與云克聯(lián)合活血通絡(luò)方組、活血通絡(luò)方組比較,差異均無統(tǒng)計學(xué)意義(u=113.500,P=0.033; u=195.500,P=0.513)。結(jié)論:云克靜脈滴注聯(lián)合自擬活血通絡(luò)方口服,能夠緩解踝關(guān)節(jié)疼痛,改善踝關(guān)節(jié)功能,其綜合療效優(yōu)于單純口服自擬活血通絡(luò)方,在緩解踝關(guān)節(jié)疼痛方面優(yōu)于單純靜脈滴注云克和單純口服自擬活血通絡(luò)方,值得臨床推廣應(yīng)用。
Abstract:
Objective:To observe the clinical curative effects of intravenous drip of Yunke(云克)combined with oral application of Huoxue Tongluo Fang(活血通絡(luò)方,HXTLF)in the treatment of talar osteochondral injury.Methods:Seventy-five patients with talar osteochondral injury were randomly divided into 3 groups,25 cases in each group.The patients were treated with intravenous drip of Yunke(Yunke group,once a day for consecutive 30 days),oral application of self-made HXTLF(HXTLF group,one dose a day for consecutive 30 days)and combination therapy of intravenous drip of Yunke and oral application of self-made HXTLF(combination therapy group)respectively.The clinical curative effects were evaluated and compared between the 3 groups at 6 months after the end of the treatment by using self-designed radiographic evaluation criterion,ankle-hindfoot scale made by American orthopaedic foot and ankle society(AOFAS)and pain numerical rating scale(NRS).Results:There was no statistical difference in ankle NRS pain scores between the 3 groups before treatment(3.000+/-0.577,3.160+/-0.624,3.080+/-0.759 points,F=0.369,P=0.693).There was statistical difference in ankle NRS pain scores between the 3 groups at 6 months after the end of the treatment(1.120+/-0.332,1.640+/-0.757,1.680+/-0.690 points,F=6.310,P=0.003).The ankle NRS pain scores were lower in combination therapy group compared to Yunke group and HXTLF group(P=0.004,P=0.0020).There was no statistical difference in ankle NRS pain scores between Yunke group and HXTLF group(P=0.821).One patient dropped out in combination therapy group.Seven patients got a good result,10 fair and 8 poor in HXTLF group; 9 patients got a good result,10 fair and 6 poor in Yunke group; while 15 patients got a good result,6 fair and 3 poor in combination therapy group at 6 months after the end of the treatment.There was statistical difference in AOFAS ankle function scores between the 3 groups(χ2=6.316,P=0.043).Further pairwise comparison(α'=0.025)showed that combination therapy group surpassed HXTLF group(u=162.000,P=0.003)and there was no statistical difference between Yunke group and combination therapy group(u=218.000,P=0.045)and between Yunke group and HXTLF group(u=251.000,P=0.232)in AOFAS ankle function scores.Five patients refused radiographic examination.At 6 months after the end of the treatment,4 patients got a good result,10 fair and 9 poor in HXTLF group; 6 patients got a good result,9 fair and 8 poor in Yunke group; while 11 patients got a good result,10 fair and 3 poor in combination therapy group.There was statistical difference in radiographic evaluation results between the 3 groups(χ2=6.588,P=0.037).Further pairwise comparison(α'=0.025)showed that combination therapy group surpassed HXTLF group(u=99.000,P=0.018)and there was no statistical difference between Yunke group and combination therapy group(u=113.500,P=0.033)and between Yunke group and HXTLF group(u=195.500,P=0.513).Conclusion:Intravenous drip of Yunke combined with oral application of self-made HXTLF can relieve the ankle pain and improve the ankle function,and its comprehensive curative effect is better than that of monotherapy of oral application of self-made HXTLF,and it also surpasses the monotherapy of intravenous drip of Yunke and the monotherapy of oral application of self-made HXTLF in relieving ankle pain,so it is worthy of popularizing in clinic.

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備注/Memo

備注/Memo:
基金項目:河南省中醫(yī)藥科學(xué)研究專項課題(2013ZY02046)
更新日期/Last Update: 2016-03-30