毛冬青汤对膝关节镜术后早期关节肿痛及炎症因子的影响
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摘要
目的观察毛冬青汤治疗膝关节镜患者术后早期关节肿痛的临床疗效及对炎症因子的影响。方法采用随机数字表法将72例膝关节镜术后患者分为治疗组和对照组各36例。2组术后均予棉垫普通绷带适当加压包扎,术后24 h内冰敷,术后1 d起予七叶皂苷钠片,每次1片,每日2次口服。治疗组术后1 d起予毛冬青汤,每日1剂,每日2次口服。术后1、5 d,观察2组患者视觉模拟评分法(VAS)评分、膝关节肿胀程度,比较2组红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞介素-1(IL-1)水平。结果术后5 d,治疗组总有效率为94.44%(34/36),对照组为80.56%(29/36),治疗组膝关节肿胀改善优于对照组(P<0.05)。与本组术后1 d比较,2组术后5 d VAS评分及ESR、CRP、IL-1水平明显下降(P<0.05);2组术后5 d比较,治疗组VAS评分及ESR、CRP、IL-1水平明显低于对照组(P<0.05)。结论毛冬青汤可明显改善膝关节镜术后患者早期关节肿痛程度,其作用机制可能与降低血清ESR、CRP、IL-1水平有关。
Objective To observe the clinical efficacy of Maodongqing Decoction on early swelling pain and inflammatory cytokines after knee arthroscopic surgery. Methods Totally 72 patients with knee arthroscopic surgery were divided into treatment group and control group according to random number table method, with 36 cases in each group. After surgery, both groups were given appropriate pressure bandage on the cotton pad, and the ice was applied within 24 hours after surgery. The aescin sodium tablets were given 1 day after the surgery, one tablet each time, twice a day. Patients in the treatment group began to take Maodongqing Decoction on the first day after surgery, one dosage per day, twice a day, orally. One and five days after surgery, VAS scores, swelling degree, ESR, CRP and IL-1 were compared between the two groups. Results Five days after surgery, the total effective rate was 94.44%(34/36) in the treatment group and 80.56%(29/36) in the control group. The improvement of knee joint swelling in the treatment group was better than that in the control group(P<0.05). Compared with one day after surgery, the VAS scores and levels of ESR, CRP and IL-1 in the two groups significantly decreased(P<0.05). The VAS scores and levels of ESR, CRP and IL-1 in the treatment group were significantly lower than those in the control group five day after surgery(P<0.05). Conclusion Maodongqing Decoction can significantly improve the early swelling pain degree of the joints of patients after knee arthroscopic surgery. Its mechanism may be related to the reduction of the levels of ESR, CRP and IL-1.
Objective To observe the clinical efficacy of Maodongqing Decoction on early swelling pain and inflammatory cytokines after knee arthroscopic surgery. Methods Totally 72 patients with knee arthroscopic surgery were divided into treatment group and control group according to random number table method, with 36 cases in each group. After surgery, both groups were given appropriate pressure bandage on the cotton pad, and the ice was applied within 24 hours after surgery. The aescin sodium tablets were given 1 day after the surgery, one tablet each time, twice a day. Patients in the treatment group began to take Maodongqing Decoction on the first day after surgery, one dosage per day, twice a day, orally. One and five days after surgery, VAS scores, swelling degree, ESR, CRP and IL-1 were compared between the two groups. Results Five days after surgery, the total effective rate was 94.44%(34/36) in the treatment group and 80.56%(29/36) in the control group. The improvement of knee joint swelling in the treatment group was better than that in the control group(P<0.05). Compared with one day after surgery, the VAS scores and levels of ESR, CRP and IL-1 in the two groups significantly decreased(P<0.05). The VAS scores and levels of ESR, CRP and IL-1 in the treatment group were significantly lower than those in the control group five day after surgery(P<0.05). Conclusion Maodongqing Decoction can significantly improve the early swelling pain degree of the joints of patients after knee arthroscopic surgery. Its mechanism may be related to the reduction of the levels of ESR, CRP and IL-1.
引文
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[19]刘璇,高美风,孔毅.水蛭化学成分及药理作用的研究进展[J].药物生物技术,2017,24(1):76-80.
[20]王琳琳,丁安伟.赤芍总苷对大鼠血瘀证模型的影响[J].南京中医药大学学报,2011,27(6):552-554.
[21]GUO R B,WANG G F,ZHAO A P,et al.Paeoniflorin protects against ischemia-induced brain damages in rats via inhibiting MAPKs/NF-κB-mediated inflammatory responses[J].PLoS One,2012,7(11):e49701.
[2]梁晓松,孙磊.快速康复外科在膝关节镜围手术期的应用前景[J].中国矫形外科杂志,2014,22(17):1597-1599.
[3]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):793-796.
[4]中华医学会.临床诊疗指南:骨科分册[M].北京:人民卫生出版社,2009:81.
[5]CASE R,THOMAS E,CLARKE E,et al.Prodromal symptoms in knee osteoarthritis:a nested case-control study using data from the Osteoarthritis Initiative[J].Osteoarthritis Cartilage,2015,23(7):1083-1089.
[6]熊天琴,廖嘉仪,庞龙,等.毛冬青总提取物对血栓形成及微循环的实验研究[J].泸州医学院学报,2013,36(3):216-219.
[7]陈元元,熊天琴,赵玉民,等.毛冬青总提取物的抗血栓作用及基于ADP的机制研究[J].中华中医药学刊,2015,33(5):1092-1096,1286.
[8]熊天琴,陈元元,李红侠,等.毛冬青皂苷B3的抗血栓作用研究[J].中草药,2012,43(9):1785-1788.
[9]付晓春,徐哲,陈建军.缩醛基毛冬青化合物R4的抗血栓作用研究[J].现代中西医结合杂志,2011,20(34):4335-4336,4456.
[10]王兰兰.毛冬青口服液抗炎作用实验研究[J].医药论坛杂志,2007,28(1):22-23.
[11]曾俊玲,杨树英,麦永前.毛冬青乙素抗炎作用研究[J].中药材,1993,16(11):31-33.
[12]郁相云,钟建华,张旭.中药三七对血液系统的药理活性研究[J].中国中医药现代远程教育,2010,8(12):249.
[13]任真真,张燕玲,王星,等.三七皂苷类成分的蛋白质相互作用网络分析[J].中国中药杂志,2014,39(11):2097-2101.
[14]马岩岩.三七皂甙成分对脂多糖诱导巨噬细胞炎性因子的影响极其机制的研究[D].广州:暨南大学,2013.
[15]张砾岩,李玲.地龙抗血栓有效部位的提取方法初探[J].中成药,2010,32(5):758-761.
[16]唐鼎,凃乾,李娟,等.药用地龙的药理作用和临床研究进展[J].中国药师,2015,18(6):1016-1019.
[17]冯彦.丹参的现代药理研究及临床应用[J].中医临床研究,2017,9(30):46-47.
[18]MICHALSEN A,LüDTKE R,CESUR O,et al.Effectiveness of leechtherapy in women with symptomatic arthrosis of the first carpometacarpal joint:a randomized controlled trial[J].Pain,2008,137(2):452-459.
[19]刘璇,高美风,孔毅.水蛭化学成分及药理作用的研究进展[J].药物生物技术,2017,24(1):76-80.
[20]王琳琳,丁安伟.赤芍总苷对大鼠血瘀证模型的影响[J].南京中医药大学学报,2011,27(6):552-554.
[21]GUO R B,WANG G F,ZHAO A P,et al.Paeoniflorin protects against ischemia-induced brain damages in rats via inhibiting MAPKs/NF-κB-mediated inflammatory responses[J].PLoS One,2012,7(11):e49701.