活血利水中药联合复方南星止痛膏治疗慢性膝关节滑膜炎的病例对照研究

目的:探讨复方南星止痛膏联合活血利水中药治疗慢性关节滑膜炎的疗效。方法:回顾性分析2008年10月至2011年3月膝骨关节滑膜炎患者120例,分为内服组、外敷组和联合组,每组40例。内服组患者平均年龄(56.58±5.47)岁;病程(7.35±2.59)个月;左膝18例,右膝17例,双膝5例;给予活血利水中药内服,该方由五苓散合桃红四物汤组成。外敷组患者平均年龄(56.25±6.35)岁;病程(7.68±2.76)个月;左膝16例,右膝20例,双膝4例;给予复方南星止痛膏外敷。联合组患者平均年龄(55.65±4.49)岁;病程(7.50±3.36)个月;左膝16例,右膝18例,双膝6例;给予活血利水中药内服结合复方南星止痛膏外敷。治疗后采用Lysholm和Gillquist膝关节评分标准和中医病症诊断疗效标准对3组治疗效果及膝关节功能进行评价。结果:纳入统计的患者118例,其中内服组40例,外敷组39例,联合组39例。治疗后联合组治愈27例,好转9例,未愈3例;外敷组治愈15例,好转16例,未愈8例;内服组治愈13例,好转16例,未愈11例。联合组的疗效高于内服组和外敷组。联合组除交锁和不稳定外,其余各项评分均高于内服组;联合组在跛行、疼痛、支撑、肿胀和爬楼梯方面评分高于外敷组;外敷组在疼痛、支撑、爬楼梯和下蹲方面评分高于内服组。结论:复方南星止痛膏联合活血利水中药治疗膝关节慢性滑膜炎可以减轻疼痛,消除肿胀,改善关节功能。复方南星止痛膏能在一定程度上减轻疼痛,改善关节功能。

Combined use of Compound Nanxing Pain Paste with blood-promoting and diuretic Chinese herbal medicines in treatment of chronic knee synovitis

Objective:To observe the clinical efficacy of combined use of Compound Nanxing Pain Paste with blood-promoting and diuretic Chinese herbal medicines in treatment of chronic knee synovitis. Methods:From October 2008 to March 2011,120 patients with chronic knee synovitis were equally divided into three groups:oral treatment group,external treatment group and combined treatment group. Patients in oral treatment group had a mean age of (56.58±5.47) years and a course of disease about (7.35±2.59) months,involving the left knee in 18 cases,the right knee in 17 cases and both knees in 5 cases,who were administered orally with blood-promoting and diuretic Chinese herbal medicines composed of Wu Ling San and Tao Hong Si Wu Decoction. Patients in external treatment group had a mean age of (56.25±6.35) years and a course of disease about (7.68±2.76) months,involving the left knee in 16 cases,the right knee in 20 and both knees in 4 cases,who were treated externally with Compound Nanxing Pain Paste. Patients in combined treatment group had a mean age of (55.65±4.49) years and a course of disease about (7.50±3.36) months,involving the left knee in 16 cases,the right knee in 18 and both knees in 6 cases,who were given both oral and external treatments. The clinical effects and knee function of the three groups were assessed and compared. Results:Finally,a total of 118 patients were included in the result analysis,including 40 patients in oral treatment group,39 patients in external treatment group and 39 patients in combined treatment group. In combined treatment group,27 patients were clinically cured,9 were improved,and 3 patients were ineffective vs 15,16 and 8 patients in external treatment group,and 13,16 and 11 in oral treatment group. The overall effective rate of combined treatment group was better than that of oral group and external treatment groups (P<0.05). The function comprehensive score of knee joints in combined treatment group was better than that of oral treatment group,while the function comprehensive score of knee joints in oral treatment group was better than that in external treatment group in terms of demand for assistance,stair-climbing ability,lameness,and swelling pain. Conclusion:Combined use of oral blood-promoting and diuretic Chinese herbal medicines with Nanxing offers a good therapeutic effect on chronic knee synovitis in relieving pain,reducing swelling and improving joint function,while Nanxing could also reduce pain and improve joint function to a certain extent.