海桐皮汤熏洗治疗老年膝骨性关节炎的临床对比研究

[目的]观察中药海桐皮汤熏洗结合玻璃酸钠关节腔内注射治疗老年膝关节骨性关节炎的的临床疗效和安全性。[方法]选取本院骨科60例老年膝关节骨性关节炎患者,随机分成试验组和对照组,每组30人,两组患者均行关节腔内注射施沛特1支,每周1次,试验组用海桐皮汤熏洗患膝关节1次/日,对照组口服洛索洛芬钠片,1片/次,3次/日；共治疗5周。分别于治疗前,治疗5周后采用疼痛视觉模拟评分法(Visual analogue scale, VAS)进行评分；西安大略和麦克马斯特大学(The Western Ontario and McMaster Universities Arthritis Index,WOMAC)骨关节炎指数、关节活动度变化情况,并在治疗期间观察有无与治疗相关的不良反应。[结果] 两组患者治疗后与治疗前比较,VSA评分,WOMAC骨关节炎指数、关节活动度,差异有统计学意义(P＜0.01),两组间比较,治疗后VSA评分,WOMAC骨关节炎指数组间差异无统计学意义(P>0.05),关节活动度组间差异有统计学意义(P＜0.05),试验组患者治疗期间未出现皮疹、胃痛不良反应,肝肾功能检查均正常,对照组患者治疗期间出现胃痛3例不良反应,肝功能异常5例,两组间差异有统计学意义(P＜0.01)。[结论] 两种方法均能够有效改善关节功能障碍,促进关节功能的恢复,但海桐皮汤熏洗结合玻璃酸钠关节腔内注射治疗老年膝关节骨性关节炎毒副反应低,在临床上更值得推广。

The clinical comparative study of Haitongpi Decoction fumigation on treatment of senile knee osteoarthritis

[Objective] To observe clinical efficacy and safety of Chinese medicine Haitongpi Decoction fumigation combined with intra-articular injection of sodium hyaluronate in the treatment of elderly osteoarthritis of the knee. [Method] Select 60 cases of senile knee osteoarthritis patients, were randomly divided into experimental group and control group, 30 cases in each group, two groups of patients underwent intraarticular injection Sofast (Sodium Hyaluronate Injectio), 1 time a week, the experimental group with Haitongpi Decoction fumigation affected knee 1 times / day, control group oral Loxoprofen Sodium Tablets, 1 tablet / time, 3 times / day for 5 weeks. Respectively before treatment and after 5 weeks of treatment, the pain visual analogue score (VAS) score; Western Ontario and McMaster Universities arthritis index(WOMAC) osteoarthritis index, joint activity degree changes. And observe the adverse reactions during the treatment. Results Before and after treatment, 2 groups of patients with VSA score, WOMAC index of bone arthritis, joint activity, the difference was statistically significant (P < 0.01), after treatment, the difference of VSA score, WOMAC index of bone arthritis were not statistically significant (P>0.05) ,but the difference of joint activity was statistically significant (P < 0.05) between two groups, the experimental group was not rash, stomach pain, liver and kidney function tests were normal. In the control group, there were 3 cases of adverse reactions, 5 cases of abnormal liver function, 2 groups had statistical significance (P < 0.01). [Conclusion] The two methods can effectively improve the joint dysfunction, promote recovery of joint function, but Haitongpi Decoction fumigation combined with intra-articular injection of sodium hyaluronate treatment of senile knee osteoarthritis low toxic side effect, in clinical practice is more worth promoting.