舒筋活血胶囊联合艾瑞昔布治疗膝骨关节炎的临床研究
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摘要
目的探讨舒筋活血胶囊联合艾瑞昔布治疗膝骨关节炎的临床疗效。方法选取2017年5月—2018年5月在邯郸市第一医院治疗的膝骨关节炎患者88例,随机分为对照组(44例)和治疗组(44例)。对照组口服艾瑞昔布片,0.1 g/次,2次/d;治疗组在对照组基础上口服舒筋活血胶囊,1.35 g/次,3次/d。两组患者均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者膝关节功能指标和血清学指标。结果治疗后,对照组和治疗组临床有效率分别为81.82%和97.73%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组骨关节指数评分(WOMAC)和VAS评分均显著降低(P<0.05),膝关节功能评分(LKSS)评分显著升高(P<0.05),且治疗组WOMAC、VAS和LKSS评分明显好于对照组(P<0.05)。治疗后,两组超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、IL-17、基质金属蛋白酶-9(MMP-9)和环氧化酶-2(COX-2)水平均显著降低(P<0.05),且治疗组上述血清学指标明显低于对照组(P<0.05)。结论舒筋活血胶囊联合艾瑞昔布片治疗膝骨关节炎,可有效降低机体炎症反应,延缓关节进一步损伤,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Shujin Huoxue Capsules combined with imrecoxib in treatment of knee osteoarthritis. Methods Patients(88 cases) with knee osteoarthritis in Handan First Hospital from May 2017 to May 2018 were randomly divided into control(44 cases) and treatment(44 cases) groups. Patients in the control group were po administered with Imrecoxib Tablets, 0.1 g/time, twice daily. Patients in the treatment group were po administered with Shujin Huoxue Capsules on the basis of the control group, 1.35 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, the knee joint function indexes and serological indexes levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 81.82% and 97.73% respectively, and there were differences between two groups(P < 0.05). After treatment, the WOMAC and VAS scores in two groups were significantly decreased(P < 0.05), but LKSS scores were significantly increased(P < 0.05), and the WOMAC, VAS and LKSS scores in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the hs-CRP, IL-1β, IL-17, MMP-9, and COX-2 levels in two groups were significantly decreased(P < 0.05), and these serological indexes levels in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Shujin Huoxue Capsules combined with imrecoxib in treatment of knee osteoarthritis can effectively reduce the inflammatory response and delay the further injury of the joints, which has a certain clinical application value.
Objective To investigate the clinical efficacy of Shujin Huoxue Capsules combined with imrecoxib in treatment of knee osteoarthritis. Methods Patients(88 cases) with knee osteoarthritis in Handan First Hospital from May 2017 to May 2018 were randomly divided into control(44 cases) and treatment(44 cases) groups. Patients in the control group were po administered with Imrecoxib Tablets, 0.1 g/time, twice daily. Patients in the treatment group were po administered with Shujin Huoxue Capsules on the basis of the control group, 1.35 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, the knee joint function indexes and serological indexes levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 81.82% and 97.73% respectively, and there were differences between two groups(P < 0.05). After treatment, the WOMAC and VAS scores in two groups were significantly decreased(P < 0.05), but LKSS scores were significantly increased(P < 0.05), and the WOMAC, VAS and LKSS scores in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the hs-CRP, IL-1β, IL-17, MMP-9, and COX-2 levels in two groups were significantly decreased(P < 0.05), and these serological indexes levels in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion Shujin Huoxue Capsules combined with imrecoxib in treatment of knee osteoarthritis can effectively reduce the inflammatory response and delay the further injury of the joints, which has a certain clinical application value.
引文
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[2]陈建洪,吴桂红,邓莎艾瑞昔布片治疗退行性膝关节炎的临床疗效观察[J].临床合理用药杂志,2016,9(16):38-39.
[3]龙志坚,翁小涛.舒筋活血胶囊治疗劳损性颈肩痛43例临床观察[J].中医药导报,2011,17(7):114-115.
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[6]Bellamy N,Buchanan W W,Goldsmith C H,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J].J Rheumatol,1988,15(12):1833-1840.
[7]高伟业,熊晓明,黄少华.膝关节间隙X线测量与骨性关节炎疼痛VAS评分的相关性分析[J].广东医学院学报,2015,33(3):298-301.
[8]顾力军,董福慧.疼痛客观化指标在膝骨关节炎患者膝关节功能和疼痛评价中的应用[J].中医正骨,2013,25(9):22-24.
[9]谢伟,王东超,陈勇,等.早期膝骨关节炎患者与健康者血清MMP-3、IL-6、TNF-α和hs-CRP的相关性研究[J].青海医学院学报,2009,30(3):183-185.
[10]陈巍,李彬,唐中尧,等.膝骨性关节炎患者关节滑液IL-1β和TNF-α的表达及临床意义[J].广东医学,2010,31(15):1998-2000.
[11]Gaffen S L.Recent advances in the IL-17 cytokine family[J].Curr Opin Immunol,2011,23(5):613-619.
[12]孙莉,王亚军,赵凡,等.血清基质金属蛋白酶-9在膝骨性关节炎治疗前后水平变化的研究[J].中国老年学杂志,2009,29(23):3134-3135.
[13]金荣忠,谈国明,胡辉东.COX-2在膝关节骨性关节炎软骨中表达及临床意义[J].生物骨科材料与临床研究,2010,7(6):18-20.
[2]陈建洪,吴桂红,邓莎艾瑞昔布片治疗退行性膝关节炎的临床疗效观察[J].临床合理用药杂志,2016,9(16):38-39.
[3]龙志坚,翁小涛.舒筋活血胶囊治疗劳损性颈肩痛43例临床观察[J].中医药导报,2011,17(7):114-115.
[4]邱贵兴.骨关节炎诊治指南[J].中华骨科杂志,2007,27(10):793-796.
[5]蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:168-168.
[6]Bellamy N,Buchanan W W,Goldsmith C H,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J].J Rheumatol,1988,15(12):1833-1840.
[7]高伟业,熊晓明,黄少华.膝关节间隙X线测量与骨性关节炎疼痛VAS评分的相关性分析[J].广东医学院学报,2015,33(3):298-301.
[8]顾力军,董福慧.疼痛客观化指标在膝骨关节炎患者膝关节功能和疼痛评价中的应用[J].中医正骨,2013,25(9):22-24.
[9]谢伟,王东超,陈勇,等.早期膝骨关节炎患者与健康者血清MMP-3、IL-6、TNF-α和hs-CRP的相关性研究[J].青海医学院学报,2009,30(3):183-185.
[10]陈巍,李彬,唐中尧,等.膝骨性关节炎患者关节滑液IL-1β和TNF-α的表达及临床意义[J].广东医学,2010,31(15):1998-2000.
[11]Gaffen S L.Recent advances in the IL-17 cytokine family[J].Curr Opin Immunol,2011,23(5):613-619.
[12]孙莉,王亚军,赵凡,等.血清基质金属蛋白酶-9在膝骨性关节炎治疗前后水平变化的研究[J].中国老年学杂志,2009,29(23):3134-3135.
[13]金荣忠,谈国明,胡辉东.COX-2在膝关节骨性关节炎软骨中表达及临床意义[J].生物骨科材料与临床研究,2010,7(6):18-20.