加味阳和汤联合塞来昔布治疗老年膝骨性关节炎临床疗效及对患者血清TNF-α、IL-1β的影响
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摘要
目的:探讨加味阳和汤联合塞来昔布治疗老年膝骨性关节炎临床疗效及对患者血清肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)的影响。方法:选取我院2015年1月～2017年9月收治的老年膝骨性关节炎患者72例,根据患者治疗方案的不同,将患者分为对照组及观察组,每组患者36例。对照组患者采用塞来昔布治疗,观察组在对照组的基础上联合加味阳和汤治疗。比较2组患者临床疗效、治疗前后血清TNF-α、IL-1β及治疗后3个月生活质量改善情况、不良反应。结果:观察组患者临床疗效总有效率明显优于对照组患者(94. 44%vs 77. 77%),差异具有统计学意义(P<0. 05); 2组患者治疗后TNF-α、IL-1β水平较治疗前出现明显变化,呈现明显降低趋势,差异具有统计学意义(P<0. 05);观察组治疗后TNF-α、IL-1β水平明显低于对照组,差异具有统计学意义(P<0. 05); 2组患者治疗3个月后生活质量PF、RP、BP、MH、RE、VT、SF、GH评分较治疗前明显上升,差异具有统计学意义(P<0. 05);观察组治疗3个月后生活质量RP、BP、MH、RE、VT、SF评分明显高于对照组,差异具有统计学意义(P<0. 05); 2组患者在治疗过程中均未出现严重不良反应。结论:加味阳和汤联合塞来昔布治疗老年膝骨性关节炎临床疗效显著,可有效改善TNF-α、IL-1β水平,提高患者生活质量水平,安全性高。
Objective: To investigate the clinical efficacy of Jiawei Yanghe Decoction combined with celecoxib in the treatment of elderly patients with knee osteoarthritis and its effect on serum TNF-α and IL-1β. Methods: 72 elderly patients with knee osteoarthritis treated in our hospital from January 2015 to September 2017 were selected. According to different treatment,the patients were divided into the control group and the observation group with 36 cases in each group. The cases in the control group were treated with celecoxib treatment and the cases in the observation group were given with Jiawei Yanghe Decoction based on the treatment of control group. The clinical efficacy,serum TNF-α and IL-1β and the improvement of life quality and adverse reactions during the 3 months after treatment were compared between the two groups. Results: The total curative rate in the observation group was significantly higher than that in the control group( 94. 44% vs 77. 77%)( P<0. 05). After treatment,The TNF-α and IL-1β level in two groups were significantly changed than before treatment with a decreased trend( P<0. 05). After treatment,the TNF-α and IL-1β level in observation group was significantly lower than that in the control group( P<0. 05). At 3 months after treatment,the PF,RP,BP,MH,RE,VT,SF and GH scores in the quality of life were significantly increased in two groups( P<0. 05). After 3 months of treatment,the RP BP,MH,RE,VT,SF scores in observation group were significantly higher than those in the control group( P < 0. 05). There were no serious adverse reactions during treatment time in the two groups. Conclusion: Jiawei Yanghe Decoction combined with celecoxib in the treatment of senile knee osteoarthritis can get significantly clinical effect,can effectively improve the level of TNF-α,IL-1β and improve the level of quality of life with high safety.
Objective: To investigate the clinical efficacy of Jiawei Yanghe Decoction combined with celecoxib in the treatment of elderly patients with knee osteoarthritis and its effect on serum TNF-α and IL-1β. Methods: 72 elderly patients with knee osteoarthritis treated in our hospital from January 2015 to September 2017 were selected. According to different treatment,the patients were divided into the control group and the observation group with 36 cases in each group. The cases in the control group were treated with celecoxib treatment and the cases in the observation group were given with Jiawei Yanghe Decoction based on the treatment of control group. The clinical efficacy,serum TNF-α and IL-1β and the improvement of life quality and adverse reactions during the 3 months after treatment were compared between the two groups. Results: The total curative rate in the observation group was significantly higher than that in the control group( 94. 44% vs 77. 77%)( P<0. 05). After treatment,The TNF-α and IL-1β level in two groups were significantly changed than before treatment with a decreased trend( P<0. 05). After treatment,the TNF-α and IL-1β level in observation group was significantly lower than that in the control group( P<0. 05). At 3 months after treatment,the PF,RP,BP,MH,RE,VT,SF and GH scores in the quality of life were significantly increased in two groups( P<0. 05). After 3 months of treatment,the RP BP,MH,RE,VT,SF scores in observation group were significantly higher than those in the control group( P < 0. 05). There were no serious adverse reactions during treatment time in the two groups. Conclusion: Jiawei Yanghe Decoction combined with celecoxib in the treatment of senile knee osteoarthritis can get significantly clinical effect,can effectively improve the level of TNF-α,IL-1β and improve the level of quality of life with high safety.
引文
[1]郝亮,简蔚泓,杨锋,等.腓骨近端截骨联合膝关节镜清理术治疗伴内翻畸形的膝关节骨关节炎[J].中国修复重建外科杂志,2016,29(11):1366~1369
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[12]张英泽,马秀军,乔刚,等.腓骨高位截骨结合膝关节镜下有限清理术加玻璃酸钠注射治疗膝骨性关节炎疗效观察[J].中国临床医生杂志,2016,44(11):47~49
[13]李靖扬,加亨,乔为民.独活寄生汤联合塞来昔布对膝关节骨性关节炎患者膝关节液IL-1β、TNF-α及MMP-3的影响[J].现代中西医结合杂志,2015,. 24(25):2780~2782
[14]徐昕,董耘,徐华,等.关节镜清理术联合透明质酸钠腔内注射治疗80例高龄膝关节骨性关节炎患者临床分析[J].中华全科医学,2016,14(9):1463~1465
[15]黄天志,郭卫春.透明质酸钠联合塞来昔布治疗膝关节骨关节炎疗效观察[J].医学临床研究,2015,30(6):1115~1117
[16]赵鹏飞,汪利合,李慧英,等.加味四妙散对兔膝骨关节炎IL-6和b FGF的影响[J].中医学报,2015,30(8):1166~1169
[17]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,2015,20(6):713~714
[18]钱臣,卞晓星,QIANChen,等. Toll样受体4表达与膝骨关节炎软骨细胞凋亡的关系[J].江苏大学学报(医学版),2015,25(2):128~132
[19]倪华伟,李海波,曾庆东,等.塞来昔布对膝关节骨性关节炎的止痛效果及其作用机制[J].山东医药,2016,56(36):71~73
[20]何坚,梁杰,罗庆禄,等.复方三七消痛软膏超声导入对兔膝骨性关节炎治疗作用及机制研究[J].中国中医基础医学杂志,2017,22(2):191~195
[2]丁心香,王爱国,信金党,等.膝骨性关节炎中医药治疗进展[J].山东中医杂志,2016,36(3):267~269
[3]田晓美,赵紫砚,侯丽.膝关节骨性关节炎中西医结合康复治疗进展[J].现代中西医结合杂志,2016,25(1):105~108
[4]张晨,马建强.加味阳和汤对膝骨性关节炎病患MMP-3、MMP-9水平的影响研究[J].陕西中医,2016,36(2):201~203
[5]侯建鹏,刘鹏,姜胜峰,等.针药结合治疗膝关节骨性关节炎的临床研究进展[J].针灸临床杂志,2016,32(11):98~102
[6]中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华骨科杂志,2007,27(10):28~30
[7]郑筱萸.中药新药临床研究指导原则[M].中国医药科技出版社,2002
[8]贾淑丽,薛愧玲,赵新爱.五藤祛湿汤治疗类风湿关节炎肝肾阴虚证临床研究[J].中医学报,2016,40(6):882~885
[9]刘敏,陈阳斌,申涟漪.透明质酸钠注射液联合塞来昔布胶囊对膝骨关节炎患者血清IL-1β和TNF-α水平的影响[J].解放军医药杂志,2016,28(6):113~116
[10]黄旭东,韩清民.经筋辨证外治法治疗足太阳经筋型膝骨关节炎的临床对照研究[J].吉林中医药,2016,36(10):1024~1026
[11] Vega A,Martín-Ferrero M A,Del C F,et al. Treatment ofKnee Osteoarthritis With Allogeneic Bone Marrow Mesenchymal Stem Cells:A Randomized Controlled Trial[J]. Transplantation, 2015, 99(8):1681
[12]张英泽,马秀军,乔刚,等.腓骨高位截骨结合膝关节镜下有限清理术加玻璃酸钠注射治疗膝骨性关节炎疗效观察[J].中国临床医生杂志,2016,44(11):47~49
[13]李靖扬,加亨,乔为民.独活寄生汤联合塞来昔布对膝关节骨性关节炎患者膝关节液IL-1β、TNF-α及MMP-3的影响[J].现代中西医结合杂志,2015,. 24(25):2780~2782
[14]徐昕,董耘,徐华,等.关节镜清理术联合透明质酸钠腔内注射治疗80例高龄膝关节骨性关节炎患者临床分析[J].中华全科医学,2016,14(9):1463~1465
[15]黄天志,郭卫春.透明质酸钠联合塞来昔布治疗膝关节骨关节炎疗效观察[J].医学临床研究,2015,30(6):1115~1117
[16]赵鹏飞,汪利合,李慧英,等.加味四妙散对兔膝骨关节炎IL-6和b FGF的影响[J].中医学报,2015,30(8):1166~1169
[17]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,2015,20(6):713~714
[18]钱臣,卞晓星,QIANChen,等. Toll样受体4表达与膝骨关节炎软骨细胞凋亡的关系[J].江苏大学学报(医学版),2015,25(2):128~132
[19]倪华伟,李海波,曾庆东,等.塞来昔布对膝关节骨性关节炎的止痛效果及其作用机制[J].山东医药,2016,56(36):71~73
[20]何坚,梁杰,罗庆禄,等.复方三七消痛软膏超声导入对兔膝骨性关节炎治疗作用及机制研究[J].中国中医基础医学杂志,2017,22(2):191~195