三联序贯通痹法治疗膝骨性关节炎40例

目的:观察三联序贯通痹法综合治疗膝骨性关节炎患者的临床疗效。方法:选取符合诊断标准的膝骨性关节炎患者80例,随机分为治疗组40例(64膝)和对照组40例(63膝),治疗组予中医特色三联序贯通痹法进行治疗,对照组予常规非甾体抗炎药美洛昔康口服,在治疗4周后,依据疼痛视觉模拟评分(VAS)、病情严重性指数(ISOA)评分标准,对治疗前后膝骨性关节炎患者的疼痛、步行能力、日常生活受累程度三个方面进行评价。结果:治疗组总体疗效优于对照组(P<0.05);治疗组和对照组均能降低疼痛分值(P<0.01),但治疗组对疼痛分值的改善明显优于对照组(P<0.01);治疗组和对照组均能降低ISOA评分,并对其疼痛或不适、最大步行距离、日常生活能力三项评分均较治疗前降低(P<0.01),有显著性差异;治疗后两组患者ISOA评分总分及其疼痛或不适评分,有明显差异(P<0.01),治疗组降低更为明显,而治疗后两组患者最大步行距离、日常生活能力无显著性差异(P>0.05);治疗组患者按照中医分型治疗后风寒湿痹证型疗效最佳,其次为痰瘀互结证型,肝肾阴虚证型疗效最差。结论:三联序贯通痹法能够改善膝骨性关节炎患者疼痛或不适、最大步行距离、日常生活能力,提高患者生活质量。

Clinical Observation on 40 cases of Knee Osteoarthritis Treated by Three-step Seqential Therapy

Objective:To observe the clinical effect on treating knee osteoarthritis by comprehensive three-step seqential therapy.Methods:First,80 samples who were diagnosed as knee osteoarthritis,were randomly divided into the experimental and the control groups with 40 cases for each group.Second,treat experimental group with the three-step seqential therapy,while treat control group with meloxicam.Third,after treating for 4 weeks,evaluate the pains,ability of walk on foot and involvement degree of daily life before and after treatment based on visual analoguescale(VAS) and ISOA.Results:There was significant difference between experimental group and control group(P<0.05),and the pain score of both groups can be cut down,but it was better in the experimental group than that in the control group(P<0.01);both of the groups can reduce the ISOA score and cut down the score on pains,the maximum walking distance and involvement degree of daily life(P<0.01),the difference was significant;there was significant diffenence between two groups on ISOA scoring and pains,and the experimental group was better in releasing pain,while there was few difference between the effect on maximum walking distance and involvement degree of daily life in two groups(P>0.05).In experimental group,the best effect was in syndrome of wind-cold-dampness,and in syndrome of intermingled phlegm and blood stasis,the effect was better,while it had the worset effect in syndrome of yin deficiency of liver and kidney.Conclusion:This research showed that the comprhensive effect of three-step seqential therapy was better than the western medicine in control group,and both of the groups can reduce pains,and have improvement in maximum walking distance and involvement degree of daily life.However,three-step seqential therapy has its advantage in reducing pain,and has greater effect on treating syndrome of wind-cold-dampness.