隔物灸联合补肾祛寒方治疗膝骨关节炎44例临床研究
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摘要
目的:观察隔物灸联合补肾祛寒方治疗肾虚寒凝型膝骨关节炎(KOA)的临床疗效。方法:将88例肾虚寒凝型KOA患者随机分为试验组和对照组各44例。试验组采用隔物灸联合补肾祛寒方治疗,对照组给予口服洛索洛芬钠分散片和双醋瑞因胶囊治疗,2组均治疗12周。观察2组治疗前后视觉模拟评分法(VAS)疼痛评分、WOMAC骨关节炎指数积分的变化,评估临床疗效和统计不良反应。结果:治疗后,2组VAS疼痛评分均较治疗前下降(P <0.05);试验组VAS疼痛评分比对照组下降更明显(P <0.05)。治疗后,2组WOMAC骨关节炎指数关节疼痛、关节僵硬、生理功能积分及总分均较治疗前降低,差异均有统计学意义(P <0.05);试验组关节疼痛积分低于对照组,差异有统计学意义(P <0.05);2组关节僵硬、生理功能积分及总分比较,差异均无统计学意义(P> 0.05)。试验组总有效率93.18%,对照组总有效率90.91%,2组比较,差异无统计学意义(P> 0.05)。试验组不良反应发生率4.55%,对照组不良反应发生率22.73%,2组比较,差异有统计学意义(P <0.05)。不良反应经对症处理后均消失。结论:隔物灸联合补肾祛寒方治疗肾虚寒凝型KOA,治疗效果与口服洛索洛芬钠分散片和双醋瑞因胶囊相当,止痛效果较好,不良反应少。
Objective:To observe the clinical effect of indirect moxibustion combined with Bushen Quhan prescription for knee osteoarthritis(KOA) of kidney deficiency and congealing coldness type. Methods:A total of 88 cases of patients with KOA of kidney deficiency and congealing coldness type were randomly divided into the experiment group and the control group,44 cases in each group. The experiment group was treated with indirect moxibustion combined with Bushen Quhan prescription while the control group received oral administration of the Loxoprofen sodium dispersible tablets and diacerein capsules. Both groups were treated for 12 weeks. The changes in pain scores of visual analogue scale(VAS) and the scores of western Ontario and McMaster university of orthopedic index(WOMAC) before and after treatment were observed,and the clinical effect and adverse reactions were evaluated. Results:After treatment,pain scores of VAS in the two groups were decreased when compared with those before treatment(P < 0.05). The decreased of the pain score of VAS in the experiment group was more obvious than that in the control group(P < 0.05). After treatment,scores of joint pain,joint stiffness and physiological function in WOMAC as well as the total scores in the two groups were decreased when compared with those before treatment,differences being significant(P < 0.05). The score of joint pain in the experiment group was lower than that in the control group, the difference being significant(P < 0.05). There was no significant difference being found in the comparisons of the score of joint stiffness and physiological function as well as total score between the two groups(P > 0.05).The total effective rate was 93.18% in the experiment group and 90.91% in the control group, there being no significant difference(P > 0.05). The incidence of adverse reactions was 4.55% in the experiment group and 22.73% in the control group,the difference being significant(P < 0.05). The adverse reactions disappeared after symptomatic treatment. Conclusion:The therapy of indirect moxibustion combined with Bushen Quhan prescription has similar therapeutic effect in treating KOA ofkidney deficiency and congealing coldness type with that of oral Loxoprofen sodium dispersible tablets and diacerein capsules,but has better analgesic effect as well as less adverse reactions.
Objective:To observe the clinical effect of indirect moxibustion combined with Bushen Quhan prescription for knee osteoarthritis(KOA) of kidney deficiency and congealing coldness type. Methods:A total of 88 cases of patients with KOA of kidney deficiency and congealing coldness type were randomly divided into the experiment group and the control group,44 cases in each group. The experiment group was treated with indirect moxibustion combined with Bushen Quhan prescription while the control group received oral administration of the Loxoprofen sodium dispersible tablets and diacerein capsules. Both groups were treated for 12 weeks. The changes in pain scores of visual analogue scale(VAS) and the scores of western Ontario and McMaster university of orthopedic index(WOMAC) before and after treatment were observed,and the clinical effect and adverse reactions were evaluated. Results:After treatment,pain scores of VAS in the two groups were decreased when compared with those before treatment(P < 0.05). The decreased of the pain score of VAS in the experiment group was more obvious than that in the control group(P < 0.05). After treatment,scores of joint pain,joint stiffness and physiological function in WOMAC as well as the total scores in the two groups were decreased when compared with those before treatment,differences being significant(P < 0.05). The score of joint pain in the experiment group was lower than that in the control group, the difference being significant(P < 0.05). There was no significant difference being found in the comparisons of the score of joint stiffness and physiological function as well as total score between the two groups(P > 0.05).The total effective rate was 93.18% in the experiment group and 90.91% in the control group, there being no significant difference(P > 0.05). The incidence of adverse reactions was 4.55% in the experiment group and 22.73% in the control group,the difference being significant(P < 0.05). The adverse reactions disappeared after symptomatic treatment. Conclusion:The therapy of indirect moxibustion combined with Bushen Quhan prescription has similar therapeutic effect in treating KOA ofkidney deficiency and congealing coldness type with that of oral Loxoprofen sodium dispersible tablets and diacerein capsules,but has better analgesic effect as well as less adverse reactions.
引文
[1]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.
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[4]胡杰,李平中.膝骨关节炎保守治疗现状[J].中国医药科学,2015,5(5):30-32.
[5]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013.
[6]黎清斌,张兆华,潘海文,等.骨宝丸对肝肾不足型膝关节骨性关节炎的疗效观察[J].陕西中医,2016,37(9):1198-1199.
[7]张美玲,陈谦艳.独活寄生汤联合艾灸治疗膝骨关节炎30例[J].风湿病与关节炎,2014,3(5):13-15.
[2]国家中医药管理局.ZY/T001.1~001.9-94中医病证诊断疗效标准[S].南京:南京大学出版社,1994.
[3]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002.
[4]胡杰,李平中.膝骨关节炎保守治疗现状[J].中国医药科学,2015,5(5):30-32.
[5]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013.
[6]黎清斌,张兆华,潘海文,等.骨宝丸对肝肾不足型膝关节骨性关节炎的疗效观察[J].陕西中医,2016,37(9):1198-1199.
[7]张美玲,陈谦艳.独活寄生汤联合艾灸治疗膝骨关节炎30例[J].风湿病与关节炎,2014,3(5):13-15.