[1]喻秋萍,唐萌芽,陈金洪.口服补肾活血方联合关节腔内注射玻璃酸钠 治疗膝骨关节炎的临床研究[J].中医正骨,2016,28(02):23-27.
　YU Qiuping,TANG Mengya,CHEN Jinhong.Clinical study on oral application of Bushen Huoxue Fang(补肾活血方)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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口服补肾活血方联合关节腔内注射玻璃酸钠 治疗膝骨关节炎的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年02期
页码:
23-27
栏目:
临床研究
出版日期:
2016-02-20

文章信息/Info

Title:
Clinical study on oral application of Bushen Huoxue Fang(补肾活血方)combined with intra-articular injection of sodium hyaluronate for the treatment of knee osteoarthritis
作者:
喻秋萍; 唐萌芽; 陈金洪
浙江省杭州市富阳中医骨伤医院,浙江 富阳 311400
Author(s):
YU Qiuping; TANG Mengya; CHEN Jinhong
Fuyang TCM Orthopedic-Traumatological Hospital,Fuyang 311400,Zhejiang,China
关键词:
骨关节炎; 膝;  中药疗法;  注射; 关节内;  透明质酸;  治疗; 临床研究性
Keywords:
osteoarthritis; knee;  drug therapy(TCD);  injections; intra-articular;  hyaluronic acid;  therapies; investigational
摘要:
目的:观察口服补肾活血方联合关节腔内注射玻璃酸钠治疗膝骨关节炎的临床疗效。方法:将90例膝骨关节炎患者随机分 为2组,每组45例,分别采用口服补肾活血方联合关节腔内注射玻璃酸钠、单纯关节腔内注射玻璃酸钠治疗。玻璃酸钠注射每次2 mL,每周1次; 补肾活血方口服每日1剂; 4周为1个疗程,共治疗3个疗程。分别于治疗前及治疗3个疗程后比较2组患者膝关节疼 痛视觉模拟量表(visual analogue scale,VAS)评分、西安大略和麦克马斯特大学(Western Ontario and McMaster universities,WOMAC)骨关节炎指数量表评分以及白细胞介素-1(interleukin-1,IL-1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)的血清含量。结果:①膝关节疼痛VAS评分 及WOMAC评分。治疗前2组患者膝关节疼痛VAS评分及WOMAC评分比较,组间差异均无统计学意义[(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]。治疗3个疗程后,口服补 肾活血方联合关节腔内注射玻璃酸钠组膝关节疼痛VAS评分及WOMAC评分均低于关节腔内注射玻璃酸钠组[(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组患者膝关节疼痛VAS评 分及WOMAC评分均低于治疗前(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。治疗前2组患者IL-1、TNF-α、hs-CRP的血清含量比较,组间差异均无统计学意义[(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]。治疗3个疗程后,口服补肾活血方联合关节腔内注射玻璃酸钠组IL-1、TNF-α、hs- CRP的血清含量均低于关节腔内玻璃酸钠注射组[(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组患者IL-1、TNF-α、hs-CRP的血清含量均低于治疗前(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)。结论:口服补肾活血方联合关节腔内注射玻璃酸钠可以减轻膝关 节炎症,缓解或消除膝关节疼痛,改善膝关节功能,其疗效优于单纯关节腔内注射玻璃酸钠,值得临床推广应用。
Abstract:
Objective:To observe the clinical curative effect of oral application of Bushen Huoxue Fang(补肾活血 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