中药内服外洗治疗肾虚血瘀型膝骨关节炎的疗效观察

【目的】观察口服补肾活血方联合舒筋外洗颗粒熏洗治疗肾虚血瘀型膝骨关节炎(KOA)的临床疗效。【方法】将120例肾虚血瘀型KOA患者随机分为西药组、联合组和补肾活血方组,每组各40例。西药组给予口服双氯芬酸钠缓释片治疗,联合组给予口服补肾活血方联合舒筋外洗颗粒熏洗治疗,补肾活血方组单纯给予口服补肾活血方治疗。采用西安大略和麦克马斯特大学(WOMAC)骨关节炎指数和KOA严重性指数(ISOA),分别于治疗前、治疗4周后对患者进行临床疗效评价。【结果】(1)治疗4周后,3组平均WOMAC骨关节炎指数评分及平均ISOA评分均较治疗前明显下降(P0.05),且联合组的下降作用均明显优于西药组和补肾活血方组,差异均有统计学意义(P0.05)。(2)治疗4周后,西药组、联合组和补肾活血方组的总有效率分别为82.5%、95.0%、80.0%,联合组疗效优于西药组和补肾活血方组,差异均有统计学意义(P0.05)。【结论】口服补肾活血方联合舒筋外洗颗粒熏洗治疗肾虚血瘀型KOA可明显缓解局部疼痛症状,有效改善膝关节的活动功能,疗效确切。

Therapeutic Effect of Oral Use and External Washing with Chinese Medicine for Knee Osteoarthritis with Kidney Deficiency and Blood Stasis

Objective To observe the clinical efficacy of oral use of Bushen Huoxue Recipe (BHR) and steam washing with Shujin Waixi Granules for the treatment of knee osteoarthritis (KOA) with kidney deficiency and blood stasis. Methods One hundred and twenty KOA patients with kidney deficiency and blood stasis were divided into western medicine group, combination group and BHR group, 40 cases in each group. Western medicine group was treated with oral use of Diclofenac Sodium Sustained-release Tablets, combination group was treated with oral use of BHR and steam washing with Shujin Waixi Granules, and BHR group was given BHR orally alone. Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and knee osteoarthritis severity index (ISOA) were used to evaluate the clinical efficacy of patients after treatment for 4 weeks. Results (1) After treatment, the scores of WOMAC osteoarthritis index and ISOA in the three groups were decreased(P< 0.01 compared with those before treatment), and the decrease in the combination group was superior to that in the western medicine group and BHR group(P< 0.05).(2) After treatment for 4 weeks, the total effective rate of western medicine group, combination group and BHR group was 82.5％, 95.0％, 80.0％ respectively, and the combination group had the strongest effect (P < 0.05). Conclusion Oral use of BHR combined with steam washing with Shujin Waixi Granules is effective for the treatment of KOA patients with kidney deficiency and blood stasis by relieving local pain and improving knee joint function.