加味独活寄生合剂联合股四头肌功能锻炼治疗膝骨关节炎的临床观察
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摘要
目的:观察加味独活寄生合剂联合股四头肌功能锻炼治疗膝骨关节炎的临床疗效。方法:将72例膝骨关节炎患者随机分为治疗组和对照组,每组36例,治疗组患者予加味独活寄生合剂口服联合股四头肌功能锻炼,对照组患者予双醋瑞因胶囊口服联合股四头肌功能锻炼。治疗6周后观察两组患者疼痛评分、功能评分,测量直腿抬高状态下大腿周径;治疗前后均行关节穿刺取关节液,检测关节液中IL-1、NO含量。结果:两组患者治疗后视觉模拟评分(VAS)均明显降低(P<0.05);治疗后两组患者VAS评分比较,治疗组低于对照组(P<0.05);治疗组患者治疗后膝关节功能Western Ontario and McMaster Univesrsities(WOMAC)评分低于对照组(P<0.05)。两组患者治疗后大腿周径均增加,治疗组患者治疗后大腿周径大于对照组(P<0.05)。与治疗前比较,治疗后两组患者关节液IL-1、NO含量均明显降低(P<0.05);两组患者治疗后关节液IL-1、NO含量比较,差异无统计学意义(P>0.05)。结论:加味独活寄生合剂联合股四头肌功能锻炼治疗膝骨关节炎,可抑制炎症反应,减轻关节疼痛,增加膝关节肌力,改善膝关节功能。
Objective: To observe the clinical curative effect of Jiawei Duhuo Jisheng Mixture(加味独活寄生合剂, JWDHJSM) combined with functional training exercise on knee osteoarthritis. Methods: Totally 72 patients with knee osteoarthritis were randomly divided into treatment group and control group. Each group with 36 cases. Patients in treatment group were given Jiawei Duhuo Jisheng Mixture and articular cavity injection of sodium hyaluronate; Patients in control group were given oral artodar and articular cavity injection of sodium hyaluronate. Both groups exercised functional training of quadriceps and gastrocnemius, the treatment group received an additional treatment--weight-bearing resistance training(1.5～2.5 kg) on the ankle. Then patients completed a visual analog scale(VAS) and were assessed by Western Ontario and McMaster Univesrsities(WOMAC),and also thigh weeks diameter was measured under the straight leg-raising. The content of IL-1 and NO were compared before and after treatment. Results: After treatment, the VAS pain scores and the WOMAC scores of both groups were significantly lower than before(P<0.05), and the VAS scores and WOMAC scores of the treatment group were lower than that of the control group(P<0.05). The treatment group had a larger thigh circumference than the control group(P <0.05). The contents of Il-1 and NO in both groups were significantly decreased after treatment(P<0.05), but there was no significant difference between the two groups(P>0.05). Conclusion: Jiawei Duhuo Jisheng Mixture combined with functional training exercise can inhibit inflammatory reaction,reduce pain and increase the muscle strength of knee joint in patients with knee osteoarthritis.
Objective: To observe the clinical curative effect of Jiawei Duhuo Jisheng Mixture(加味独活寄生合剂, JWDHJSM) combined with functional training exercise on knee osteoarthritis. Methods: Totally 72 patients with knee osteoarthritis were randomly divided into treatment group and control group. Each group with 36 cases. Patients in treatment group were given Jiawei Duhuo Jisheng Mixture and articular cavity injection of sodium hyaluronate; Patients in control group were given oral artodar and articular cavity injection of sodium hyaluronate. Both groups exercised functional training of quadriceps and gastrocnemius, the treatment group received an additional treatment--weight-bearing resistance training(1.5～2.5 kg) on the ankle. Then patients completed a visual analog scale(VAS) and were assessed by Western Ontario and McMaster Univesrsities(WOMAC),and also thigh weeks diameter was measured under the straight leg-raising. The content of IL-1 and NO were compared before and after treatment. Results: After treatment, the VAS pain scores and the WOMAC scores of both groups were significantly lower than before(P<0.05), and the VAS scores and WOMAC scores of the treatment group were lower than that of the control group(P<0.05). The treatment group had a larger thigh circumference than the control group(P <0.05). The contents of Il-1 and NO in both groups were significantly decreased after treatment(P<0.05), but there was no significant difference between the two groups(P>0.05). Conclusion: Jiawei Duhuo Jisheng Mixture combined with functional training exercise can inhibit inflammatory reaction,reduce pain and increase the muscle strength of knee joint in patients with knee osteoarthritis.
引文
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[10]卢敏,谢心军,严可,等.伤速康巴布膏对兔膝骨性关节炎模型关节液中SOD、NO水平变化影响的实验研究[J].中国中医骨伤科杂志,2011,19(10):1-3,6.
[11]卢敏,谭旭仪,谢心军,等.伤速康贴膏对兔膝骨性关节炎模型关节液中IL-1、IL-6及TNF-α水平的影响[J].湖南中医药大学学报,2011,31(7):18-21.
[12] Serrao P R,Vasilceac F A,Gramani-Say K. Men with Early Degrees of Knee Osteoarthritis Present Functional and Morphological Impairments of the Quadriceps Femoris Muscle[J].American journal of physical medicine&rehabilitation/Association of Academic Physiatrists,2014,17(4):236-9.
[13]曹月龙,庞坚,詹红生,等.肌肉因素与骨关节炎的临床研究现状[J].中国骨伤,2008,21(6):476.
[14]王芳,古英,钟晓鸣.独活寄生汤联合功能锻炼治疗膝关节骨关节炎的临床观察[J].中医药导报,2015,21(24):61-63.
[2]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,1994:30.
[3]李杨,陆倩,钱金栿.天南星提取物的抗炎作用及机制研究[J].大理学院学报,2013,12(9):14-16.
[4]唐丽琴,魏伟,王晓玉.IL-1α对佐剂性关节炎大鼠滑膜细胞功能的影响及木瓜苷的作用[J].中国药理学通报,2009,25(1):44-47.
[5]邝高艳,严可,柴爽,等.独活寄生汤加减治疗膝骨关节炎疗效及安全性的Meta分析[J].中医药导报,2016,22(17):59-62.
[6]邓娟娟,陈艳.温针灸联合独活寄生汤加减治疗膝关节骨关节炎的疗效观察[J].中医药导报,2017,23(18):90-92.
[7]谭开云,卢敏.加味独活寄生合剂治疗风寒湿痹·肝肾亏虚型膝骨关节炎临床疗效观察[J].中华中医药学刊,2016,34(2):425-427.
[8]龚志贤,谭旭仪,卢敏.小针刀配合针灸辨证治疗膝骨性关节炎的临床观察[J].湖南中医药大学学报,2011,31(11):69-72.
[9]段航,卢敏,王林华,等.卢敏教授治疗膝骨关节炎的用药经验总结[J].中国中医骨伤科杂志,2018,26(10):80-82.
[10]卢敏,谢心军,严可,等.伤速康巴布膏对兔膝骨性关节炎模型关节液中SOD、NO水平变化影响的实验研究[J].中国中医骨伤科杂志,2011,19(10):1-3,6.
[11]卢敏,谭旭仪,谢心军,等.伤速康贴膏对兔膝骨性关节炎模型关节液中IL-1、IL-6及TNF-α水平的影响[J].湖南中医药大学学报,2011,31(7):18-21.
[12] Serrao P R,Vasilceac F A,Gramani-Say K. Men with Early Degrees of Knee Osteoarthritis Present Functional and Morphological Impairments of the Quadriceps Femoris Muscle[J].American journal of physical medicine&rehabilitation/Association of Academic Physiatrists,2014,17(4):236-9.
[13]曹月龙,庞坚,詹红生,等.肌肉因素与骨关节炎的临床研究现状[J].中国骨伤,2008,21(6):476.
[14]王芳,古英,钟晓鸣.独活寄生汤联合功能锻炼治疗膝关节骨关节炎的临床观察[J].中医药导报,2015,21(24):61-63.