中药Ⅱ号方外敷配合运动疗法治疗风寒湿痹阻型膝骨性关节炎临床研究
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摘要
目的探究平乐正骨中药Ⅱ号方配合运动锻炼治疗膝骨性关节炎(KOA)的临床疗效。方法 135例患者按入院先后顺序随机分为治疗组(68例)和对照组(67例)。对照组给予口服硫酸氨基葡萄糖、塞来昔布胶囊治疗,指导患者运动锻炼。治疗组患者运用院内自制中药Ⅱ号方外敷,同样指导患者运动锻炼。观察两组患者治疗后临床疗效及西安大略麦马斯特大学骨性关节炎指数量表(WOMAC)评分、血清中相关炎症因子[白细胞介素1β(IL-1β)、转化生长因子-β(TGF-β)]水平情况。结果经过4周治疗后,治疗组总有效率为87. 69%,对照组为83. 54%,两组总有效率比较差异有统计学意义(P <0. 05)。两组患者治疗后4周WOMAC评分均显著下降,与治疗前比较差异有统计学意义(P <0. 01),且治疗组下降幅度高于对照组(P <0. 05)。两组治疗4周,治疗组与对照组炎症因子IL-1β、TGF-β水平均高于本组治疗前,差异有统计学意义(P <0. 01),且治疗组升高水平高于对照组(P <0. 05)。结论平乐正骨中药Ⅱ号方配合运动锻炼治疗KOA能明显改善患者临床症状,值得临床推广应用。
Objective To explore the clinical therapeutic effects on knee osteoarthritis( KOA) treated with pingle zhengguo Chinese medicine Ⅱ formula and kinetotherapy. Methods A total of 135 patients were randomized into a treatment group( 68 cases) and a control group( 67 cases) according to the hospital admission sequence. In the control group,glucosamine sulfate and celecoxib capsules were prescribed for oral administration. Additionally,the physical exercise was provided under guidance. In the treatment group,the self-prepared pingle zhengguo Chinese medicine Ⅱ formula was adopted for the external application. Additionally,the physical exercise was provided under guidance. The clinical effects,WOMAC scores and the related inflammatory factors in serum( IL-1β and TGF-β) were observed after treatment in the two groups. Results After 4-week treatment,the total effective rate was 87. 69% in the treatment group and was83. 54% in the control group,indicating the significant difference in comparison( P < 0. 05). After 4-week treatment,WOMAC scores were all reduced in the two groups,indicating the significant differences as compared with the scores before treatment( P < 0. 01). The reducing amplitude in the treatment group was larger than the control group( P < 0. 05). After 4-week treatment,the levels of IL-1β and TGF-β were all higher than the levels before treatment in comparison within the same group( P < 0. 01). The increases in the treatment group were larger than the control group( P < 0. 05). Conclusion The combined treatment with pingle zhengguo Chinese medicine Ⅱ formula and kinetotherapy obviously relieves the clinical symptoms in KOA patients. This treatment deserves to be promoted in clinical application.
Objective To explore the clinical therapeutic effects on knee osteoarthritis( KOA) treated with pingle zhengguo Chinese medicine Ⅱ formula and kinetotherapy. Methods A total of 135 patients were randomized into a treatment group( 68 cases) and a control group( 67 cases) according to the hospital admission sequence. In the control group,glucosamine sulfate and celecoxib capsules were prescribed for oral administration. Additionally,the physical exercise was provided under guidance. In the treatment group,the self-prepared pingle zhengguo Chinese medicine Ⅱ formula was adopted for the external application. Additionally,the physical exercise was provided under guidance. The clinical effects,WOMAC scores and the related inflammatory factors in serum( IL-1β and TGF-β) were observed after treatment in the two groups. Results After 4-week treatment,the total effective rate was 87. 69% in the treatment group and was83. 54% in the control group,indicating the significant difference in comparison( P < 0. 05). After 4-week treatment,WOMAC scores were all reduced in the two groups,indicating the significant differences as compared with the scores before treatment( P < 0. 01). The reducing amplitude in the treatment group was larger than the control group( P < 0. 05). After 4-week treatment,the levels of IL-1β and TGF-β were all higher than the levels before treatment in comparison within the same group( P < 0. 01). The increases in the treatment group were larger than the control group( P < 0. 05). Conclusion The combined treatment with pingle zhengguo Chinese medicine Ⅱ formula and kinetotherapy obviously relieves the clinical symptoms in KOA patients. This treatment deserves to be promoted in clinical application.
引文
[1]孙贵香,郭艳幸,何清湖,等.平乐正骨(下转第109页)动静互补平衡论———平乐正骨理论体系之平衡理论研究(三)[J].中医正骨,2012,24(11):65-69.
[2]孙贵香,郭艳幸,何清湖,等.平乐正骨筋骨互用平衡论———平乐正骨理论体系之平衡理论研究(二)[J].中医正骨,2012,24(10):73-77.
[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.
[5]Coleman S,Briffa NK,Carroll G,et al. Effects of self-management,education and specific exercises,delivered by health professionals,inpatients with osteoarthritis of the knee[J]. BMC Musculoskelet Dis-ord,2008,9:133.
[6]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2004:24.
[7]李国锐.《中医病症诊断疗效标准》出台[J].质量技术监督研究,1995(2):5.
[8]陈宝军,闫虎,张庆,等.壮骨健膝方治疗肝肾亏虚、风寒湿痹型膝骨关节炎76例临床观察[J].福建中医药大学学报,2013(6):3-5.
[9]刘福英,刘卫华.自我管理教育对膝骨关节炎患者临床康复影响[J].中国医药科学,2014,4(23):153-156.
[10]汪凤兰,张小丽,郝晶,等.老年膝骨关节炎患者运动锻炼自我管理行为及影响因素调查[J].中国康复理论与实践,2014,20(3):295-297.
[11]孙贵香,郭艳幸,何清湖,等.平乐正骨起居有常平衡论———平乐正骨理论体系之平衡理论研究(九)[J].中医正骨,2013(5):69-71.
[12]孙贵香,郭艳幸,何清湖,等.平乐正骨标本兼顾平衡论———平乐正骨理论体系之平衡理论研究(七)[J].中医正骨,2013(3):75-77.
[13]黄小龙,陈明.川乌、草乌和附子治疗痹证探讨[J].中国中医基础医学杂志,2014,20(1):113-114.
[14]袁晓航.中药川乌与草乌的鉴别比较及药理活性探究[J].内蒙古中医药,2017,36(18):137-138.
[15]王英豪.从化学、药理学和炮制的角度探讨附子、川乌和草乌的传统应用[J].光明中医,2009,24(9):1805-1806.
[16]龙丽,赵金霞,贾汝琳,等.草乌甲素对大鼠佐剂性关节炎的影响[J].临床药物治疗杂志,2013(1):16-18.
[17]尹丽颖,边晓燕,韩玉生,等.伸筋草醇提物对佐剂性关节炎大鼠滑膜组织的形态学影响[J].中医药信息,2008,25(2):28-30.
[18]苗兵,杨金,周忠光,等.伸筋草乙醇提取物对佐剂性关节炎大鼠类风湿因子和血清细胞因子的影响[J].中医药信息,2008,25(3):22-24.
[19]Bhatia D,Bejarano T,Novo M. Current interventions in the manage-ment of knee osteoarthritis[J]. J Pharm Bioallied Sci,2013,5(1):30-38.
[2]孙贵香,郭艳幸,何清湖,等.平乐正骨筋骨互用平衡论———平乐正骨理论体系之平衡理论研究(二)[J].中医正骨,2012,24(10):73-77.
[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.
[5]Coleman S,Briffa NK,Carroll G,et al. Effects of self-management,education and specific exercises,delivered by health professionals,inpatients with osteoarthritis of the knee[J]. BMC Musculoskelet Dis-ord,2008,9:133.
[6]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2004:24.
[7]李国锐.《中医病症诊断疗效标准》出台[J].质量技术监督研究,1995(2):5.
[8]陈宝军,闫虎,张庆,等.壮骨健膝方治疗肝肾亏虚、风寒湿痹型膝骨关节炎76例临床观察[J].福建中医药大学学报,2013(6):3-5.
[9]刘福英,刘卫华.自我管理教育对膝骨关节炎患者临床康复影响[J].中国医药科学,2014,4(23):153-156.
[10]汪凤兰,张小丽,郝晶,等.老年膝骨关节炎患者运动锻炼自我管理行为及影响因素调查[J].中国康复理论与实践,2014,20(3):295-297.
[11]孙贵香,郭艳幸,何清湖,等.平乐正骨起居有常平衡论———平乐正骨理论体系之平衡理论研究(九)[J].中医正骨,2013(5):69-71.
[12]孙贵香,郭艳幸,何清湖,等.平乐正骨标本兼顾平衡论———平乐正骨理论体系之平衡理论研究(七)[J].中医正骨,2013(3):75-77.
[13]黄小龙,陈明.川乌、草乌和附子治疗痹证探讨[J].中国中医基础医学杂志,2014,20(1):113-114.
[14]袁晓航.中药川乌与草乌的鉴别比较及药理活性探究[J].内蒙古中医药,2017,36(18):137-138.
[15]王英豪.从化学、药理学和炮制的角度探讨附子、川乌和草乌的传统应用[J].光明中医,2009,24(9):1805-1806.
[16]龙丽,赵金霞,贾汝琳,等.草乌甲素对大鼠佐剂性关节炎的影响[J].临床药物治疗杂志,2013(1):16-18.
[17]尹丽颖,边晓燕,韩玉生,等.伸筋草醇提物对佐剂性关节炎大鼠滑膜组织的形态学影响[J].中医药信息,2008,25(2):28-30.
[18]苗兵,杨金,周忠光,等.伸筋草乙醇提取物对佐剂性关节炎大鼠类风湿因子和血清细胞因子的影响[J].中医药信息,2008,25(3):22-24.
[19]Bhatia D,Bejarano T,Novo M. Current interventions in the manage-ment of knee osteoarthritis[J]. J Pharm Bioallied Sci,2013,5(1):30-38.