补肾活血方内服联合中药塌渍治疗膝骨关节炎的临床疗效及对关节软骨的影响
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摘要
目的:评价补肾活血方内服联合中药塌渍治疗膝骨关节炎的临床疗效及对关节软骨的影响。方法:膝骨关节炎患者126例,根据Excel随机表格法将患者分为研究组和对照组,每组63例。对照组给予塞来昔布联合中药塌渍治疗,研究组给予补肾活血方联合中药塌渍治疗,共治疗4周。比较两组治疗疗效、治疗前后VAS、WOMAC评分,治疗前后IL-1β、TGF-β1、TIMP-1及MMP-3水平和NO、MDA及SOD水平。结果:研究结果显示,研究组治疗总有效率为92.06%高于对照组治疗总有效率的77.78%(P<0.05),和治疗前相比,两组治疗后VAS、WOMAC评分均有所降低,组间比较结果显示,研究组治疗后VAS、WOMAC评分低于对照组(P<0.05);两组治疗后MMP-3、IL-1β低于治疗前,TIMP-1、TGF-β1高于治疗前。组间结果比较显示,研究组治疗后MMP-3、IL-1β低于对照组,TIMP-1、TGF-β1高于高于对照组(P<0.05);两组治疗后NO、MDA低于治疗前,SOD高于治疗前。组间结果比较显示,研究组治疗后NO、MDA低于对照组,SOD高于对照组(P<0.05)。结论:补肾活血方内服联合中药塌渍能显著改善膝骨关节炎患者的临床症状,提高治疗效果,减轻炎性反应,纠正氧自由基代谢紊乱,具有保护膝关节软骨的作用。
Objective:To evaluate the clinical efficacy of Bushen Huoxue Decoction combined with traditional Chinese medicine in treating knee osteoarthritis and its effect on articular cartilage.Methods:Totally 126 patients with knee osteoarthritis were divided into study group and control group according to the randommethod, with 63 cases in each group. The control group was given celecoxib combined with traditional Chinese medicine, and the study group was treated with Bushen Huoxue Decoction combined with traditional Chinese medicine collapse treatment for 4 weeks. The therapeutic efficacy, VAS and WOMAC scores before and after treatment, the levels of IL-1 beta, TGF-beta 1, TIMP-1 and MMP-3, and NO, MDA and SOD levels were compared between the two groups.Results:The results showed that the total effective rate ofthe study group was 92.06% which was higher than that of the control group(P<0.05). Compared with those before treatment, the scores of VAS and WOMAC in the two groups were reduced. The scores of VAS and WOMAC in the study group were lower than that of the control group(P<0.05). After treatment, MMP-3 and IL-1 beta were lower than those before treatment. TIMP-1 and TGF-1 were higher than those before treatment. The results showed that the MMP-3 and IL-1 beta in the study group were lower than those in the control group, and TIMP-1 and TGF-beta 1 were higher than those in the control group(P<0.05). The two groups' were lower than those before treatment, and the SOD was higher than that before treatment. NO and MDA in study group were lower than those in control group after treatment, and SOD was higher than that in control group(P<0.05).Conclusion:The combination of Bushen Huoxue Decoction combined with traditional Chinese medicine collapsing can significantly improve the clinical symptoms of the patients with knee osteoarthritis, improve the therapeutic effect, reduce the inflammatory reaction, correct the metabolic disorder of oxygen free radicals, and protect the cartilage of the knee joint.
Objective:To evaluate the clinical efficacy of Bushen Huoxue Decoction combined with traditional Chinese medicine in treating knee osteoarthritis and its effect on articular cartilage.Methods:Totally 126 patients with knee osteoarthritis were divided into study group and control group according to the randommethod, with 63 cases in each group. The control group was given celecoxib combined with traditional Chinese medicine, and the study group was treated with Bushen Huoxue Decoction combined with traditional Chinese medicine collapse treatment for 4 weeks. The therapeutic efficacy, VAS and WOMAC scores before and after treatment, the levels of IL-1 beta, TGF-beta 1, TIMP-1 and MMP-3, and NO, MDA and SOD levels were compared between the two groups.Results:The results showed that the total effective rate ofthe study group was 92.06% which was higher than that of the control group(P<0.05). Compared with those before treatment, the scores of VAS and WOMAC in the two groups were reduced. The scores of VAS and WOMAC in the study group were lower than that of the control group(P<0.05). After treatment, MMP-3 and IL-1 beta were lower than those before treatment. TIMP-1 and TGF-1 were higher than those before treatment. The results showed that the MMP-3 and IL-1 beta in the study group were lower than those in the control group, and TIMP-1 and TGF-beta 1 were higher than those in the control group(P<0.05). The two groups' were lower than those before treatment, and the SOD was higher than that before treatment. NO and MDA in study group were lower than those in control group after treatment, and SOD was higher than that in control group(P<0.05).Conclusion:The combination of Bushen Huoxue Decoction combined with traditional Chinese medicine collapsing can significantly improve the clinical symptoms of the patients with knee osteoarthritis, improve the therapeutic effect, reduce the inflammatory reaction, correct the metabolic disorder of oxygen free radicals, and protect the cartilage of the knee joint.
引文
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[10] 毛伟欢,胡旭华,李光阳,等.牛膝醇溶液透入辅助治疗在膝骨关节炎患者中的疗效观察[J].浙江创伤外科,2017,22(5):852-853.
[11] 王窕, 杜义斌, 许东云, 等. 中药溻渍联合中药内服治疗风寒湿痹证膝骨关节炎的临床观察 [J]. 云南中医中药杂志, 2018,39(1):41-42.
[12] 孙达志,王旭红.艾灸联合桃红饮加味治疗瘀血阻络型类风湿性关节炎的临床疗效研究[J].针灸临床杂志,2018,34(2):20-24.
[13] 杨黎黎, 王庆甫, 王欢, 等.通络止痛方对人膝骨关节炎滑膜炎性细胞TLR4、IL-1β及NO的影响 [J]. 中华中医药杂志, 2017,32(9):4124-4126.
[14] 郝胜坤, 纪斌, 石继祥, 等. 补肾活血中药治疗膝骨关节炎的作用机制 [J]. 中医正骨, 2017,29(4):31-33.
[15] 李哲,白玉,闫冬,等.膝三针、艾灸结合超激光照射治疗膝骨关节炎对下肢生物力学相关参数变化的影响[J].针灸临床杂志,2018,34(1):33-36.
[16] 岳馥鸿,于慧敏.乌梅透骨汤对大鼠膝骨关节炎动物模型血清炎性因子及关节软骨含水率影响[J].四川中医,2018,36(2):60-63.
[17] 蒋华,曾勇,马红兵,等.炎症分子核因子κB及骨桥蛋白在骨关节炎患者膝关节液中的表达及临床意义[J].标记免疫分析与临床,2017,24(11):1293-1297.
[18] 侯宝生,姜婷,金立,等.艾瑞昔布单独应用及与仙灵骨葆胶囊联合治疗膝骨关节炎的疗效比较[J].现代医学,2017,45(7):941-945.
[19] 杨帆, 袁芳, 侯秀娟, 等. 补肾通络方对大鼠膝骨关节炎膝关节软骨细胞外基质代谢的影响 [J]. 吉林中医药, 2018,38(1):67-71.
[20] 袁家骏, 罗程, 黄毅, 等. 口服自拟补肾活血汤治疗早期膝骨关节炎的临床研究 [J]. 中医正骨, 2017,29(8):26-32.
[21] 李朝军, 韩丽, 李小健, 等. 自拟补肾活血方对膝关节骨性关节炎血清SOD NO及MDA水平的影响 [J]. 四川中医, 2016,34(2):101-102.
[22] 曾令烽, 杨伟毅, 潘建科, 等. 瘀肾合治方药辅助治疗膝骨性关节炎的文献研究与分析 [J]. 中华中医药杂志, 2017,32(11):5088-5095.
[23] 梁桂洪, 梁祖建, 林勇凯, 等. 补肾活血中药对比塞来昔布治疗膝骨性关节炎疗效与安全性的Meta分析 [J]. 中国药房, 2016,27(27):3810-3814.
[2] 陈军号,陶凯.瘀血痹片联合玻璃酸钠治疗膝关节骨性关节炎的临床研究[J].现代药物与临床,2018,33(3):651-654.
[3] 邝高艳, 严可, 柴爽, 等. 加味独活寄生合剂治疗膝骨关节炎临床疗效及对关节液中IL-1,IL-6,TNF-α及NO的影响[J]. 中国实验方剂学杂志, 2017,23(1):174-178.
[4] 张永辉, 欧梁, 邝高艳, 等. 加味独活寄生合剂促进膝骨关节炎软骨修复疗效及作用机制研究 [J]. 中国中医药信息杂志, 2018,25(1):28-32.
[5] 包芸,高小明,包毅敏.金天格胶囊联合美洛昔康治疗膝骨关节炎的疗效观察[J].现代药物与临床,2017,32(12):2434-2437.
[6] 任伟亮. 骨氏葆方联合膝关节内粘疗法对膝骨关节炎患者骨代谢的影响及其有效性、安全性临床研究 [J]. 中医临床研究, 2017,9(7):11-13.
[7] 王娟.电针与温针灸治疗瘀血阻滞型膝关节骨性关节炎的研究[J].检验医学与临床,2017,14(4):508-509.
[8] 苏柯, 白玉明, 王军, 等. 关节内联合松质骨内注射富血小板血浆治疗膝骨关节炎的临床观察 [J]. 中华关节外科杂志(电子版), 2017,11(5):471-476.
[9] 张师侥, 杨永菊, 闵冬雨, 等. 基于肾虚血瘀病机探析膝痛康治疗膝骨关节炎机理[J]. 中华中医药学刊, 2018,36(3):741-743.
[10] 毛伟欢,胡旭华,李光阳,等.牛膝醇溶液透入辅助治疗在膝骨关节炎患者中的疗效观察[J].浙江创伤外科,2017,22(5):852-853.
[11] 王窕, 杜义斌, 许东云, 等. 中药溻渍联合中药内服治疗风寒湿痹证膝骨关节炎的临床观察 [J]. 云南中医中药杂志, 2018,39(1):41-42.
[12] 孙达志,王旭红.艾灸联合桃红饮加味治疗瘀血阻络型类风湿性关节炎的临床疗效研究[J].针灸临床杂志,2018,34(2):20-24.
[13] 杨黎黎, 王庆甫, 王欢, 等.通络止痛方对人膝骨关节炎滑膜炎性细胞TLR4、IL-1β及NO的影响 [J]. 中华中医药杂志, 2017,32(9):4124-4126.
[14] 郝胜坤, 纪斌, 石继祥, 等. 补肾活血中药治疗膝骨关节炎的作用机制 [J]. 中医正骨, 2017,29(4):31-33.
[15] 李哲,白玉,闫冬,等.膝三针、艾灸结合超激光照射治疗膝骨关节炎对下肢生物力学相关参数变化的影响[J].针灸临床杂志,2018,34(1):33-36.
[16] 岳馥鸿,于慧敏.乌梅透骨汤对大鼠膝骨关节炎动物模型血清炎性因子及关节软骨含水率影响[J].四川中医,2018,36(2):60-63.
[17] 蒋华,曾勇,马红兵,等.炎症分子核因子κB及骨桥蛋白在骨关节炎患者膝关节液中的表达及临床意义[J].标记免疫分析与临床,2017,24(11):1293-1297.
[18] 侯宝生,姜婷,金立,等.艾瑞昔布单独应用及与仙灵骨葆胶囊联合治疗膝骨关节炎的疗效比较[J].现代医学,2017,45(7):941-945.
[19] 杨帆, 袁芳, 侯秀娟, 等. 补肾通络方对大鼠膝骨关节炎膝关节软骨细胞外基质代谢的影响 [J]. 吉林中医药, 2018,38(1):67-71.
[20] 袁家骏, 罗程, 黄毅, 等. 口服自拟补肾活血汤治疗早期膝骨关节炎的临床研究 [J]. 中医正骨, 2017,29(8):26-32.
[21] 李朝军, 韩丽, 李小健, 等. 自拟补肾活血方对膝关节骨性关节炎血清SOD NO及MDA水平的影响 [J]. 四川中医, 2016,34(2):101-102.
[22] 曾令烽, 杨伟毅, 潘建科, 等. 瘀肾合治方药辅助治疗膝骨性关节炎的文献研究与分析 [J]. 中华中医药杂志, 2017,32(11):5088-5095.
[23] 梁桂洪, 梁祖建, 林勇凯, 等. 补肾活血中药对比塞来昔布治疗膝骨性关节炎疗效与安全性的Meta分析 [J]. 中国药房, 2016,27(27):3810-3814.