84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]黃巖石.獨(dú)活寄生湯口服聯(lián)合富血小板血漿關(guān)節(jié)腔內(nèi)注射治療膝骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2021,33(02):1-11.
　HUANG Yanshi.A clinical study of oral application of Duhuo Jisheng Tang(獨(dú)活寄生湯)combined with intra-articular injection of platelet-rich plasma for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(02):1-11.
點(diǎn)擊復(fù)制

獨(dú)活寄生湯口服聯(lián)合富血小板血漿關(guān)節(jié)腔內(nèi)注射治療膝骨關(guān)節(jié)炎的臨床研究()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年02期
頁(yè)碼:
1-11
欄目:
臨床研究
出版日期:
2021-02-20

文章信息/Info

Title:
A clinical study of oral application of Duhuo Jisheng Tang(獨(dú)活寄生湯)combined with intra-articular injection of platelet-rich plasma for treatment of knee osteoarthritis
作者:
黃巖石
(南陽(yáng)市第二人民醫(yī)院,河南 南陽(yáng) 473003)
Author(s):
HUANG Yanshi
Nanyang Second General Hospital,Nanyang 473003,Henan,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  獨(dú)活寄生湯;  富血小板血漿;  5-羥色胺;  β-內(nèi)啡肽;  前列腺素E2;  白細(xì)胞介素1β;  白細(xì)胞介素6;  腫瘤壞死因子α;  白三烯B4;  基質(zhì)金屬蛋白酶9;  基質(zhì)金屬蛋白酶13;  抗沉默因子1a;  沉默信息調(diào)節(jié)因子1;  臨床試驗(yàn)
Keywords:
osteoarthritis; knee;  DuHuo JiSheng decoction;  platelet-rich plasma;  5-hydroxytryptamine;  β-endorphin;  prostaglandin E2;  interleukin 1β;  interleukin 6;  tumor necrosis factor α;  leukotriene B4;  matrix metalloproteinase 9;  matrix metalloproteinase 13;  anti-silencing factor 1a;  silent mating-type information regulation 2 homolog 1;  clinical trial
摘要:
目的:探討?yīng)毣罴纳鷾诜?lián)合富血小板血漿(platelet-rich plasma,PRP)關(guān)節(jié)腔內(nèi)注射治療膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)的臨床療效和安全性,并初步探討其作用機(jī)制。方法:將104例KOA患者隨機(jī)分為2組,每組52例。單純PRP注射組采用PRP關(guān)節(jié)腔內(nèi)注射治療,每2周注射1次,3次為1個(gè)療程,共2個(gè)療程; 聯(lián)合治療組在PRP注射的基礎(chǔ)上聯(lián)合獨(dú)活寄生湯口服治療,每天1劑,早晚分服,6周為1個(gè)療程,共2個(gè)療程。分別于治療前以及治療1個(gè)、2個(gè)療程后,記錄并比較2組患者膝關(guān)節(jié)疼痛視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)分,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),5-羥色胺(5-hydroxytryptamine,5-HT)、β內(nèi)啡肽(β-endorphin,β-EP)、前列腺素E2(prostaglandin E2,PGE2)、白細(xì)胞介素(interleukin,IL)-1β、IL-6、腫瘤壞死因子-α(tumor necrosis factor-α,TNF-α)、白三烯B4(leukotriene B4,LTB4)、基質(zhì)金屬蛋白酶(matrix metalloproteinase,MMP)-9、MMP-13血清含量,以及抗沉默因子1a(anti-silencing factor 1a,ASF1a)、沉默信息調(diào)節(jié)因子1(silent mating-type information regulation 2 homolog 1,SIRT1)mRNA表達(dá)量,并觀察并發(fā)癥發(fā)生情況。
Abstract:
To explore the clinical curative effects and safety of oral application of Duhuo Jisheng Tang(獨(dú)活寄生湯,DHJST)combined with intra-articular injection of platelet-rich plasma(PRP)for treatment of knee osteoarthritis(KOA)and to explore its mechanism of action.Methods:One hundred and four KOA patients were enrolled in the study and were randomly divided into monotherapy group and combination therapy group,52 cases in each group.All patients in the 2 groups were treatd with intra-articular injection of PRP,once every 2 weeks for consecutive 2 courses of treatment,three times for each course; moreover,the patients in combination therapy group were treatd with oral application of DHJST,one dose a day in the morning and evening respectively for consecutive 2 courses of treatment,consecutive 6 weeks for each course.The knee pain visual analogue scale(VAS)scores,Western Ontario and McMaster Universities(WOMAC)osteoarthritis index,the serum contents of 5-hydroxytryptamine(5-HT),β-endorphin(β-EP),prostaglandin E2(PGE2),interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α),leukotriene B4(LTB4),matrix metalloproteinase(MMP)-9 and MMP-13 and the mRNA expression levels of anti-silencing factor 1a(ASF1a)and silent mating-type information regulation 2 homolog 1(SIRT1)were recorded and compared between the 2 groups before the treatment and after 1- and 2-course treatment respectively,and the complications were observed.Results:The knee pain VAS scores presented a time-dependent decreasing trend in the 2 groups(combination therapy group:5.48±1.34,2.27±0.48,1.03±0.31 points,F=34.667,P=0.001; monotherapy group:5.63±1.27,3.02±0.61,2.51±0.28 points,F=14.657,P=0.001).The knee pain VAS scores were lower in combination therapy group compared to monotherapy group after 1- and 2-course treatment(t=6.968,P=0.001; t=25.549,P=0.002).The WOMAC osteoarthritis index presented a time-dependent decreasing trend in the 2 groups(combination therapy group:43.25±10.16,24.69±9.07,17.42±8.15 points,F=24.368,P=0.001; monotherapy group:44.07±12.48,30.74±7.65,23.14±10.03 points,F=41.572,P=0.001).The WOMAC osteoarthritis index was lower in combination therapy group compared to monotherapy group after 1- and 2-course treatment(t=3.677,P=0.001; t=3.192,P=0.002).The serum content of 5-HT presented a time-dependent decreasing trend in the 2 groups(combination therapy group:876.59±46.59,677.59±19.79,635.22±15.80 μg/L,F=246.729,P=0.001; monotherapy group:881.34±41.52,701.25±20.61,676.34±17.18 μg/L,F=158.776,P=0.001).The serum content of 5-HT was lower in combination therapy group compared to monotherapy group after 1- and 2-course treatment(t=5.971,P=0.001; t=12.686,P=0.002).The serum content of β-EP presented a time-dependent increasing trend in the 2 groups(combination therapy group:157.68±24.49,233.69±34.27,276.58±31.78 ng/L,F=56.724,P=0.001; monotherapy group:160.05±23.18,198.57±30.50,237.64±35.39 ng/L,F=84.172,P=0.001).

參考文獻(xiàn)/References:

[1] 張遼,鄧穎萍,金甬,等.基于數(shù)據(jù)挖掘法的葉海教授治療膝骨關(guān)節(jié)炎用藥規(guī)律研究[J].中醫(yī)正骨,2020,32(2):36-41.
[2] 高晶,劉學(xué)政.電針聯(lián)合威靈仙關(guān)節(jié)腔內(nèi)注射對(duì)大鼠膝骨關(guān)節(jié)炎TNF-α、MMP、HA及TIMP-1的影響[J].中國(guó)免疫學(xué)雜志,2019,35(6):686-692.
[3] 趙棟,王文良,張玲,等.氨甲環(huán)酸治療膝骨關(guān)節(jié)炎患者全膝關(guān)節(jié)置換術(shù)出血量的效果研究[J].中國(guó)全科醫(yī)學(xué),2018,21(35):4405-4407.
[4] COOK C S,SMITH P A.Clinical update:why PRP should be your first choice for injection therapy in treating osteoarthritis of the knee[J].Curr Rev Musculoskelet Med,2018,11(4):583-592.
[5] HUANG Y,LIU X,XU X,et al.Intra-articular injections of platelet-rich plasma,hyaluronic acid or corticosteroids for knee osteoarthritis:a prospective randomized controlled study[J].Orthopade,2019,48(3):239-247.
[6] 邱少彬,吳金玉,蔣軍艷,等.獨(dú)活寄生湯輔助治療肝腎虧虛型類風(fēng)濕關(guān)節(jié)炎的臨床效果[J].廣西醫(yī)學(xué),2018,40(22):2675-2677.
[7] 徐銘,姜宏.獨(dú)活寄生湯治療寒濕痹阻型腰椎間盤突出癥的臨床療效及預(yù)后觀察[J].陜西中醫(yī),2018,39(2):157-159.
[8] 中華醫(yī)學(xué)會(huì)風(fēng)濕病學(xué)分會(huì).骨關(guān)節(jié)炎診斷及治療指南[J].中華風(fēng)濕病學(xué)雜志,2010,14(6):416-419.
[9] 國(guó)家中醫(yī)藥管理局.22個(gè)專業(yè)95個(gè)病種中醫(yī)診療方案[M].北京:中國(guó)中醫(yī)藥出版社,2010:129-130.
[10] JANVIER T,JENNANE R,TOUMI H,et al.Subchondral tibial bone texture predicts the incidence of radiographic knee osteoarthritis:data from the osteoarthritis initiative[J].Osteoarthritis Cartilage,2017,25(12):2047-2054.
[11] SYMONDS T,HUGHES B,LIAO S,et al.Validation of the Chinese Western Ontarion and McMaster Universities osteoarthritis index in patients from mainland China with osteoarthritis of the knee[J].Arthritis Care Res(Hoboken),2015,67(11):1553-1560.
[12] 周宙,譚麗娟,陳茂華.富血小板血漿對(duì)關(guān)節(jié)鏡治療膝關(guān)節(jié)退行性病變患者療效的影響[J].中國(guó)內(nèi)鏡雜志,2019,25(10):73-77.
[13] 袁濤,席剛,韓鵬飛,等.關(guān)節(jié)腔內(nèi)注射PRP與HA治療膝關(guān)節(jié)骨性關(guān)節(jié)炎的薈萃分析[J].中國(guó)矯形外科雜志,2019,27(3):235-242.
[14] 賈學(xué)鋒,朱詠梅,張?zhí)飳?等.關(guān)節(jié)內(nèi)注射透明質(zhì)酸鈉聯(lián)合健骨逐瘀湯加減外敷治療膝骨性關(guān)節(jié)炎50例[J].安徽中醫(yī)藥大學(xué)學(xué)報(bào),2018,37(4):30-33.
[15] 吳宗英.獨(dú)活寄生湯加減聯(lián)合中醫(yī)骨傷手法按摩治療腰椎間盤突出癥療效觀察[J].現(xiàn)代中西醫(yī)結(jié)合雜志,2018,27(7):759-762.
[16] 陳世宣,計(jì)靜,馮偉,等.風(fēng)寒濕痹型膝骨關(guān)節(jié)炎患者膝部筋結(jié)點(diǎn)分布特征及獨(dú)活寄生湯聯(lián)合手法松解對(duì)其影響的研究[J].上海中醫(yī)藥雜志,2019,53(2):51-55.
[17] 陳俊,吳廣文,許惠鳳,等.獨(dú)活寄生湯干預(yù)膝骨關(guān)節(jié)炎模型大鼠軟骨PERK/Bip信號(hào)通路的表達(dá)[J].中國(guó)組織工程研究,2018,22(28):4493-4500.
[18] 邱高高,張繼平,殷慧琳,等.不同分期KOA患者炎癥因子表達(dá)與臨床癥狀的相關(guān)性[J].昆明醫(yī)科大學(xué)學(xué)報(bào),2018,39(10):58-62.
[19] 章海鳳,陳樹(shù)濤,冒姣娜,等.熱敏灸對(duì)膝骨性關(guān)節(jié)炎兔模型IL-1β、TNF-α、MMP-13的影響[J].中華中醫(yī)藥雜志,2018,33(9):3913-3917.
[20] 劉建華,趙海勇,溫芳,等.炎性細(xì)胞因子在膝骨關(guān)節(jié)炎中的表達(dá)及與高敏C反應(yīng)蛋白和紅細(xì)胞沉降率的相關(guān)性[J].天津醫(yī)藥,2020,48(1):55-58.
[21] MUN C J,LETZEN J E,NANCE S,et al.Sex differences in interleukin-6 responses over time following laboratory pain testing among patients with knee osteoarthritis[J].J Pain,2020,21(5/6):731-741.
[22] 曹迪,張亞密.加味芍藥甘草湯輔助治療對(duì)癌性疼痛患者疼痛介質(zhì)及炎性因子的影響[J].中國(guó)醫(yī)藥導(dǎo)報(bào),2020,17(7):143-146.
[23] 袁定坤,肖啟賢.硫酸氨基葡萄糖膠囊聯(lián)合獨(dú)活寄生湯治療膝骨關(guān)節(jié)炎對(duì)LTB4、LTC4、LTD4水平影響[J].中國(guó)處方藥,2019,17(7):65-66.
[24] KISAND K,TAMM A E,LINTROP M,et al.New insights into the natural course of knee osteoarthritis:early regulation of cytokines and growth factors,with emphasis on sex-dependent angiogenesis and tissue remodeling.A pilot study[J].Osteoarthritis Cartilage,2018,26(8):1045-1054.
[25] 張其鎮(zhèn),苗雨,王大力,等.溫針灸配合獨(dú)活寄生湯治療風(fēng)寒濕痹型膝骨關(guān)節(jié)炎患者的臨床隨機(jī)對(duì)照研究及體液中ASF1a,SIRT1水平變化[J].遼寧中醫(yī)雜志,2018,45(12):2624-2628.
[26] LI J,ZHU X,SHAO Q,et al.Allogeneic adipose-derived stem cell transplantation on knee osteoarthritis rats and its effect on MMP-13 and DDR2[J].Exp Ther Med,2019,18(1):99-104.
[27] ZHAO Q H,LIN L P,GUO Y X,et al.Matrix metalloproteinase-13,NF-κB p65 and interleukin-1β are associated with the severity of knee osteoarthritis[J].Exp Ther Med,2020,19(6):3620-3626.
[28] 亓洪德,盧程,李庭,等.牡荊素對(duì)Ⅱ型膠原蛋白誘導(dǎo)的大鼠類風(fēng)濕關(guān)節(jié)炎的緩解作用及對(duì)血漿Th17,Th23和MMPs蛋白水平的影響[J].中國(guó)免疫學(xué)雜志,2020,36(10):1201-1205.
[29] 夏玉坤.RLX/RXFP1、MMP9/MMP13和RANKL/OPG在關(guān)節(jié)炎軟骨和骨破壞及中藥治療中的作用[D].武漢:華中科技大學(xué),2012.

相似文獻(xiàn)/References:

[1]樊慶陽(yáng),任凱晶.定制3D打印切模輔助全膝關(guān)節(jié)置換術(shù)治療 膝骨關(guān)節(jié)炎合并股骨干骨折畸形愈合[J].中醫(yī)正骨,2015,27(11):37.
[2]劉曉雅,孫永強(qiáng),劉國(guó)杰.主動(dòng)快速康復(fù)鍛煉對(duì)全膝關(guān)節(jié)置換術(shù)后關(guān)節(jié)活動(dòng)度的影響[J].中醫(yī)正骨,2015,27(09):73.
[3]鄭春松,葉蕻芝,李西海,等.透骨消痛膠囊中補(bǔ)腎柔肝藥和活血祛風(fēng)藥治療 骨關(guān)節(jié)炎作用方式的計(jì)算機(jī)模擬比較[J].中醫(yī)正骨,2015,27(07):6.
　ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Comparison of the mode of action of Bushen Rougan(補(bǔ)腎柔肝)drugs versus Huoxue Qufeng(活血祛風(fēng))drugs contained in Tougu Xiaotong Jiaonang(透骨消痛膠囊)for the treatment of osteoarthritis:A computer simulation study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):6.
[4]宋兵華,孫俊英,倪增良,等.全膝關(guān)節(jié)置換術(shù)前CT測(cè)量股骨后髁角的臨床意義[J].中醫(yī)正骨,2015,27(07):38.
[5]鄭春松,葉蕻芝,李西海,等.獨(dú)活寄生湯含藥血清對(duì)白細(xì)胞介素1β誘導(dǎo)的 退變關(guān)節(jié)軟骨細(xì)胞中基質(zhì)金屬蛋白酶 和環(huán)氧化酶2表達(dá)的影響[J].中醫(yī)正骨,2015,27(12):1.
　ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Impact of Duhuo Jisheng Tang(獨(dú)活寄生湯)medicated serum on expression of matrix metalloproteinase and cyclooxygenase 2 in degenerative articular chondrocytes induced by interleukin-1 beta[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):1.
[6]王金良,孫京濤,李玲,等.骨水泥聯(lián)合螺釘修復(fù)全膝關(guān)節(jié)置換術(shù)中 脛骨平臺(tái)內(nèi)側(cè)骨缺損[J].中醫(yī)正骨,2015,27(12):55.
[7]馮榮,王平,李炳奇,等.鈹針刺絡(luò)拔罐結(jié)合中藥口服治療膝骨關(guān)節(jié)炎合并 原發(fā)性血小板增多癥1例[J].中醫(yī)正骨,2015,27(12):73.
[8]蔡云仙.圍手術(shù)期耳穴按壓聯(lián)合平衡針療法 在全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛中的應(yīng)用[J].中醫(yī)正骨,2015,27(06):41.
[9]張榮,王健.人工全膝關(guān)節(jié)置換術(shù)的圍手術(shù)期心理護(hù)理[J].中醫(yī)正骨,2015,27(05):77.
[10]喻長(zhǎng)純,楊明路,王戰(zhàn)朝.不同手術(shù)方式治療脛骨平臺(tái)骨折畸形愈合的體會(huì)[J].中醫(yī)正骨,2015,27(03):37.
[11]孟維娜,明立功,王新德,等.關(guān)節(jié)鏡下清理聯(lián)合腓骨近1/3段截骨治療膝骨關(guān)節(jié)炎[J].中醫(yī)正骨,2015,27(11):40.
[12]明立功,孟維娜,王新德,等.腓骨近端截骨治療內(nèi)側(cè)間室膝骨關(guān)節(jié)炎的近期療效觀察[J].中醫(yī)正骨,2015,27(10):25.
[13]張杰,王人彥,張玉柱.膝骨關(guān)節(jié)炎的治療進(jìn)展[J].中醫(yī)正骨,2015,27(10):68.
[14]梁朝,蔡靜怡,閆立,等.針刀療法改善膝骨關(guān)節(jié)炎早期疼痛癥狀的療效評(píng)價(jià)[J].中醫(yī)正骨,2015,27(09):9.
　LIANG Zhao,CAI Jingyi,YAN Li,et al.Evaluation of the curative effect of needle-knife therapy for relieving knee pain in patients with early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):9.
[15]王建武,黨建軍,李強(qiáng),等.四聯(lián)療法治療膝骨關(guān)節(jié)炎[J].中醫(yī)正骨,2015,27(08):44.
[16]劉紅娟,郭會(huì)利,郭樹(shù)農(nóng).云克聯(lián)合中藥治療膝骨關(guān)節(jié)炎的護(hù)理[J].中醫(yī)正骨,2015,27(08):75.
[17]陳衛(wèi)衡.探索建立系統(tǒng)的膝骨關(guān)節(jié)炎中醫(yī)臨床科研范式 和理論體系[J].中醫(yī)正骨,2015,27(07):1.
[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(jī)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(02):15.
[19]梅其杰,袁長(zhǎng)深,段戡,等.壯藥骨痹方燙熨聯(lián)合運(yùn)動(dòng)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(02):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(02):31.

更新日期/Last Update: 2021-02-20