骨痹方治疗膝骨关节炎肾虚络痹证临床观察

目的:通过观察骨痹方对肾虚络痹证的膝骨关节炎(knee osteoarthritis,KOA)患者的临床疗效,评价其有效性及安全性。方法:本临床观察共纳入肾虚络痹证的KOA患者60例,按随机数字表法分为两组,各30例,治疗组予口服骨痹方,1剂/d,对照组予口服硫酸氨基葡萄糖,0.5 g/次,3次/d,疗程均为3个月,观察治疗前和治疗后两组膝关节疼痛视觉模拟评分法(VAS)评分,西安大略和麦克马斯特大学(WOMAC)骨关节炎指数,中医证候积分,血沉(ESR),C反应蛋白(CRP)等的变化,并比较两组中医证候疗效及疾病疗效差别,同时观察不良反应。结果:中医证候疗效比较,治疗组总有效率是100%,优于对照组的88.3%(P0.01)。疾病疗效比较,治疗组总有效率是100%,优于对照组的76.7%(P0.01)。与本组治疗前比较,治疗后两组患者膝部疼痛,膝部肿胀,膝关节屈伸不利,下肢乏力,腰脊酸痛,畏寒怕冷,VAS评分及WOMAC指数的关节疼痛,功能积分,僵硬积分、总积分均下降(P0.05,P0.01)。与对照组治疗后相比,治疗组患者膝部疼痛,膝部肿胀,膝关节屈伸不利,腰脊酸痛,畏寒怕冷,VAS评分,WOMAC指数的僵硬积分明显降低(P0.05,P0.01),下肢乏力及WOMAC指数的总积分、疼痛、功能积分降低不明显。活动指标比较,与本组治疗前比较,两组治疗后ESR,CRP均有改善(P0.05,P0.01),但两组无明显差异。结论:骨痹方可有效控制膝骨关节炎,且无明显不良反应。

Effect of Gubi Recipe in Treating Knee Osteoarthritis with Symptom of Kidney Deficiency and Collateral Obstruction

Objective: To observe the clinical efficacy of Guibi recipe on knee osteoarthritis (KOA) with symptom of kidney deficiency and collaterals obstruction, in order to evaluate the effectiveness and safety. Method: In this study, 60 cases of KOA with symptom of kidney deficiency and collateral obstruction were included, and divided into treatment group (30) taking Guibi recipe and control group (30) taking glucosamine sulfate, 0.5 g/times, 3 times/day. The treatment source was 3 months. The changes in visual analogue scale/score (VAS), the Western Ontario and McMaster (WOMAC) osteoarthritis index, traditional Chinese medicine (TCM) syndrome score, erythrocyte sedimentation rate(ESR) and C-reactive protein (CRP) in the two groups were observed before and after treatment, so as to compare the TCM syndrome efficacy and disease efficacy differences of the two groups; meanwhile the adverse reactions were also observed. Result: Comparison of TCM syndromes, the total effective rate in treatment group was 100%, which was higher than 88.3% in control group (P<0.01). Comparison of disease efficacy, the total effective rate in the treatment group was 100%, which was higher than 76.7% in the control group (P<0.01). Compared with before treatment, knee pain, knee swelling, knee flexion and extension, lower limb weakness, lumbar soreness, chills, VAS score and WOMAC index of joint pain, functional integral, stiffness integral and total score of the two groups of patients decreased (P<0.05, P<0.01). Compared with control group, knee pain, knee swelling, knee flexion and extension adverse, lumbar soreness, chills, VAS score, WOMAC index stiffness score of the treatment group of patients significantly reduced (P<0.05, P<0.01); lower limb weakness and total score, pain, functional score of WOMAC index slightly decreased. Activity indicators comparison, ESR, CRP of the treatment group and the control group were improved (P<0.05, P<0.01), but with no significant difference between the two groups. Conclusion: Gubi recipe can effectively control KOA, with no obvious adverse reaction.