荣筋片联合透明质酸钠治疗老年膝关节骨性关节炎的疗效及对患者生活质量的影响
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摘要
目的:探讨荣筋片联合透明质酸钠治疗老年膝关节骨性关节炎的临床疗效,并分析其对患者生活质量的影响。方法:选取2016年2月—2018年2月本院收治的老年膝关节骨性关节炎患者108例为研究对象,采用随机数字表法分为治疗组与对照组,对照组患者给予关节腔内注射透明质酸钠治疗,治疗组患者在对照组的基础上给予荣筋片治疗,对比两组患者临床疗效、治疗前后关节骨性关节炎自评量表评分(关节僵硬、关节疼痛、关节功能)、生活质量评分、中医证候积分炎症因子水平[C-反应蛋白(CRP)、白细胞介素-18(IL-18)、白细胞介素-6(IL-6)],并观察两组患者不良反应发生情况。结果:治疗组与对照组患者的总有效率分别为90. 74%、74. 07%,治疗组患者的临床疗效显著高于对照组(P <0. 05);治疗前,两组患者的关节僵硬、关节疼痛、关节功能评分比较无明显差异(P <0. 05),治疗后两组患者的关节僵硬、关节疼痛、关节功能评分均较治疗前降低,且治疗组患者的关节僵硬、关节疼痛、关节功能评分明显低于对照组(P <0. 05);治疗前,两组患者的生活质量评分、中医证候积分比较无明显差异(P> 0. 05),治疗后,两组患者的生活质量评分较治疗前明显升高,中医证候积分较治疗前明显降低(P <0. 05),且治疗组患者生活质量评分高于对照组,中医证候积分低于对照组(P <0. 05);治疗前,两组患者炎症因子水平比较无明显差异(P> 0. 05),治疗后两组患者的CRP、IL-18、IL-6水平均较治疗前明显降低,且治疗组患者的CRP、IL-18、IL-6水平低于对照组(P <0. 05);两组患者均未发生明显的不良反应。结论:在透明质酸钠治疗的基础上联用荣筋片质量老年膝关节骨性关节炎临床疗效显著,可有效改善患者关节功能、减轻炎症反应、提高生活质量,且安全性高,值得临床推广。
Objective: To investigate the clinical efficacy of Rongjin Tablets and sodium hyaluronate in the treatment of osteoarthritis of the knee and analyze its effect on the quality of life of the patients. Methods: A total of 108 cases of senile knee osteoarthritis treated in our hospital in February 2016-February 2018 were selected as the research objects. The patients were divided into the treatment group and the control group by the random digital table method. The control group was treated with sodium hyaluronate injection in the joint cavity. The patients in the treatment group were treated with Rongjin Tablets on the basis of the control group,and the two groups were compared. The clinical curative effect,the self rating scale of joint osteoarthritis( joint stiffness,joint pain,joint function),quality of life score,TCM syndrome score,C-reactive protein( CRP),interleukin-18( IL-18),interleukin-6( IL-6) and the adverse reactions in the two groups were observed. Results: The total effective rate of the treatment group and the control group was 90. 74% and 74. 07% respectively. The clinical efficacy of the patients in the treatment group was significantly higher than that of the control group( P < 0. 05). Before treatment,there was no significant difference in joint stiffness,joint pain or joint function score between the two groups( P < 0. 05),and the joint stiffness and joint pain in the two groups of patients after treatment had no difference. The score of joint function was lower than that before treatment,and the joint stiffness,joint pain and joint function score of the patients in the treatment group were significantly lower than those of the control group( P < 0. 05). Before treatment,the quality of life score and TCM syndrome score of the two groups were not significantly different( P > 0. 05). After treatment,the quality of life of the two groups of patients was scored. The score of TCM syndrome was significantly lower than that before treatment( P < 0. 05),and the quality of life of the patients in the treatment group was higher than that of the control group. The score of TCM syndrome was lower than that of the control group( P < 0. 05). Before treatment,there was no significant difference in the levels of inflammatory factors between the two groups( P > 0. 05),and the CRP and IL-18 of the two groups of patients after treatment had no difference. The level of IL-6 was significantly lower than that before treatment,and the levels of CRP,IL-18 and IL-6 in the treatment group were lower than those of the control group( P < 0. 05),and there was no obvious adverse reaction in the two groups. Conclusion: On the basis of sodium hyaluronate treatment combined with Rongjin Tablets,the clinical efficacy of senile osteoarthritis of knee joint is remarkable. It can effectively improve the function of knee joint,alleviate inflammatory reaction and improve the quality of life. It is safe and worthy of clinical promotion.
Objective: To investigate the clinical efficacy of Rongjin Tablets and sodium hyaluronate in the treatment of osteoarthritis of the knee and analyze its effect on the quality of life of the patients. Methods: A total of 108 cases of senile knee osteoarthritis treated in our hospital in February 2016-February 2018 were selected as the research objects. The patients were divided into the treatment group and the control group by the random digital table method. The control group was treated with sodium hyaluronate injection in the joint cavity. The patients in the treatment group were treated with Rongjin Tablets on the basis of the control group,and the two groups were compared. The clinical curative effect,the self rating scale of joint osteoarthritis( joint stiffness,joint pain,joint function),quality of life score,TCM syndrome score,C-reactive protein( CRP),interleukin-18( IL-18),interleukin-6( IL-6) and the adverse reactions in the two groups were observed. Results: The total effective rate of the treatment group and the control group was 90. 74% and 74. 07% respectively. The clinical efficacy of the patients in the treatment group was significantly higher than that of the control group( P < 0. 05). Before treatment,there was no significant difference in joint stiffness,joint pain or joint function score between the two groups( P < 0. 05),and the joint stiffness and joint pain in the two groups of patients after treatment had no difference. The score of joint function was lower than that before treatment,and the joint stiffness,joint pain and joint function score of the patients in the treatment group were significantly lower than those of the control group( P < 0. 05). Before treatment,the quality of life score and TCM syndrome score of the two groups were not significantly different( P > 0. 05). After treatment,the quality of life of the two groups of patients was scored. The score of TCM syndrome was significantly lower than that before treatment( P < 0. 05),and the quality of life of the patients in the treatment group was higher than that of the control group. The score of TCM syndrome was lower than that of the control group( P < 0. 05). Before treatment,there was no significant difference in the levels of inflammatory factors between the two groups( P > 0. 05),and the CRP and IL-18 of the two groups of patients after treatment had no difference. The level of IL-6 was significantly lower than that before treatment,and the levels of CRP,IL-18 and IL-6 in the treatment group were lower than those of the control group( P < 0. 05),and there was no obvious adverse reaction in the two groups. Conclusion: On the basis of sodium hyaluronate treatment combined with Rongjin Tablets,the clinical efficacy of senile osteoarthritis of knee joint is remarkable. It can effectively improve the function of knee joint,alleviate inflammatory reaction and improve the quality of life. It is safe and worthy of clinical promotion.
引文
[1]玉玲,吕明.盐酸氨基葡萄糖联合吡罗昔康贴片治疗膝骨关节炎98例疗效观察[J].海峡药学,2015,27(11):63.
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[3]胡田生,杨亚军,胡日鹤.超激光加中药熏洗配合关节腔内注射治疗膝关节骨性关节炎43例[J].湖南中医杂志,2013,29(5):14-16.
[4]程志鹏.超激光疼痛治疗仪照射联合益肾温阳推拿法治疗膝关节骨性关节炎60例临床观察[J].河北中医,2014,36(9):1357-1358.
[5]俞泉.臭氧联合玻璃酸钠治疗膝关节骨性关节炎的临床疗效评估[J].北方药学,2017,14(3):127-128.
[6]于国胜.膝关节骨性关节炎的中西医治疗进展[J].河北中医,2012,34(5):775.
[7]王晓冰,韩文朝,王献印,等.中西医结合治疗老年膝关节骨性关节炎的临床研究[J].中医临床研究,2016,8(1):115-116.
[8]孙瑛.实用关节炎诊断治疗学[M].北京:北京大学医学出版社,2002:319-333.
[9]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[10]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:300.
[11]姜丽,张金华.臭氧联合玻璃酸钠治疗膝关节骨性关节炎的临床研究[J].中国临床医生杂志,2016,44(6):67-68.
[12]高毅.中西医结合治疗膝关节骨性关节炎39例体会[J].内蒙古中医药,2012,31(12):28.
[13]范杰,曹铨,石钢.透明质酸钠联合六味地黄丸治疗老年膝关节骨性关节炎临床疗效及对血清CRP水平影响研究[J].中国生化药物杂志,2016,36(3):105-106.
[14]刘立丽,荣兵.温阳通痹汤联合温针灸对老年骨性膝关节炎MMP-3、MMP-9及炎症因子的影响[J].陕西中医,2017,38(9):1234-1236.
[15]江浩.温针灸法治疗老年骨性膝关节炎临床疗效观察[J].陕西中医,2016,37(1):99-100.
[16]俸道荣,盘晓荣,覃一玨.桃红四物汤和高压氧对膝关节骨性关节炎患者血清TNF-α及IL-6含量的影响[J].中西医结合心血管病电子杂志,2017,5(30):171-172.
[17]李镇顺,黄皓,赵先英.基质金属蛋白酶与骨性关节炎的机制探讨[J].国际检验医学杂志,2016,37(5):633-634.
[18]应永生.加味阳和汤对膝骨性关节炎患者血清基质金属蛋白酶-3、9水平的影响及疗效观察[J].中国中医基础医学杂志,2015,21(6):713-714,721.
[19]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.
[20]蔡西国,钱宝延,曹留拴,等.本体感觉训练结合透明质酸钠关节腔注射治疗老年患者膝关节骨性关节炎的疗效观察[J].中华物理医学与康复杂志,2014,36(6):445-448.
[21]范荣,刘玉金.温针灸结合推拿对膝关节骨性关节炎患者血清骨保护素、降钙素及骨钙素的影响[J].中国现代医学杂志,2015,25(16):86-89.
[22]吐尔洪·吐尔逊,陈洪涛.关节镜下有限清理术联合中药烫疗治疗老年膝关节骨性关节炎疗效观察[J].现代中西医结合杂志,2017,26(22):2490-2492.
[23]张东洋.固肾蠲痹方联合氨基葡萄糖治疗老年膝关节骨性关节炎疗效观察[J].山西中医,2017,33(9):26-27.
[2]杨亚军,胡田生,林丽燕.超激光对缓解膝关节骨性关节炎疼痛症状的疗效观察[J].中国实用医药,2014,12(15):84-85.
[3]胡田生,杨亚军,胡日鹤.超激光加中药熏洗配合关节腔内注射治疗膝关节骨性关节炎43例[J].湖南中医杂志,2013,29(5):14-16.
[4]程志鹏.超激光疼痛治疗仪照射联合益肾温阳推拿法治疗膝关节骨性关节炎60例临床观察[J].河北中医,2014,36(9):1357-1358.
[5]俞泉.臭氧联合玻璃酸钠治疗膝关节骨性关节炎的临床疗效评估[J].北方药学,2017,14(3):127-128.
[6]于国胜.膝关节骨性关节炎的中西医治疗进展[J].河北中医,2012,34(5):775.
[7]王晓冰,韩文朝,王献印,等.中西医结合治疗老年膝关节骨性关节炎的临床研究[J].中医临床研究,2016,8(1):115-116.
[8]孙瑛.实用关节炎诊断治疗学[M].北京:北京大学医学出版社,2002:319-333.
[9]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[10]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:300.
[11]姜丽,张金华.臭氧联合玻璃酸钠治疗膝关节骨性关节炎的临床研究[J].中国临床医生杂志,2016,44(6):67-68.
[12]高毅.中西医结合治疗膝关节骨性关节炎39例体会[J].内蒙古中医药,2012,31(12):28.
[13]范杰,曹铨,石钢.透明质酸钠联合六味地黄丸治疗老年膝关节骨性关节炎临床疗效及对血清CRP水平影响研究[J].中国生化药物杂志,2016,36(3):105-106.
[14]刘立丽,荣兵.温阳通痹汤联合温针灸对老年骨性膝关节炎MMP-3、MMP-9及炎症因子的影响[J].陕西中医,2017,38(9):1234-1236.
[15]江浩.温针灸法治疗老年骨性膝关节炎临床疗效观察[J].陕西中医,2016,37(1):99-100.
[16]俸道荣,盘晓荣,覃一玨.桃红四物汤和高压氧对膝关节骨性关节炎患者血清TNF-α及IL-6含量的影响[J].中西医结合心血管病电子杂志,2017,5(30):171-172.
[17]李镇顺,黄皓,赵先英.基质金属蛋白酶与骨性关节炎的机制探讨[J].国际检验医学杂志,2016,37(5):633-634.
[18]应永生.加味阳和汤对膝骨性关节炎患者血清基质金属蛋白酶-3、9水平的影响及疗效观察[J].中国中医基础医学杂志,2015,21(6):713-714,721.
[19]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.
[20]蔡西国,钱宝延,曹留拴,等.本体感觉训练结合透明质酸钠关节腔注射治疗老年患者膝关节骨性关节炎的疗效观察[J].中华物理医学与康复杂志,2014,36(6):445-448.
[21]范荣,刘玉金.温针灸结合推拿对膝关节骨性关节炎患者血清骨保护素、降钙素及骨钙素的影响[J].中国现代医学杂志,2015,25(16):86-89.
[22]吐尔洪·吐尔逊,陈洪涛.关节镜下有限清理术联合中药烫疗治疗老年膝关节骨性关节炎疗效观察[J].现代中西医结合杂志,2017,26(22):2490-2492.
[23]张东洋.固肾蠲痹方联合氨基葡萄糖治疗老年膝关节骨性关节炎疗效观察[J].山西中医,2017,33(9):26-27.