摘要
【目的】观察中药外敷配合内服加味海七丸治疗膝骨性关节炎(KOA)的临床疗效。【方法】将120例KOA患者随机分为治疗组和对照组,每组各60例。治疗组给予中药外敷配合内服加味海七丸治疗,对照组给予口服塞来昔布胶囊治疗,疗程为1个月。观察2组患者治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、Lysholm评分及炎症指标血清白细胞介素1(IL-1)、肿瘤坏死因子α(TNF-α)水平的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗1个月后,治疗组的临床控制率及总有效率分别为56.67%和93.33%,对照组分别为20.00%和73.33%,治疗组的总体疗效、临床控制率和总有效率均优于对照组,差异均有统计学意义(P <0.05或P <0.01)。(2)治疗后,2组患者WOMAC量表的各项评分及其总分均较治疗前降低,Lysholm量表的各项评分及其总分均较治疗前升高,差异均有统计学意义(P <0.05),且治疗组对WOMAC量表的各项评分及其总分的降低作用和对Lysholm量表的各项评分及其总分的升高作用均优于对照组(P <0.05)。(3)治疗后,2组患者血清IL-1和TNF-α水平均较治疗前明显降低(P <0.05),且治疗组的降低作用均明显优于对照组(P <0.05)。【结论】中药外敷配合内服加味海七丸治疗KOA疗效确切,能有效降低WOMAC评分,提高Lysholm评分,降低血清中炎症因子水平,改善膝关节功能,提高患者生活质量。
Objective To observe the clinical effect of external application of Chinese medicine combined with oral administration of modified Haiqi Pills for the treatment of knee osteoarthritis(KOA). Methods One hundred and twenty KOA patients were randomly divided into treatment group and control group,60 cases in each group. The treatment group was given external application of Chinese medicine combined with oral administration of modified Haiqi Pills,and the control group was given oral use of celebrex capsules,the course of treatment lasting one month. Before and after treatment,the scores of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lysholm scores for knee joint function,and serum levels of interleukin 1(IL-1)and tumor necrosis factor alpha(TNF-α)in the two groups were observed. Results(1)After treatment for one month,the clinical control rate was 56.67% and the total effective rate was 93.33% in the treatment group,and the clinical control rate was 20.00% and the total effective rate was 73.33% in the control group. The treatment group had stronger overall efficacy, and higher clinical control rate and total effective rate than the control group, the difference being statistically signficant(P<0.05 or P < 0.01).(2)After treatment,the scores of each item of WOMAC as well as the overall WOMAC scores were significantly decreased,and the scores of each item of Lysholm as well as the overall Lysholm scores were significantly increased in the two groups as compared with those before treatment,the difference being statistically signficant(P<0.05). The treatment group had stronger effect on decreasing the scores of each item of WOMAC as well as the overall WOMAC scores and on increasing the scores of each item of Lysholm as well as the overall Lysholm scores than the control group(P < 0.05).(3)After treatment, serum IL-1 and TNF-α levels in the two groups were decreased after treatment in comparison with those before treatment(P <0.05),and the decrease in the treatment group was superior to that in the control group(P < 0.05). Conclusion External application of Chinese medicine combined with oral administration of modified Haiqi Pills has significant therapeutic effect for the treatment of knee osteoarthritis. The combined therapy is effective on decreasing WOMAC scores, increasing Lysholm scores, declining the serum inflammatory factor levels, improving knee joint function,and enhancing the quality of life of the knee osteoarthritis patients.
作者
黄桂忠
王少伟
蔡煜林
HUANG Gui-Zhong;WANG Shao-Wei;CAI Yu-Lin(Dept.of Orthopedics,Shantou Hospital of Traditional Chinese Medicine,Shantou 515031 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2020年第3期438-442,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
膝骨性关节炎
中药外敷
加味海七丸
WOMAC评分
Lysholm评分
炎症因子
knee osteoarthritis
external application of Chinese medicine
modified Haiqi Pills
WOMAC scores
Lysholm scores
inflammatory factors
作者简介
黄桂忠(1980-),男,硕士,副主任医师,E-mail:14700010@qq.com。
