[1]白宗堂,韩文朝,刘长坯,等.膝痹方治疗膝骨关节炎肝肾亏虚证[J].中医正骨,2025,37(08):76-79.
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膝痹方治疗膝骨关节炎肝肾亏虚证()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年08期
页码:
76-79
栏目:
临床报道
出版日期:
2025-08-20

文章信息/Info

作者:
白宗堂; 韩文朝; 刘长坯; 申震; 王会如; 王晓冰; 张玉民
濮阳市中医医院,河南 濮阳 457003
关键词:
骨关节炎; 膝;  肝肾亏虚;  中医药疗法
摘要:
目的:观察膝痹方治疗膝骨关节炎(knee osteoarthritis,KOA)肝肾亏虚证的临床疗效和安全性。方法:2023年1月至2024年2月,采用口服膝痹方治疗KOA肝肾亏虚证患者50例。男22例,女28例。年龄40～68岁,中位数53岁。左侧27例,右侧23例。Kellgren-Lawrence影像学分级Ⅰ级17例、Ⅱ级33例。病程3～9年,中位数6年。治疗过程中观察不良反应发生情况。参照《中药新药临床研究指导原则(试行)》中KOA疾病疗效判定标准制定综合疗效评价标准(包括主症评分和次症评分)评价综合疗效,采用西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)评分和Lysholm膝关节评分评价膝关节功能、视觉模拟量表(visual analogue scale,VAS)评分评价膝关节疼痛程度。采用ELISA法检测血清中骨钙素N端中分子片段(N-terminal mid-fragment of osteocalcin,N-MID)、骨钙素、骨碱性磷酸酶(bone alkaline phosphatase,BALP)、C反应蛋白(C-reactive protein,CRP)、基质金属蛋白酶(matrix metalloproteinase,MMP)-3、白细胞介素(interleukin,IL)-6水平。结果:本组患者均完成治疗。治疗结束后,患者的综合疗效评分、WOMAC评分、膝关节疼痛VAS评分均较治疗前降低[主症:(8.15±1.24)分,(4.89±0.91)分; 次症:(3.75±0.47)分,(2.42±0.32)分; WOMAC评分:(50.49±4.98)分,(20.83±3.87)分; 膝关节疼痛VAS评分:(4.63±0.67)分,(2.18±0.38)分],Lysholm膝关节评分较治疗前升高[(60.01±6.03)分,(76.42±7.94)分]。血清N-MID、骨钙素、BALP水平均较治疗前升高[N-MID:(18.01±2.19)ng·mL-1,(20.78±2.43)ng·mL-1; 骨钙素:(6.09±0.98)μg·L-1,(8.01±1.19)μg·L-1; BALP:(90.21±10.17)μg·L-1,(107.58±15.19)μg·L-1],血清CRP、MMP-3、IL-6水平均较治疗前降低[CRP:(16.23±2.28)mg·L-1,(11.78±2.01)mg·L-1; MMP-3:(129.42±11.76)mg·L-1,(98.76±9.21)mg·L-1; IL-6:(14.13±2.67)mg·L-1,(6.72±1.03)mg·L-1]。治疗过程中,所有患者均未出现严重不良反应,2例出现皮疹、2例出现轻微胃肠道反应,均自行缓解。结论:膝痹方治疗KOA肝肾亏虚证,可缓解炎症反应、减轻膝关节疼痛、改善膝关节功能,综合疗效良好,安全性高。

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备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(2023ZY2178)
通讯作者:韩文朝 E-mail:hanwenchao80@sina.com
更新日期/Last Update: 1900-01-01