小针刀配合蠲痹汤加减治疗肝肾亏虚型膝关节骨性关节炎的临床效果研究
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摘要
目的:探讨小针刀配合蠲痹汤加减治疗肝肾亏虚型膝关节骨性关节炎的临床效果。方法:选取2017年5月至2019年1月在北京中医医院顺义医院收治的肝肾亏虚型膝关节骨性关节炎患者126例作为研究对象,按照随机数字表法将其分为对照组和观察组,每组63例。对照组单独应用小针刀治疗,观察组在对照组的基础上加用蠲痹汤加减治疗。观察2组患者临床疗效,以及治疗前后膝关节功能评分(HSS评分)、关节肿胀积分、骨摩擦音个数及中医证候积分。结果:观察组治疗总有效率为95. 2%(60/63),高于对照组的82. 5%(52/63),2组比较差异有统计学意义(P <0. 05);治疗前,2组患者HSS评分、关节肿胀积分、骨摩擦音关节及中医证候积分比较,差异均无统计学意义(均P <0. 05);治疗后,观察组患者HSS评分中疼痛评分、功能及总分均高于对照组(均P <0. 05),观察组患者关节肿胀积分、骨摩擦音关节个数及中医证候积分均显著低于对照组(均P <0. 05)。结论:小针刀配合蠲痹汤加减治疗肝肾亏虚型膝关节骨性关节炎疗效显著,可有效减轻患者疼痛,提高膝关节功能,减轻患者关节肿胀程度,值得临床应用。
Objective: To investigate the clinical effects of small needle knife combined with Juanbi Decoction on knee osteoarthritis of liver and kidney deficiency type. Methods: A total of 126 patients with osteoarthritis of knee joint of liver and kidney deficiency type admitted to Shunyi Hospital of Beijing Hospital of Traditional Chinese Medicine from May 2017 to January 2019 were selected and divided into an observation group and a control group according to random number table method,with 63 cases in each group. The control group was treated with small needle knife alone,while the observation group was treated with Juanbi Decoction on the basis of the control group. The clinical efficacy,knee joint function score( HSS score),joint swelling score,bony crepitus and TCM syndrome score of 2 groups were observed before and after treatment. Results: The total effective rate of the observation group was 95. 2%( 60/63),higher than that of the control group 82. 5%( 52/63),and there was significant difference( P <0. 05); before treatment,there was no significant difference in HSS score,joint swelling score,bony crepitus and TCM syndrome score between the 2 groups( P > 0. 05); after treatment,the pain score,function score and total score of the observation group were higher than those of the control group( P < 0. 05). The score of joint swelling,the number of joints with bony crepitus and the score of TCM syndromes in the observation group were lower than the control group( P < 0. 05). Conclusion: Small needle knife combined with Juanbi Decoction is effective in treating knee osteoarthritis of liver and kidney deficiency type. It can effectively relieve inertia pain,improve knee function and reduce the degree of joint swelling. It is worthy of clinical application.
Objective: To investigate the clinical effects of small needle knife combined with Juanbi Decoction on knee osteoarthritis of liver and kidney deficiency type. Methods: A total of 126 patients with osteoarthritis of knee joint of liver and kidney deficiency type admitted to Shunyi Hospital of Beijing Hospital of Traditional Chinese Medicine from May 2017 to January 2019 were selected and divided into an observation group and a control group according to random number table method,with 63 cases in each group. The control group was treated with small needle knife alone,while the observation group was treated with Juanbi Decoction on the basis of the control group. The clinical efficacy,knee joint function score( HSS score),joint swelling score,bony crepitus and TCM syndrome score of 2 groups were observed before and after treatment. Results: The total effective rate of the observation group was 95. 2%( 60/63),higher than that of the control group 82. 5%( 52/63),and there was significant difference( P <0. 05); before treatment,there was no significant difference in HSS score,joint swelling score,bony crepitus and TCM syndrome score between the 2 groups( P > 0. 05); after treatment,the pain score,function score and total score of the observation group were higher than those of the control group( P < 0. 05). The score of joint swelling,the number of joints with bony crepitus and the score of TCM syndromes in the observation group were lower than the control group( P < 0. 05). Conclusion: Small needle knife combined with Juanbi Decoction is effective in treating knee osteoarthritis of liver and kidney deficiency type. It can effectively relieve inertia pain,improve knee function and reduce the degree of joint swelling. It is worthy of clinical application.
引文
[1]郭艳波,段祥余,雷晓芬,等.热敏灸配合针刺治疗膝关节骨性关节炎(肝肾亏虚证)60例的临床观察[J].中医临床研究,2014,6(28):33-34.
[2]王智博,王秀华.培补肝肾方联合超声电导药物透入治疗肝肾亏虚型膝关节骨性关节炎随机平行对照研究[J].实用中医内科杂志,2015,29(4):63-64.
[3]于泉,赵云飞,王玉玲.迈之灵治疗膝关节骨性关节炎合并滑膜炎疗效分析[J].中国医药,2013,8(8):1132-1133.
[4]董军格,于健,刘京,等.护理康复配合中药熏洗及透明质酸钠关节腔注射治疗原发性膝关节骨性关节炎疗效观察[J].河北中医,2015,37(12):1896-1898.
[5]Vojtassak J Jr,Vojtassak J Sr.Ultrasound monitoring of the treatment of clinically significant knee osteoarthritis[J].Bratisl Lek Listy,2014,115(2):86-90.
[6]谢颖颖,肖楚吟.综合康复治疗联合塞来昔布对老年患者膝骨关节炎的疗效观察[J].现代医院,2015,15(1):20-22.
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[8]国家食品药品监督管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社.2002.
[9]吴晓云,王晓华,李应宏.身痛逐瘀汤联合西药治疗银屑病关节炎瘀血痹阻证患者疗效观察[J].内科,2017,12(4):480-483.
[10]郝浩,孔立,韩宁,等.参附注射液对脓毒性休克血流动力学及多糖包被的影响[J].中成药,2017,39(11):2437-2440.
[11]吕世伟,关雪峰.补正续骨丸联合电针透穴综合疗法治疗膝骨关节炎疗效评价[J].中华中医药杂志,2016,31(11):4857-4859.
[12]Jeong BO,Kim TY,Baek JH,et al.Following the correction of varus deformity of the knee through total knee arthroplasty,significant compensatory changes occur not only at the ankle and subtalar joint,but also at the foot[J].Knee Surg Sports Traumatol Arthrosc,2018,26(11):3230-3237.
[13]郑晓明,郑炜宏,王康振,等.中药内服配合中药封包治疗肝肾亏虚型膝关节骨性关节炎疗效分型[J].内蒙古中医药,2017,36(9):93.
[14]黄献京.膝关节骨性关节炎的临床治疗技术进展[J].临床合理用药杂志,2014,7(20):145-146.
[15]余红超,孙菊,董博,等.针刀整体松解术配合蠲痹汤治疗肝肾亏虚型膝骨性关节炎临床观察[J].中国医药导报,2017,14(3):169-171.
[16]陈旭东,蒋凯睿,黄河,等.中西医结合治疗肝肾亏虚型膝关节骨性关节炎40例[J].湖南中医杂志,2018,34(7):21-23.
[2]王智博,王秀华.培补肝肾方联合超声电导药物透入治疗肝肾亏虚型膝关节骨性关节炎随机平行对照研究[J].实用中医内科杂志,2015,29(4):63-64.
[3]于泉,赵云飞,王玉玲.迈之灵治疗膝关节骨性关节炎合并滑膜炎疗效分析[J].中国医药,2013,8(8):1132-1133.
[4]董军格,于健,刘京,等.护理康复配合中药熏洗及透明质酸钠关节腔注射治疗原发性膝关节骨性关节炎疗效观察[J].河北中医,2015,37(12):1896-1898.
[5]Vojtassak J Jr,Vojtassak J Sr.Ultrasound monitoring of the treatment of clinically significant knee osteoarthritis[J].Bratisl Lek Listy,2014,115(2):86-90.
[6]谢颖颖,肖楚吟.综合康复治疗联合塞来昔布对老年患者膝骨关节炎的疗效观察[J].现代医院,2015,15(1):20-22.
[7]中华医学会骨科分会.骨关节炎诊治指南(2007版)[J].中华骨科杂志,2007,27(10):793-796.
[8]国家食品药品监督管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社.2002.
[9]吴晓云,王晓华,李应宏.身痛逐瘀汤联合西药治疗银屑病关节炎瘀血痹阻证患者疗效观察[J].内科,2017,12(4):480-483.
[10]郝浩,孔立,韩宁,等.参附注射液对脓毒性休克血流动力学及多糖包被的影响[J].中成药,2017,39(11):2437-2440.
[11]吕世伟,关雪峰.补正续骨丸联合电针透穴综合疗法治疗膝骨关节炎疗效评价[J].中华中医药杂志,2016,31(11):4857-4859.
[12]Jeong BO,Kim TY,Baek JH,et al.Following the correction of varus deformity of the knee through total knee arthroplasty,significant compensatory changes occur not only at the ankle and subtalar joint,but also at the foot[J].Knee Surg Sports Traumatol Arthrosc,2018,26(11):3230-3237.
[13]郑晓明,郑炜宏,王康振,等.中药内服配合中药封包治疗肝肾亏虚型膝关节骨性关节炎疗效分型[J].内蒙古中医药,2017,36(9):93.
[14]黄献京.膝关节骨性关节炎的临床治疗技术进展[J].临床合理用药杂志,2014,7(20):145-146.
[15]余红超,孙菊,董博,等.针刀整体松解术配合蠲痹汤治疗肝肾亏虚型膝骨性关节炎临床观察[J].中国医药导报,2017,14(3):169-171.
[16]陈旭东,蒋凯睿,黄河,等.中西医结合治疗肝肾亏虚型膝关节骨性关节炎40例[J].湖南中医杂志,2018,34(7):21-23.