摘要
目的观察补肾活血协定方治疗膝关节骨性关节炎(knee osteoarthritis,KOA)(肾虚血瘀证)的疗效。方法选取2018年2月—2020年2月医院收治的KOA患者186例,按照随机数字表法将患者分为对照组(n=93例)和观察组(n=93例)。对照组给予依托考昔片口服,观察组在对照组基础上加用补肾活血协定方口服,连续治疗2个月。分别以疼痛视觉模拟评分法(visual analogue scale,VAS)、美国特种外科医院量表(hospital for special surgery scores,HSS)评价膝关节疼痛程度与膝关节功能,用膝关节高频超声检查软骨厚度、滑膜厚度,检测关节液中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、Toll样受体-4(Toll-like receptor 4,TLR-4)、P物质(Substance P,SP)含量及血清中脂联素(adiponectin,APN)、低氧诱导因子1α(hypoxic induction factor-1α,HIF-1α)水平,对比两组治疗效果。结果:观察组的有效率93.55%(87/93),与对照组82.79%(77/93)的有效率比较,以观察组显著升高(χ2=5.155,P<0.05);两组患者的VAS评分在治疗治疗2周、治疗4周后均降低,HSS评分在治疗2周、治疗4周后均升高,以观察组VAS评分显著高于对照组,HSS评分显著高于对照组(P<0.05);治疗后,两组在增加关节软骨厚度、降低滑膜厚度等方面均具有一定效果,以观察组软骨厚度增加程度、滑膜厚度降低程度更明显(P<0.05);观察组患者经治疗后关节液中TNF-α、TLR-4、P物质水平均显著低于对照组(P<0.05);血清APN水平显著升高,HIF-1α水平显著降低(P<0.05)。结论补肾活血协定方利于减轻膝骨性关节炎患者的关节疼痛,提高膝关节功能,其机制可能与调节关节液、血清中相关因子水平以减轻滑膜炎症、调节软骨代谢有关,值得进行临床推广。
Objective To observe the effect of Bushen Huoxue Decoction(补肾活血协定方)on knee osteoarthritis(KOA)(kidney deficiency and blood stasis syndrome).Methods A total of 186 KOA patients admitted to our hospital from February 2018 to February 2020 were selected and divided into control group(n=93)and observation group(n=93)according to random number table method.The control group was given etexoxib orally,and the observation group was given Bushen Huoxue Decoction orally on the basis of the control group for 2 consecutive months.Pain degree and knee function were evaluated by Visual Analogue Scale(VAS)and hospital for special surgery scores(HSS)respectively.Cartilage thickness and synovial thickness were examined by high-frequency ultrasound of the knee joint,and tumor necrosis factor-α(TNF-α)was detected in the joint fluid.The levels of TNF-α,toll-like receptor-4(TLR-4),substance P(SP),adiponectin(APN)and hypoxic induction factor-1α(HIF-1α)in the joint fluid were detected,and the therapeutic effects of the two groups were compared.Results The effective rate of the observation group was 93.55%(87/93),which was significantly higher than that of the control group(82.79%,77/93)(χ2=5.155,P<0.05).The VAS scores of the two groups decreased after 2 and 4 weeks of treatment,while HSS scores were increased after 2 and 4 weeks of treatment.The VAS scores in the observation group were significantly higher than those in the control group,and HSS scores were significantly higher than those in the control group(P<0.05).After treatment,both groups had certain effects in increasing the thickness of articular cartilage and decreasing the thickness of synovium.In the observation group,the increase degree of cartilage thickness and the decrease degree of synovial thickness were more obvious(P<0.05).After treatment,the levels of TNF-α,TLR-4 and SP in the articular fluid of the observation group were significantly lower than those of the control group(P<0.05).The serum level of APN was significantly increased and HIF-1αlevel significantly decreased(P<0.05).Conclusion Bushen Huoxue Decoction can alleviate joint pain and improve knee joint function in patients with knee osteoarthritis.The mechanism may be related to reducing levels of related factors in joint fluid and serum to reduce synovial inflammation and regulate cartilage metabolism,which is worthy of clinical promotion.
作者
李朋
李钊
罗天
胡仕畅
杨冰旋
梁详翰
LI Peng;LI Zhao;LUO Tian;HU Shichang;YANG Bingxuan;LIANG Xianghan(Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510240,Guangdong,China;Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,Guangdong,China)
出处
《辽宁中医杂志》
CAS
2021年第7期96-100,共5页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(82071024)
广东省中医药局科研项目(20201171)
关键词
膝骨关节炎
补肾活血协定方
肾虚血瘀证
依托考昔
knee osteoarthritis
Bushen Huoxue Decoction(补肾活血协定方)
kidney deficiency and blood stasis syndrome
etoncoxib
作者简介
李朋(1982-),男,河南洛阳人,主治医师,研究方向:骨关节方向。
