[1]方亮,董睿,金红婷,等.富血小板血浆关节腔注射联合补肾活血方口服治疗膝骨关节炎肝肾亏虚证的临床研究[J].中医正骨,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(补肾活血方)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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富血小板血浆关节腔注射联合补肾活血方口服治疗膝骨关节炎肝肾亏虚证的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年11期
页码:
1-5,12
栏目:
临床研究
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(补肾活血方)for treatment of knee osteoarthritis with liver-kidney deficiency syndrome
作者:
方亮1; 董睿1; 金红婷1; 童培建2; 肖鲁伟1
(1.浙江中医药大学,浙江 杭州 310053; 2.浙江中医药大学附属第一医院,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
关键词:
骨关节炎; 膝;  肝肾亏虚;  补肾活血方;  富血小板血浆;  注射; 关节内;  临床试验
Keywords:
osteoarthritis; knee;  liver-kidney deficiency;  Bushen Huoxue Fang;  platelet-rich plasma;  injections; intra-articular; clinical trial
摘要:
目的:观察富血小板血浆(platelet-rich plasma,PRP)关节腔注射联合补肾活血方口服治疗膝骨关节炎肝肾亏虚证的临床疗效。方法:将符合要求的75例膝骨关节炎肝肾亏虚证患者随机分为2组,分别采用PRP关节腔注射联合补肾活血方口服治疗(联合治疗组40例)和单纯PRP关节腔注射治疗(单纯关节腔注射组35例)。PRP关节腔注射每周1次,连续注射3次为1个疗程,休息1周后继续下1个疗程,共3个疗程; 补肾活血方水煎服,每日1剂,早晚2次服用,连续服用12周。分别于治疗前及治疗开始后1个月、3个月、6个月,比较2组患者膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分和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。结果:①膝关节疼痛VAS 评分。时间因素和分组因素存在交互效应(F=13.328,P=0.000); 2组患者膝关节疼痛VAS评分比较,差异有统计学意义,即存在分组效应(F=60.715,P=0.000); 2组患者治疗前后不同时间点膝关节疼痛VAS评分的差异有统计学意义,即存在时间效应(F=222.014,P=0.000); 2组患者膝关节疼痛VAS评分随时间均呈下降趋势,但2组的下降趋势不完全一致[(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]; 治疗前,2组患者的膝关节疼痛VAS评分比较,差异无统计学意义(t=1.605,P=0.113); 治疗开始后1个月、3个月、6个月,联合治疗组的膝关节疼痛VAS评分均低于单纯关节腔注射组(t=6.996,P=0.000; t=4.526,P=0.000; t=6.547,P=0.000)。②WOMAC骨关节炎指数量表评分。时间因素和分组因素存在交互效应(F=3.013,P=0.031); 2组患者WOMAC骨关节炎指数量表评分比较,差异有统计学意义,即存在分组效应(F=1.918,P=0.017); 2组患者治疗前后不同时间点WOMAC骨关节炎指数量表评分的差异有统计学意义,即存在时间效应(F=152.186,P=0.000); 2组患者WOMAC骨关节炎指数量表评分随时间均呈下降趋势,但2组的下降趋势不完全一致[(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]; 治疗前和治疗开始后1个月,2组患者的WOMAC骨关节炎指数量表评分比较,组间差异均无统计学意义(t=0.850,P=0.398; t=0.064,P=0.949); 治疗开始后3个月、6个月,联合治疗组的WOMAC骨关节炎指数量表评分均低于单纯关节腔注射组(t=2.309,P=0.024; t=3.318,P=0.001)。结论:采用PRP关节腔注射联合补肾活血方口服与单纯PRP关节腔注射治疗膝骨关节炎肝肾亏虚证,均能缓解膝关节疼痛和促进膝关节功能恢复,但前者的疗效优于后者。
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(补肾活血方,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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备注/Memo

备注/Memo:
基金项目:国家自然科学基金面上项目(81774332,81673997); 浙江省中医药科技计划项目(2018ZZ011,2018ZA034)
通讯作者:童培建 E-mail:tongpeijian@163.com
更新日期/Last Update: 2018-11-30