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[1]方亮,董睿,金紅婷,等.富血小板血漿關(guān)節(jié)腔注射聯(lián)合補(bǔ)腎活血方口服治療膝骨關(guān)節(jié)炎肝腎虧虛證的臨床研究[J].中醫(yī)正骨,2018,30(11):1-5,12.
　FANG Liang,DONG Rui,JIN Hongting,et al.A clinical study of intra-articular injection of platelet-rich plasma combined with oral application of Bushen Huoxue Fang(補(bǔ)腎活血方)for treatment of knee osteoarthritis with liver-kidney deficiency syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(11):1-5,12.
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富血小板血漿關(guān)節(jié)腔注射聯(lián)合補(bǔ)腎活血方口服治療膝骨關(guān)節(jié)炎肝腎虧虛證的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年11期
頁碼:
1-5,12
欄目:
臨床研究
出版日期:
2018-11-20

文章信息/Info

Title:
A clinical study of intra-articular injection of platelet-rich plasma combined with oral application of Bushen Huoxue Fang(補(bǔ)腎活血方)for treatment of knee osteoarthritis with liver-kidney deficiency syndrome
作者:
方亮1; 董睿1; 金紅婷1; 童培建2; 肖魯偉1
(1.浙江中醫(yī)藥大學(xué),浙江 杭州 310053; 2.浙江中醫(yī)藥大學(xué)附屬第一醫(yī)院,浙江 杭州 310006)
Author(s):
FANG Liang1; DONG Rui1; JIN Hongting1; TONG Peijian2; XIAO Luwei1
1.Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China; 2.The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310006,Zhejiang,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  肝腎虧虛;  補(bǔ)腎活血方;  富血小板血漿;  注射; 關(guān)節(jié)內(nèi);  臨床試驗(yàn)
Keywords:
osteoarthritis; knee;  liver-kidney deficiency;  Bushen Huoxue Fang;  platelet-rich plasma;  injections; intra-articular; clinical trial
摘要:
目的:觀察富血小板血漿(platelet-rich plasma,PRP)關(guān)節(jié)腔注射聯(lián)合補(bǔ)腎活血方口服治療膝骨關(guān)節(jié)炎肝腎虧虛證的臨床療效。方法:將符合要求的75例膝骨關(guān)節(jié)炎肝腎虧虛證患者隨機(jī)分為2組,分別采用PRP關(guān)節(jié)腔注射聯(lián)合補(bǔ)腎活血方口服治療(聯(lián)合治療組40例)和單純PRP關(guān)節(jié)腔注射治療(單純關(guān)節(jié)腔注射組35例)。PRP關(guān)節(jié)腔注射每周1次,連續(xù)注射3次為1個(gè)療程,休息1周后繼續(xù)下1個(gè)療程,共3個(gè)療程; 補(bǔ)腎活血方水煎服,每日1劑,早晚2次服用,連續(xù)服用12周。分別于治療前及治療開始后1個(gè)月、3個(gè)月、6個(gè)月,比較2組患者膝關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分和西安大略和麥克馬斯特大學(xué)(Western Ontario and McMaster universities,WOMAC)骨關(guān)節(jié)炎指數(shù)量表評分。結(jié)果:①膝關(guān)節(jié)疼痛VAS 評分。時(shí)間因素和分組因素存在交互效應(yīng)(F=13.328,P=0.000); 2組患者膝關(guān)節(jié)疼痛VAS評分比較,差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=60.715,P=0.000); 2組患者治療前后不同時(shí)間點(diǎn)膝關(guān)節(jié)疼痛VAS評分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=222.014,P=0.000); 2組患者膝關(guān)節(jié)疼痛VAS評分隨時(shí)間均呈下降趨勢,但2組的下降趨勢不完全一致[(4.77±0.85)分,(2.19±0.47)分,(1.72±0.41)分,(2.51±0.35)分,F=236.155,P=0.000;(4.47±0.72)分,(3.12±0.67)分,(2.33±0.75)分,(3.25±0.60)分,F=57.475,P=0.000]; 治療前,2組患者的膝關(guān)節(jié)疼痛VAS評分比較,差異無統(tǒng)計(jì)學(xué)意義(t=1.605,P=0.113); 治療開始后1個(gè)月、3個(gè)月、6個(gè)月,聯(lián)合治療組的膝關(guān)節(jié)疼痛VAS評分均低于單純關(guān)節(jié)腔注射組(t=6.996,P=0.000; t=4.526,P=0.000; t=6.547,P=0.000)。②WOMAC骨關(guān)節(jié)炎指數(shù)量表評分。時(shí)間因素和分組因素存在交互效應(yīng)(F=3.013,P=0.031); 2組患者WOMAC骨關(guān)節(jié)炎指數(shù)量表評分比較,差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=1.918,P=0.017); 2組患者治療前后不同時(shí)間點(diǎn)WOMAC骨關(guān)節(jié)炎指數(shù)量表評分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=152.186,P=0.000); 2組患者WOMAC骨關(guān)節(jié)炎指數(shù)量表評分隨時(shí)間均呈下降趨勢,但2組的下降趨勢不完全一致[(35.68±7.53)分,(22.23±5.16)分,(16.35±3.07)分,(22.25±3.91)分,F=99.261,P=0.000;(34.22±7.20)分,(22.14±5.56)分,(18.37±4.45)分,(25.47±4.51)分,F=52.156,P=0.000]; 治療前和治療開始后1個(gè)月,2組患者的WOMAC骨關(guān)節(jié)炎指數(shù)量表評分比較,組間差異均無統(tǒng)計(jì)學(xué)意義(t=0.850,P=0.398; t=0.064,P=0.949); 治療開始后3個(gè)月、6個(gè)月,聯(lián)合治療組的WOMAC骨關(guān)節(jié)炎指數(shù)量表評分均低于單純關(guān)節(jié)腔注射組(t=2.309,P=0.024; t=3.318,P=0.001)。結(jié)論:采用PRP關(guān)節(jié)腔注射聯(lián)合補(bǔ)腎活血方口服與單純PRP關(guān)節(jié)腔注射治療膝骨關(guān)節(jié)炎肝腎虧虛證,均能緩解膝關(guān)節(jié)疼痛和促進(jìn)膝關(guān)節(jié)功能恢復(fù),但前者的療效優(yōu)于后者。
Abstract:
Objective:To observe the clinical curative effects of intra-articular injection of platelet-rich plasma(PRP)combined with oral application of Bushen Huoxue Fang(補(bǔ)腎活血方,BSHXF)for treatment of knee osteoarthritis(KOA)with liver-kidney deficiency syndrome.Methods:Seventy-five patients with liver-kidney deficiency type KOA were randomly divided into combination therapy group(40 cases)and monotherapy group(35 cases),and were treated with combination therapy of intra-articular injection of PRP and oral application of BSHXF and monotherapy of intra-articular injection of PRP respectively.The intra-articular injection of PRP were performed on the patients once a week for consecutive 3 courses of treatment,consecutive 3 times for each course with a 1-week rest-insertion between courses.The BSHXF decoctions were taken one dose a day in the morning and evening respectively for consecutive 12 weeks.The knee pain visual analogue scale(VAS)scores and the Western Ontario and McMaster universities(WOMAC)osteoarthritis index scores were compared between the 2 groups before treatment and at 1,3 and 6 months after the beginning of the treatment respectively.Results:There was interaction between time factor and group factor in knee pain VAS scores(F=13.328,P=0.000).There was statistical difference in knee pain VAS scores between the 2 groups,in other words,there was group effect(F=60.715,P=0.000).There was statistical difference in knee pain VAS scores between different timepoints before and after the treatment,in other words,there was time effect(F=222.014,P=0.000).The knee pain VAS scores presented a time-dependent decreasing trend in the 2 groups,while the 2 groups were inconsistent with each other in the decreasing trend of knee pain VAS scores(4.77+/-0.85,2.19+/-0.47,1.72+/-0.41,2.51+/-0.35 points,F=236.155,P=0.000; 4.47+/-0.72,3.12+/-0.67,2.33+/-0.75,3.25+/-0.60 points,F=57.475,P=0.000).There was no statistical difference in knee pain VAS scores between the 2 groups before treatment(t=1.605,P=0.113).The knee pain VAS scores were lower in combination therapy group compared to monotherapy group at 1,3 and 6 months after the beginning of the treatment(t=6.996,P=0.000; t=4.526,P=0.000; t=6.547,P=0.000).There was interaction between time factor and group factor in WOMAC osteoarthritis index scores(F=3.013,P=0.031).There was statistical difference in WOMAC osteoarthritis index scores between the 2 groups,in other words,there was group effect(F=1.918,P=0.017).There was statistical difference in WOMAC osteoarthritis index scores between different timepoints before and after the treatment,in other words,there was time effect(F=152.186,P=0.000).The WOMAC osteoarthritis index scores presented a time-dependent decreasing trend in the 2 groups,while the 2 groups were inconsistent with each other in the decreasing trend of WOMAC osteoarthritis index scores(35.68+/-7.53,22.23+/-5.16,16.35+/-3.07,22.25+/-3.91 points,F=99.261,P=0.000; 34.22+/-7.20,22.14+/-5.56,18.37+/-4.45,25.47+/-4.51 points,F=52.156,P=0.000).There was no statistical difference in WOMAC osteoarthritis index scores between the 2 groups before treatment and at 1 month after the beginning of the treatment(t=0.850,P=0.398; t=0.064,P=0.949).The WOMAC osteoarthritis index scores were lower in combination therapy group compared to monotherapy group at 3 and 6 months after the beginning of the treatment(t=2.309,P=0.024; t=3.318,P=0.001).Conclusion:Both the combination therapy of intra-articular injection of PRP and oral application of BSHXF and the monotherapy of intra-articular injection of PRP can relieve knee pain and promote knee functional recovery,however,the former surpasses the latter in clinical curative effects.

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備注/Memo

備注/Memo:
基金項(xiàng)目:國家自然科學(xué)基金面上項(xiàng)目(81774332,81673997); 浙江省中醫(yī)藥科技計(jì)劃項(xiàng)目(2018ZZ011,2018ZA034)
通訊作者:童培建 E-mail:[email protected]
更新日期/Last Update: 2018-11-30