中药内外同治慢性膝关节滑膜炎疗效观察
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摘要
目的观察自拟滑膜炎汤联合伤科消炎膏治疗慢性膝关节滑膜炎痰凝湿阻型的临床疗效。方法选择50例诊断为膝关节慢性滑膜炎且中医辨证为痰凝湿阻证患者,随机分为治疗组和对照组,每组25例。治疗组采用内服滑膜炎汤联合外用伤科消炎膏治疗。对照组仅给予双氯芬酸钠(扶他林)外敷。2组患者均以2周为1个疗程,治疗2个疗程。观察2组患者治疗前后膝关节VAS疼痛评分、膝关节肿胀程度评分、骨关节炎评分(WOMAC),统计2组疗效。结果 2组治疗后VAS疼痛评分、肿胀度评分、WOMAC评分均明显降低(P均<0.05),且治疗组各项评分均明显低于对照组(P均<0.05)。治疗组总有效率明显高于对照组(P<0.05)。2组在治疗过程中均未出现药物不良反应。结论中药滑膜炎汤内服联合外敷伤科消炎膏治疗慢性膝关节滑膜炎能明显改善膝关节疼痛、肿胀及膝关节功能,疗效确切,不良反应少,值得进一步推广和研究。
Objective It is to observe the clinical efficacy of self-made synovitis decoction combined with Shangke Xiaoyan ointment in the treatment of chronic knee joint synovitis of type of phlegm-dampness stagnation. Methods Fifty patients who were diagnosed as chronic synovitis of knee joint and syndrome of phlegm-dampness stagnation according to syndrome differentiation were randomly divided into treatment group and control group, 25 cases in each group. The treatment group was treated with synovitis decoction by oral administration combined with Shangke Xiaoyan ointment by external application. The control group was only given external application of diclofenac sodium. Two weeks as a course of treatment, both groups were treated for two courses. The VAS pain scores and swelling scores of knee joint,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) before and after treatment were observed before and after treatment,and the clinical curative effects were evaluated in the two groups. Results After treatment, the scores of VAS, swelling scores and WOMAC scores were significantly decreased in the two groups(P<0.05), and the scores in the treatment group were significantly lower than those in the control group(P<0.05).The total effective rate in the treatment group was significantly higher than that in the control group(P<0.05). There was no significant difference occurred during treatment period in the two groups. Conclusion Synovitis decoction by oral administration combined with Shangke Xiaoyan ointment by external application can significantly improve pain, swelling of knee joint and knee joint function in the treatment of knee joint synovitis. Its curative is definite with less side effect, and is worth for further promotion and research.
Objective It is to observe the clinical efficacy of self-made synovitis decoction combined with Shangke Xiaoyan ointment in the treatment of chronic knee joint synovitis of type of phlegm-dampness stagnation. Methods Fifty patients who were diagnosed as chronic synovitis of knee joint and syndrome of phlegm-dampness stagnation according to syndrome differentiation were randomly divided into treatment group and control group, 25 cases in each group. The treatment group was treated with synovitis decoction by oral administration combined with Shangke Xiaoyan ointment by external application. The control group was only given external application of diclofenac sodium. Two weeks as a course of treatment, both groups were treated for two courses. The VAS pain scores and swelling scores of knee joint,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) before and after treatment were observed before and after treatment,and the clinical curative effects were evaluated in the two groups. Results After treatment, the scores of VAS, swelling scores and WOMAC scores were significantly decreased in the two groups(P<0.05), and the scores in the treatment group were significantly lower than those in the control group(P<0.05).The total effective rate in the treatment group was significantly higher than that in the control group(P<0.05). There was no significant difference occurred during treatment period in the two groups. Conclusion Synovitis decoction by oral administration combined with Shangke Xiaoyan ointment by external application can significantly improve pain, swelling of knee joint and knee joint function in the treatment of knee joint synovitis. Its curative is definite with less side effect, and is worth for further promotion and research.
引文
[1] 成人膝关节滑膜炎诊断及临床疗效评价专家共识[J].中华骨伤科杂志,2016,24(1):1-3
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[11] 陈利国.四妙散散治疗膝关节滑膜炎[J].四川中医,2009,27(12):104
[12] 李绍军,郭敏.膝关节滑膜炎的中医药治疗进展[J].中国社区医师:医学专业,2010,12(15):121-122
[13] 王西伦.中西医结合综合疗法治疗膝关节滑膜炎125例临床观察[J].中国医药指南,2007,5(10):131-132
[14] 张智,张建华.中药外治法治疗膝关节滑膜炎研究进展[J].中医药临床杂志,2018,30(1):179-181
[15] 姜耘宙.补肾温阳利水汤治疗中老年慢性膝关节滑膜炎65例[J].浙江中医杂志,2014,49(4):261
[16] 王战朝,杜志谦,闫永昌,等.通经活利汤治疗膝关节滑膜炎的临床研究[J].中医正骨,2012,24(4):26-29
[17] 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[J].世界中西医结合杂志,2016,11(2):242-245
[18] 孙鲁宁,黄桂成,赵燕华,等.伤科消炎膏对木瓜蛋白酶诱导兔膝骨关节炎模型滑膜中白介素-1、白三烯、金属蛋白酶-3的影响[J].辽宁中医药大学学报,2012,14(9):143-145
[2] 马勇,周重建,宋敏.中医筋伤学[M].北京:人民卫生出版社,2012
[3] 赵新杰,孙实,武爱玲.中医药治疗膝关节滑膜炎的研究进展[J].中医正骨,2015,27(8):65-66;68
[4] 胥少汀,葛宝丰,徐印坎.实用骨科学(下)[M].北京:人民军医出版社,2012
[5] 詹红生,郑昱新.成人膝关节滑膜炎诊断与临床疗效评价专家共识[J].中国中医骨伤科杂志,2016,24(1):1-3
[6] 国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994
[7] 国家中医药管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002
[8] Aitken RC.Measurement of feelings using visual analoguescales[J].Proc R Soc Med,1969,62(10):989-993
[9] Bellamy N,Buchanan WW,Goldsmith CH,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patient relevant outcomes to antirheumaticdrug therapy in patients with osteoarthritis of the or knee[J].J Rheumatol,1988,15(12):1833-1840
[10] 丁呈彪,周云.膝骨性关节炎患者滑膜炎的发病机制及研究进展[J].中国组织工程研究,2015,19(51):8327-8332
[11] 陈利国.四妙散散治疗膝关节滑膜炎[J].四川中医,2009,27(12):104
[12] 李绍军,郭敏.膝关节滑膜炎的中医药治疗进展[J].中国社区医师:医学专业,2010,12(15):121-122
[13] 王西伦.中西医结合综合疗法治疗膝关节滑膜炎125例临床观察[J].中国医药指南,2007,5(10):131-132
[14] 张智,张建华.中药外治法治疗膝关节滑膜炎研究进展[J].中医药临床杂志,2018,30(1):179-181
[15] 姜耘宙.补肾温阳利水汤治疗中老年慢性膝关节滑膜炎65例[J].浙江中医杂志,2014,49(4):261
[16] 王战朝,杜志谦,闫永昌,等.通经活利汤治疗膝关节滑膜炎的临床研究[J].中医正骨,2012,24(4):26-29
[17] 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[J].世界中西医结合杂志,2016,11(2):242-245
[18] 孙鲁宁,黄桂成,赵燕华,等.伤科消炎膏对木瓜蛋白酶诱导兔膝骨关节炎模型滑膜中白介素-1、白三烯、金属蛋白酶-3的影响[J].辽宁中医药大学学报,2012,14(9):143-145