独活寄生汤对膝关节骨性关节炎行关节置换患者ESR、CRP、MMP-9水平的影响
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摘要
目的:探讨独活寄生汤对膝关节骨性关节炎行关节置换患者血液红细胞沉降率(ESR)、C反应蛋白(CRP)以及基质金属蛋白酶-9(MMP-9)水平的影响。方法:选取64例膝关节骨性关节炎关节置换手术患者为研究对象,按照随机数表法将患者分为两组,每组32例。两组均接受全膝关节置换治疗,常规护理。观察组在对照组治疗基础上给予独活寄生汤治疗。评价临床疗效和关节功能评分。治疗前后,采集静脉血3ml,检测ESR、血清CRP、MMP-9水平。结果:治疗后观察组总有效率为96.88%,明显高于对照组总有效率78.13%,差异有统计学意义(P<0.05)。治疗前两组患者关节功能评分对比差异不具有统计学意义(P>0.05);观察组治疗后1个月和3个月关节功能评分均分别低于对照组治疗后1个月和3个月关节功能评分,差异比较具有统计学意义(P<0.05)。两组治疗前ESR、血清CRP、MMP-9指标水平对比不具有统计学意义(P>0.05);两组患者治疗后ESR、血清CRP、MMP-9水平均显著下降,观察组指标水平明显低于对照组指标水平,且两组指标水平对比有统计学意义(P<0.05)。结论:独活寄生汤能够降低膝关节骨性关节炎行关节置换患者的炎症反应水平,且能够改善患者关节功能,提高治疗效果,值得临床应用。
Objective:To investigate the clinical effects of Duhuo Jisheng decoction ERS(CRP)and(MMP-9)levels in patients with arthritis of knee joint.Methods:64 patients with knee joint osteoarthritis joint replacement surgery were enrolled in the study.The patients were divided into two groups according to the random number table method,32 cases in each group.Both groups underwent total knee arthroplasty and routine care.The observation group was given the treatment of Duhuo Jisheng decoction on the basis of the treatment of the control group.Clinical efficacy and joint function scores were evaluated.Before and after treatment,3 ml of venous blood was collected,and ESR,serum CRP,and MMP-9 levels were measured.Results:After treatment,the total effective rate of observation group was 96.88%,which was significantly higher than the total effective rate of the control group of 78.13%,and the data were statistically significant between the two groups(P<0.05).There was no significant difference in the scores of joint functions between the observation group and the control group before treatment(P>0.05).The joint function scores of the observation group at 1 month and 3 months after treatment were lower than those of the control group 1 month and 3 months after treatment,and the joint function scores were statistically significant between the two groups(P<0.05).There was no significant difference in the levels of ESR,serum CRP and MMP-9 between the observation group and the control group before treatment(P>0.05).The ESR,serum CRP and MMP-9 levels were significantly decreased after treatment,and the observation group was significantly lower than the control group(P<0.05).Conclusion:Duhuo Jisheng decoction can reduce the level of inflammatory reaction in patients with arthrodesis of knee joint osteoarthritis,and can improve the joint function of patients and improve the therapeutic effect.It is worthy of clinical recommendation.
Objective:To investigate the clinical effects of Duhuo Jisheng decoction ERS(CRP)and(MMP-9)levels in patients with arthritis of knee joint.Methods:64 patients with knee joint osteoarthritis joint replacement surgery were enrolled in the study.The patients were divided into two groups according to the random number table method,32 cases in each group.Both groups underwent total knee arthroplasty and routine care.The observation group was given the treatment of Duhuo Jisheng decoction on the basis of the treatment of the control group.Clinical efficacy and joint function scores were evaluated.Before and after treatment,3 ml of venous blood was collected,and ESR,serum CRP,and MMP-9 levels were measured.Results:After treatment,the total effective rate of observation group was 96.88%,which was significantly higher than the total effective rate of the control group of 78.13%,and the data were statistically significant between the two groups(P<0.05).There was no significant difference in the scores of joint functions between the observation group and the control group before treatment(P>0.05).The joint function scores of the observation group at 1 month and 3 months after treatment were lower than those of the control group 1 month and 3 months after treatment,and the joint function scores were statistically significant between the two groups(P<0.05).There was no significant difference in the levels of ESR,serum CRP and MMP-9 between the observation group and the control group before treatment(P>0.05).The ESR,serum CRP and MMP-9 levels were significantly decreased after treatment,and the observation group was significantly lower than the control group(P<0.05).Conclusion:Duhuo Jisheng decoction can reduce the level of inflammatory reaction in patients with arthrodesis of knee joint osteoarthritis,and can improve the joint function of patients and improve the therapeutic effect.It is worthy of clinical recommendation.
引文
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[10]邝高艳,严可,柴爽,等.独活寄生汤加减治疗膝骨关节炎疗效及安全性的Meta分析[J].中医药导报,2016,16(17):59-62.
[11]房显辉,金远林,梁日楚,等.独活寄生汤联合乌麻膏治疗膝骨关节炎的疗效观察[J].中国实用医药,2016,11(11):193-194.
[12]王雷,闫相斌.膝骨关节炎采用独活寄生汤辅助效果及对关节滑液中细胞因子的影响[J].陕西中医,2016,37(12):1600-1602.
[13]冯雍,邹季.独活寄生汤对兔膝骨性关节炎关节液中白介素-1β、肿瘤坏死因子-α和Ⅱ型胶原的影响[J].湖北中医药大学学报,2017,19(1):15-18.
[14]庞青民,赵欲晓,王承惠,等.针灸联合独活寄生汤加减治疗膝骨性关节炎患者疗效观察及对炎症因子和血液流变学影响[J].辽宁中医杂志,2017,16(4):782-785.
[15]孙鹏,李建,樊炜骏,等.独活寄生汤含药血清对膝骨性关节炎大鼠关节软骨细胞凋亡及GRP78,CHOP,HIRA及ASFla表达的影响[J].中国实验方剂学杂志,2017,16(13):158-163.
[2]文曦娜,李敏清,何苗,等.盐酸氨基葡萄糖对比独活寄生汤治疗膝骨关节炎临床疗效观察[J].华西医学,2016,36(5):808-810.
[3]芦丹,汪亚群,孙迪.独活寄生汤对膝骨性关节炎患者关节液炎症因子、疗效及膝关节功能状况的影响分析[J].中华中医药学刊,2017,16(4):1050-1052.
[4]张璟婷,裘敏蕾.独活寄生汤治疗膝骨关节炎药理研究及临床应用进展[J].河北中医,2017,39(3):468-472.
[5]雷文淼,张鸿.独活寄生汤治疗膝骨性关节炎患者的疗效及对患者关节液MMP-3、MMP-9水平的影响[J].陕西中医,2017,38(10):1432-1433.
[6]刘奎,谢维.独活寄生汤治疗膝骨关节炎的临床效果评价[J].内蒙古中医药,2017,36(10):4-5.
[7]吴漫.独活寄生汤对膝骨性关节炎患者血清TNF-α和IL-6水平的影响[J].光明中医,2017,32(12):1688-1689.
[8]胡长宇.加味四妙汤联合独活寄生汤治疗膝骨性关节炎的临床观察[J].内蒙古中医药,2016,35(3):8-9.
[9]杨剑标.独活寄生汤治疗膝关节骨性关节炎临床疗效及对膝关节液炎症因子的影响[J].河北中医,2016,38(8):1202-1205.
[10]邝高艳,严可,柴爽,等.独活寄生汤加减治疗膝骨关节炎疗效及安全性的Meta分析[J].中医药导报,2016,16(17):59-62.
[11]房显辉,金远林,梁日楚,等.独活寄生汤联合乌麻膏治疗膝骨关节炎的疗效观察[J].中国实用医药,2016,11(11):193-194.
[12]王雷,闫相斌.膝骨关节炎采用独活寄生汤辅助效果及对关节滑液中细胞因子的影响[J].陕西中医,2016,37(12):1600-1602.
[13]冯雍,邹季.独活寄生汤对兔膝骨性关节炎关节液中白介素-1β、肿瘤坏死因子-α和Ⅱ型胶原的影响[J].湖北中医药大学学报,2017,19(1):15-18.
[14]庞青民,赵欲晓,王承惠,等.针灸联合独活寄生汤加减治疗膝骨性关节炎患者疗效观察及对炎症因子和血液流变学影响[J].辽宁中医杂志,2017,16(4):782-785.
[15]孙鹏,李建,樊炜骏,等.独活寄生汤含药血清对膝骨性关节炎大鼠关节软骨细胞凋亡及GRP78,CHOP,HIRA及ASFla表达的影响[J].中国实验方剂学杂志,2017,16(13):158-163.