平乐正骨中药内服及外敷治疗湿热阻络型膝关节炎滑膜炎疗效观察
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摘要
目的:观察平乐正骨中药内服、外敷治疗湿热阻络型膝关节炎滑膜炎的临床疗效。方法:将96例膝关节炎滑膜炎患者按照随机数字表随机分成治疗组与对照组,各48例。治疗组采用平乐正骨中药内服外敷治疗,对照组采用口服滑膜炎片配合消痛贴膏外敷治疗,共治疗2周,治疗前后通过彩超滑膜炎评价、VAS疼痛评分、WOMAC功能评分、实验室CRP及ESR检查等指标进行疗效评价。结果:治疗后,肌骨超声评分治疗组关节腔积液减少,滑膜增生及滑膜血流信号均较对照组显著改善(P<0.05);治疗后两组的VAS、WOMAC评分较治疗前均显著改善(P<0.05);治疗后两组间比较,治疗组的VAS、WOMAC评分改善优于对照组,差异有统计学意义(P<0.05);治疗后两组实验室检查CPR、ESR指标均较治疗前明显改善(P<0.05),治疗后两组间比较,治疗组实验室检查CPR、ESR指标均较对照组显著改善(P<0.05);试验组总有效率为91.66%,对照组总有效率为81.25%,差异有统计学意义(P<0.05)。结论:平乐正骨中药内服、外敷疗法能有效缓解膝关节炎滑膜炎的疼痛,改善关节功能,同时可以减少关节腔积液、抑制滑膜增生、减少滑膜血流信号,但其疗效的延续作用仍需临床上反复验证。
Objective: To observe the clinical effect of traditional Chinese medicine Pingle Zhenggu in the treatment of synovitis with damp-heat blocking collaterals. Methods: Ninety-six cases of knee joint inflammatory synovitis were randomly divided into two groups according to the random digital table, 48 cases in the test group and 48 cases in the control group. The control group was treated with oral synovitis tablets combined with indomethacin plaster, once a day, for 14 days as a course of treatment. Before and after treatment, the patients were evaluated by color Doppler synovitis and VAS pain score. WOMAC function score, laboratory CRP and ESR test were used to evaluate the curative effect. Results: After treatment, the joint cavity effusion decreased, synovial hyperplasia and synovial blood flow signal were improved significantly in the treatment group, which had statistical difference compared with the control group(P<0.05). In the treatment group and control group, the VAS, WOMAC scores of the two groups were significantly improved after treatment compared with those before treatment(P<0.05), and there was a significant difference between the two groups before and after treatment(P<0.05). After treatment, the VAS, WOMAC score of the treatment group was significantly better than that of the control group, the difference was statistically significant(P<0.05).In the treatment group and the control group before and after treatment, the CPR, ESR indexes of the two groups were obviously improved after treatment, the difference was statistically significant(P<0.05), and there was a significant difference between the two groups after the treatment(P<0.05). The total effective rate was 91.66% in the test group and 81.25% in the control group(P<0.05). Conclusion: Internal and external application of traditional Chinese medicine Pingle Zhenggu can effectively relieve the pain of knee joint synovitis and improve the joint function. At the same time, it can reduce joint cavity effusion, inhibit synovial hyperplasia, reduce synovial blood flow signal, but the continuation of its efficacy still needs to be repeated in clinical trials.
Objective: To observe the clinical effect of traditional Chinese medicine Pingle Zhenggu in the treatment of synovitis with damp-heat blocking collaterals. Methods: Ninety-six cases of knee joint inflammatory synovitis were randomly divided into two groups according to the random digital table, 48 cases in the test group and 48 cases in the control group. The control group was treated with oral synovitis tablets combined with indomethacin plaster, once a day, for 14 days as a course of treatment. Before and after treatment, the patients were evaluated by color Doppler synovitis and VAS pain score. WOMAC function score, laboratory CRP and ESR test were used to evaluate the curative effect. Results: After treatment, the joint cavity effusion decreased, synovial hyperplasia and synovial blood flow signal were improved significantly in the treatment group, which had statistical difference compared with the control group(P<0.05). In the treatment group and control group, the VAS, WOMAC scores of the two groups were significantly improved after treatment compared with those before treatment(P<0.05), and there was a significant difference between the two groups before and after treatment(P<0.05). After treatment, the VAS, WOMAC score of the treatment group was significantly better than that of the control group, the difference was statistically significant(P<0.05).In the treatment group and the control group before and after treatment, the CPR, ESR indexes of the two groups were obviously improved after treatment, the difference was statistically significant(P<0.05), and there was a significant difference between the two groups after the treatment(P<0.05). The total effective rate was 91.66% in the test group and 81.25% in the control group(P<0.05). Conclusion: Internal and external application of traditional Chinese medicine Pingle Zhenggu can effectively relieve the pain of knee joint synovitis and improve the joint function. At the same time, it can reduce joint cavity effusion, inhibit synovial hyperplasia, reduce synovial blood flow signal, but the continuation of its efficacy still needs to be repeated in clinical trials.
引文
[1]中华中医药学会骨伤科分会.成人膝关节滑膜炎诊断与临床疗效评价专家共识.中国中医骨伤科杂志,2016,24(1):1-3
[2]刘斌,郭艳幸,郭珈宜,等.平乐正骨治疗慢性膝关节滑膜炎经验荟萃.世界中西医结合杂志,2016,11(2):242-244
[3]郭珈宜,崔宏勋,郭马珑,等.平乐郭氏正骨流派学术思想的传承与创新.中医正骨,2015,27(1):71-74
[4]中华医学会骨科分会.骨关节诊治指南(2007年版).中华骨科杂志,2007,27(10):793
[5]Kellgren J H,Laerence J S.Radiological assessment of osteoarthritis.Annals of the Rheumatic Diseases,1957,16:494
[6]Walther M,Harms H,Krenn V,et al.Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis.Arthritis&Rheumatism,2001,44(2):331-338
[7]Iagnocco A,Epis O,Delle Sedie A,et al.Ultrasound imaging for the rheumatologist.XVII. role of colour doppler and power doppler.Clinical and Experimental Rheumatology,2007,26(5):759-762
[8]Dalvi S R,Moser D W,Samuels J.Ultrasound and treatment algorithmsofRAandJIA.RheumDisClinNorth Am,2013,39(3):669-688
[9]国家中医药管理局.中医病证诊断疗效标准.南京:南京大学出版社,1994:165
[10]黄海青,殷长俊.膝关节退行性骨关节炎的MR诊断与中医辨证分型对比性研究.江苏中医药,2009,41(6):21-22
[11]肖碧跃,郭艳幸,何清湖,等.整体哲学思维对平乐正骨的影响.中华中医药杂志,2015,30(11):3847-3849
[12]肖碧跃,郭艳幸,何清湖,等.“和合”哲学思想对平乐正骨理论的影响.中华中医药杂志,2016,31(3):850-852
[13]肖碧跃,郭艳幸,何清湖,等.“仁”学思想对平乐正骨的影响.中华中医药杂志,2016,31(1):114-116
[14]郭珈宜,李峰,崔宏勋,等.平乐正骨养骨理论基础.中华中医药杂志,2017,32(9):3950-3952
[15]Takaseminegishi K,Horita N,Kobayashi K,et al.Diagnostic test accuracy of ultrasound for synovitis in rheumatoid arthritis:Systematic review and meta-analysis.Rheumatology,2017,57(1):49-58
[16]张栋,王庆甫,石鑫超,等.膝骨关节炎肌骨超声与X线片表现的比较与分析.中国骨伤,2016,29(5):429-433
[17]Fritz J.Magnetic resonance imaging versus ultrasonography for the diagnosis of synovitis in rheumatoid arthritis.Rheumatology,2017,57(1):5-7
[18]Lazaar H,Lhoste-Trouilloud A,Pereira B,et al.Does rheumatoid synovitis activity vary during the day?Evaluation with color doppler sonography.Bmc Musculoskeletal Disorders,2017,18(1):98
[19]马玉峰,祁印泽,贺立娟,等.膝骨性关节炎肌骨超声滑膜病变与Lysholm评分的相关性分析.中国中医骨伤科杂志,2016,24(11):19-23
[20]王大力.腹部推拿配合中药熏蒸疗法治疗膝关节骨性关节炎合并关节腔积液的临床观察.中华中医药杂志,2017,32(9):4324-4326
[21]李顺利,张铁刚,李颖,等.中西医综合治疗方案治疗膝关节滑膜炎80例临床观察.中医杂志,2014,55(10):868-870
[2]刘斌,郭艳幸,郭珈宜,等.平乐正骨治疗慢性膝关节滑膜炎经验荟萃.世界中西医结合杂志,2016,11(2):242-244
[3]郭珈宜,崔宏勋,郭马珑,等.平乐郭氏正骨流派学术思想的传承与创新.中医正骨,2015,27(1):71-74
[4]中华医学会骨科分会.骨关节诊治指南(2007年版).中华骨科杂志,2007,27(10):793
[5]Kellgren J H,Laerence J S.Radiological assessment of osteoarthritis.Annals of the Rheumatic Diseases,1957,16:494
[6]Walther M,Harms H,Krenn V,et al.Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis.Arthritis&Rheumatism,2001,44(2):331-338
[7]Iagnocco A,Epis O,Delle Sedie A,et al.Ultrasound imaging for the rheumatologist.XVII. role of colour doppler and power doppler.Clinical and Experimental Rheumatology,2007,26(5):759-762
[8]Dalvi S R,Moser D W,Samuels J.Ultrasound and treatment algorithmsofRAandJIA.RheumDisClinNorth Am,2013,39(3):669-688
[9]国家中医药管理局.中医病证诊断疗效标准.南京:南京大学出版社,1994:165
[10]黄海青,殷长俊.膝关节退行性骨关节炎的MR诊断与中医辨证分型对比性研究.江苏中医药,2009,41(6):21-22
[11]肖碧跃,郭艳幸,何清湖,等.整体哲学思维对平乐正骨的影响.中华中医药杂志,2015,30(11):3847-3849
[12]肖碧跃,郭艳幸,何清湖,等.“和合”哲学思想对平乐正骨理论的影响.中华中医药杂志,2016,31(3):850-852
[13]肖碧跃,郭艳幸,何清湖,等.“仁”学思想对平乐正骨的影响.中华中医药杂志,2016,31(1):114-116
[14]郭珈宜,李峰,崔宏勋,等.平乐正骨养骨理论基础.中华中医药杂志,2017,32(9):3950-3952
[15]Takaseminegishi K,Horita N,Kobayashi K,et al.Diagnostic test accuracy of ultrasound for synovitis in rheumatoid arthritis:Systematic review and meta-analysis.Rheumatology,2017,57(1):49-58
[16]张栋,王庆甫,石鑫超,等.膝骨关节炎肌骨超声与X线片表现的比较与分析.中国骨伤,2016,29(5):429-433
[17]Fritz J.Magnetic resonance imaging versus ultrasonography for the diagnosis of synovitis in rheumatoid arthritis.Rheumatology,2017,57(1):5-7
[18]Lazaar H,Lhoste-Trouilloud A,Pereira B,et al.Does rheumatoid synovitis activity vary during the day?Evaluation with color doppler sonography.Bmc Musculoskeletal Disorders,2017,18(1):98
[19]马玉峰,祁印泽,贺立娟,等.膝骨性关节炎肌骨超声滑膜病变与Lysholm评分的相关性分析.中国中医骨伤科杂志,2016,24(11):19-23
[20]王大力.腹部推拿配合中药熏蒸疗法治疗膝关节骨性关节炎合并关节腔积液的临床观察.中华中医药杂志,2017,32(9):4324-4326
[21]李顺利,张铁刚,李颖,等.中西医综合治疗方案治疗膝关节滑膜炎80例临床观察.中医杂志,2014,55(10):868-870