活血止痛胶囊联合依托考昔治疗膝关节骨性关节炎的疗效观察
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摘要
目的探讨活血止痛胶囊联合依托考昔治疗膝关节骨性关节炎的临床疗效。方法选取选取2016年2月—2017年2月天津中医药大学第一附属医院骨伤科膝关节骨性关节炎患者60例,随机分为对照组和治疗组,每组各30例。对照组患者饭后口服依托考昔片,1片/次,1次/d。治疗组在对照组治疗基础上口服活血止痛胶囊,6粒/次,2次/d。两组均连续治疗4周。观察两组的临床疗效,比较两组治疗前后VAS评分、WOMAC评分、Lysholm评分、Lequesne指数、患肢红外热成像温度的变化情况。结果治疗后,对照组和治疗组的总有效率分别为86.67%、96.67%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组VAS评分、WOMAC评分和Lequesne指数均较治疗前显著降低,Lysholm评分较治疗前显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组VAS评分、WOMAC评分和Lequesne指数低于对照组,Lysholm评分高于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患膝红外热成像温度均较治疗前显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后治疗组患膝红外热成像温度低于对照组,两组比较差异有统计学意义(P<0.05)。结论活血止痛胶囊联合依托考昔治疗膝关节骨性关节炎具有较好的临床疗效,能减轻患者膝关节疼痛和改善膝关节功能,降低患膝红外热成像温度,具有一定的临床推广应用价值。
Objective To investigate the clinical effect of Huoxue Zhitong Capsules combined with etoricoxib in treatment of knee osteoarthritis. Methods Patients(60 cases) with knee osteoarthritis in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from February 2016 to February 2017 were randomly divided into control(30 cases) and treatment(30 cases)groups. Patients in the control group were po administered with Etoricoxib Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Huoxue Zhitong Capsules on the basis of the control group, 6 grains/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the changes of VAS score, WOMAC score,Lysholm score, Lequesne index, and infrared thermal imaging temperature of the affected limb in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 86.67% and96.67%, respectively, and there were differences between two groups(P < 0.05). After treatment, VAS score, WOMAC score, and Lequesne index in two groups were significantly decreased, but Lysholm score was significantly increased, and there were differences in the same group(P < 0.05). After treatment, VAS score, WOMAC score, and Lequesne index in the treatment group were lower than those in the control group, but Lysholm score was higher than that in the control group, and there were differences between two groups(P < 0.05). After treatment, the infrared thermal imaging temperature of both groups was significantly lower than that before treatment, and there were differences in the same group(P < 0.05). After treatment, the infrared thermal imaging temperature in the treatment group were lower than those in the control group, and there were differences between two groups(P <0.05). Conclusion Huoxue Zhitong Capsules combined with etoricoxib has significant effect in treatment of knee osteoarthritis, and can reduce knee joint pain and improve knee joint function, and also can reduce the infrared thermal imaging temperature of the affected knee, which has a certain clinical application value.
Objective To investigate the clinical effect of Huoxue Zhitong Capsules combined with etoricoxib in treatment of knee osteoarthritis. Methods Patients(60 cases) with knee osteoarthritis in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from February 2016 to February 2017 were randomly divided into control(30 cases) and treatment(30 cases)groups. Patients in the control group were po administered with Etoricoxib Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Huoxue Zhitong Capsules on the basis of the control group, 6 grains/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the changes of VAS score, WOMAC score,Lysholm score, Lequesne index, and infrared thermal imaging temperature of the affected limb in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 86.67% and96.67%, respectively, and there were differences between two groups(P < 0.05). After treatment, VAS score, WOMAC score, and Lequesne index in two groups were significantly decreased, but Lysholm score was significantly increased, and there were differences in the same group(P < 0.05). After treatment, VAS score, WOMAC score, and Lequesne index in the treatment group were lower than those in the control group, but Lysholm score was higher than that in the control group, and there were differences between two groups(P < 0.05). After treatment, the infrared thermal imaging temperature of both groups was significantly lower than that before treatment, and there were differences in the same group(P < 0.05). After treatment, the infrared thermal imaging temperature in the treatment group were lower than those in the control group, and there were differences between two groups(P <0.05). Conclusion Huoxue Zhitong Capsules combined with etoricoxib has significant effect in treatment of knee osteoarthritis, and can reduce knee joint pain and improve knee joint function, and also can reduce the infrared thermal imaging temperature of the affected knee, which has a certain clinical application value.
引文
[1]赵绵松,李小霞.骨性关节炎的临床表现与诊断[J].解放军保健医学杂志,2005,7(3):135-137.
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[5]黄凯,唐旭东.活血止痛软胶囊联合骨肽治疗膝骨性关节炎的临床研究[J].现代药物与临床,2016,31(6):838-841.
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[7]夏传涛,余方方,方华,等.西安大略和麦克马斯特大学骨关节炎指数量表应用于大骨节病的信度和效度评价[J].中华地方病学杂志,2015,34(4):274-277.
[8]吴向科,童培建,陈志进.膝关节骨性关节炎中西医结合治疗的临床疗效研究分析[J].中华中医药学刊,2015,33(4):999-1001.
[9]席立成,李宏宇,赵子星,等.体外冲击波治疗早中期膝关节骨性关节炎效果观察及其机制[J].山东医药,2016,56(48):60-62.
[10]吴登科,赵世阳,马国涛,等.关节镜下有限清理联合骨赘清除治疗膝关节骨性关节炎疗效分析[J].中国医学工程,2016,24(12):118-119.
[11]陈付艳,周鑫.痹祺胶囊联合塞来昔布治疗膝骨性关节炎的临床研究[J].现代药物与临床,2017,32(7):1341-1344.
[12]何正惠,陈静.中西医结合治疗膝关节骨性关节炎效果观察[J].河南外科学杂志,2016,24(4):42-43.
[13]Lane N E,Brandt K,Hawker G,et al.OARSI+FDAinitiative:defining the disease state of osteoarthritis[J].Osteoarthr Cartil,2011,19(5):478-482.
[14]Williams F M,Skinner J,Spector T D,et al.Dietary garlic and hip osteoarthritis:evidence of a protective effect and putative mechanism of action[J].BMCMusculoskelet Disord,2010,11(1):69-78.
[15]郭梦如,何东仪.骨关节炎治疗的中医药研究进展[J].风湿病与关节炎,2019,8(1):73-75.
[16]张念森.非甾体抗炎药的临床应用及不良反应[J].中国药物评价,2013,30(1):37-38.
[17]王叶亭,李建其,王冠,等.依托考昔有关物质的合成研究[J].中国药物化学杂志,2016,26(6):475-479.
[18]邝翠琼,陈超,赖建茵,等.依托考昔与塞来昔布治疗骨关节炎的疗效和安全性对比[J].北方药学,2017,14(7):133-134.
[19]Reginster J Y,Malmstrom K,Mehta A,et al.Evaluation of the efficacy and safety of etoricoxib compared with naproxen in two,138-week randomised studies of patients with osteoarthritis[J].Ann Rheum Dis,2007,66(7):945-951.
[20]张昕,曹俊青,肖少雄.活血止痛方联合膝关节清理术治疗气滞血瘀型轻中度膝骨性关节炎的临床观察[J].湖南中医药大学学报,2018,20(5):95-97.
[21]关志宇,濮存海,段广勋.活血止痛胶囊处方考证及研究进展[J].食品与药品,2006,8(2):17-21.
[22]中华人民共和国药典[S].一部.2005:546
[23]单英,孔树佳,傅继华.活血止痛胶囊的抗炎镇痛作用及其作用机制[J].辽宁中医杂志,2007,34(8):1162-1163.
[24]王玉忠,郑传莉.活血止痛胶囊对大鼠急性软组织损伤的修复作用研究[J].中药材,2015,38(6):1263-1265.
[25]汪洋.活血止痛软胶囊联合骨肽治疗膝骨性关节炎对血清炎性因子变化的影响[J].光明中医,2018,33(13):1951-1952.
[26]昝韬,靖光武.活血止痛软胶囊联合维骨力治疗膝骨关节炎的临床研究[J].中药药理与临床,2015,31(4):279-280.
[27]李佳,朱爱松,谢晚晴,等.关于补肾中药防治骨关节炎分子机制的体外实验研究[J].中国骨质疏松杂志,2016,22(7):877-882.
[28]Nahm F S.Infrared thermography in pain[J].Korean JPain,2013,26(3):219-222.
[29]Chen H B,Yang K H,Wang Z G.Biomechanics of whiplash injury[J].Chin J Traumatol,2009,12(5):305-314.
[30]Lee Y S,Paeng S H,Farhadi H F,et al.The effectiveness of infrared thermography in patients with whiplash injury[J].J Korean Neurosurg Soc,2015,57(4):283-288.
[2]Bijlsma J W,Berenbaum F,Lafeber F P.Osteoarthritis:an update with relevance for clinical practice[J].Lancet,2011,377(9783):2115-2126.
[3]武宏,韩颖,生孟军,等.骨关节炎治疗进展[J].医学综述,2007,13(14):1089-1091.
[4]王国春.依托考昔在骨关节炎的治疗研究进展[J].中华关节外科杂志:电子版,2014,8(6):83-85.
[5]黄凯,唐旭东.活血止痛软胶囊联合骨肽治疗膝骨性关节炎的临床研究[J].现代药物与临床,2016,31(6):838-841.
[6]中华医学会骨科学分会关节外科学组.骨关节炎诊疗指南(2018年版)[J].中华骨科杂志,2018,38(12):705-715.
[7]夏传涛,余方方,方华,等.西安大略和麦克马斯特大学骨关节炎指数量表应用于大骨节病的信度和效度评价[J].中华地方病学杂志,2015,34(4):274-277.
[8]吴向科,童培建,陈志进.膝关节骨性关节炎中西医结合治疗的临床疗效研究分析[J].中华中医药学刊,2015,33(4):999-1001.
[9]席立成,李宏宇,赵子星,等.体外冲击波治疗早中期膝关节骨性关节炎效果观察及其机制[J].山东医药,2016,56(48):60-62.
[10]吴登科,赵世阳,马国涛,等.关节镜下有限清理联合骨赘清除治疗膝关节骨性关节炎疗效分析[J].中国医学工程,2016,24(12):118-119.
[11]陈付艳,周鑫.痹祺胶囊联合塞来昔布治疗膝骨性关节炎的临床研究[J].现代药物与临床,2017,32(7):1341-1344.
[12]何正惠,陈静.中西医结合治疗膝关节骨性关节炎效果观察[J].河南外科学杂志,2016,24(4):42-43.
[13]Lane N E,Brandt K,Hawker G,et al.OARSI+FDAinitiative:defining the disease state of osteoarthritis[J].Osteoarthr Cartil,2011,19(5):478-482.
[14]Williams F M,Skinner J,Spector T D,et al.Dietary garlic and hip osteoarthritis:evidence of a protective effect and putative mechanism of action[J].BMCMusculoskelet Disord,2010,11(1):69-78.
[15]郭梦如,何东仪.骨关节炎治疗的中医药研究进展[J].风湿病与关节炎,2019,8(1):73-75.
[16]张念森.非甾体抗炎药的临床应用及不良反应[J].中国药物评价,2013,30(1):37-38.
[17]王叶亭,李建其,王冠,等.依托考昔有关物质的合成研究[J].中国药物化学杂志,2016,26(6):475-479.
[18]邝翠琼,陈超,赖建茵,等.依托考昔与塞来昔布治疗骨关节炎的疗效和安全性对比[J].北方药学,2017,14(7):133-134.
[19]Reginster J Y,Malmstrom K,Mehta A,et al.Evaluation of the efficacy and safety of etoricoxib compared with naproxen in two,138-week randomised studies of patients with osteoarthritis[J].Ann Rheum Dis,2007,66(7):945-951.
[20]张昕,曹俊青,肖少雄.活血止痛方联合膝关节清理术治疗气滞血瘀型轻中度膝骨性关节炎的临床观察[J].湖南中医药大学学报,2018,20(5):95-97.
[21]关志宇,濮存海,段广勋.活血止痛胶囊处方考证及研究进展[J].食品与药品,2006,8(2):17-21.
[22]中华人民共和国药典[S].一部.2005:546
[23]单英,孔树佳,傅继华.活血止痛胶囊的抗炎镇痛作用及其作用机制[J].辽宁中医杂志,2007,34(8):1162-1163.
[24]王玉忠,郑传莉.活血止痛胶囊对大鼠急性软组织损伤的修复作用研究[J].中药材,2015,38(6):1263-1265.
[25]汪洋.活血止痛软胶囊联合骨肽治疗膝骨性关节炎对血清炎性因子变化的影响[J].光明中医,2018,33(13):1951-1952.
[26]昝韬,靖光武.活血止痛软胶囊联合维骨力治疗膝骨关节炎的临床研究[J].中药药理与临床,2015,31(4):279-280.
[27]李佳,朱爱松,谢晚晴,等.关于补肾中药防治骨关节炎分子机制的体外实验研究[J].中国骨质疏松杂志,2016,22(7):877-882.
[28]Nahm F S.Infrared thermography in pain[J].Korean JPain,2013,26(3):219-222.
[29]Chen H B,Yang K H,Wang Z G.Biomechanics of whiplash injury[J].Chin J Traumatol,2009,12(5):305-314.
[30]Lee Y S,Paeng S H,Farhadi H F,et al.The effectiveness of infrared thermography in patients with whiplash injury[J].J Korean Neurosurg Soc,2015,57(4):283-288.