祛寒逐风合剂联合西医常规疗法治疗膝骨关节炎风寒痹阻证临床研究

目的观察祛寒逐风合剂联合西医常规疗法对膝骨关节炎风寒痹阻证的临床疗效,以及对关节症状及相关实验室指标的影响。方法采用随机数字表法将94例膝骨关节炎风寒痹阻证患者分为观察组和对照组各47例。对照组采用常规药物疗法+康复训练,观察组在对照组基础上予祛寒逐风合剂,每次50m L,每日3次,口服。2组均连续治疗2周。比较2组临床疗效,观察2组治疗前后美国西大略湖和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟评分法(VAS)评分、压痛指数、中医症状评分,白细胞介素(IL)-1β、IL-6、血管内皮生长因子(VEGF)、肿瘤坏死因子(TNF)-α、骨钙素、抗酒石酸盐酸性磷酸酶异构体(TRACP)-5b、骨特异性碱性磷酸酶(BALP)、纤维蛋白原、红细胞沉降率和红细胞聚集指数,对2组进行安全性评价。结果观察组总有效率为89.36%(42/47),对照组为74.47%(35/47),观察组明显优于对照组(P<0.05)。与本组治疗前比较,2组治疗后WOMAC评分、VAS评分、压痛指数、中医症状评分明显下降(P<0.05);2组治疗后比较,观察组WOMAC评分、VAS评分、压痛指数、中医症状评分明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后IL-1β、IL-6、TNF-α、VEGF、TRACP-5b水平明显下降,骨钙素、BALP水平明显升高(P<0.05);2组治疗后比较,观察组IL-1β、IL-6、TNF-α、VEGF、TRACP-5b水平明显低于对照组,骨钙素、BALP水平明显高于对照组(P<0.05)。与本组治疗前比较,观察组治疗后纤维蛋白原、红细胞沉降率、红细胞聚集指数明显下降(P<0.05);2组治疗后比较,观察组血液流变学各项指标明显低于对照组(P<0.05)。2组均未发生不良反应。结论祛寒逐风合剂联合西医常规疗法治疗膝骨关节炎风寒痹阻证患者疗效较好,可明显改善关节症状及相关实验室指标。

Clinical Study on Quhan Zhufeng Mixture Combined with Conventional Western Medicine Therapy for Treatment of Knee Osteoarthritis with Wind Cold Blocking Type

Objective To observe the clinical efficacy of Quhan Zhufeng Mixture combined with conventional western medicine therapy for knee osteoarthritis with wind cold blocking type and its effects on joint symptoms and related laboratory indicators. Methods Totally 94 patients with knee osteoarthritis were divided into observation group and control group according to random number table method, with 47 cases in each group. The control group used the conventional treatment method + rehabilitation exercise, and the observation group took Quhan Zhufeng Mixture on the basis of the conventional treatment, 50 mL each time, three times a day, orally. The treatment for both groups lasted for 2 weeks. The clinical efficacy of the two groups was compared. The Western Ontario and McMaster Universities osteoarthritis index(WOMAC) score, VAS score, tenderness index, TCM symptom scores, interleukin(IL)-1β, IL-6, vascular endothelial growth factor(VEGF), tumor necrosis factor(TNF)-α, osteocalcin, tartrate-resistant acid phosphatase isomer(TRACP)-5b, bone-specific alkaline phosphatase(BALP), fibrinogen, erythrocyte sedimentation rate, and erythrocyte aggregation index were observed, and safety of the two groups was evaluated. Results The total effective rate in the observation group was 89.36%(42/47) and the control group was 74.47%(35/47). The observation group was significantly better than the control group(P<0.05). Compared with before treatment, the WOMAC score, VAS score, tenderness index, and TCM symptom scores of the two groups decreased significantly after treatment(P<0.05);After treatment, the WOMAC score, VAS score, tenderness index, and TCM symptoms scores of the observation group were significantly lower than those of the control group(P<0.05). Compared with before treatment, the levels of IL-1β, IL-6, TNF-α, VEGF, and TRACP-5b in the two groups decreased significantly after treatment, and the levels of osteocalcin and BALP increased significantly(P<0.05);After treatment, the levels of IL-1β, IL-6, TNF-α, VEGF, and TRACP-5b in the observation group were significantly lower than those in the control group, and the levels of osteocalcin and BALP were significantly higher than those in the control group(P<0.05). Compared with before treatment, the observation group had a significant decrease in fibrinogen, erythrocyte sedimentation rate, and erythrocyte aggregation index after treatment(P<0.05);After treatment, the hemorheology indicators in the observation group were significantly lower than those in the control group(P<0.05). No adverse reactions occurred in either group. Conclusion Quhan Zhufeng Mixture combined with conventional western medicine therapy has a good curative effect on patients with knee osteoarthritis of wind cold blocking type, which can significantly improve joint symptoms and related laboratory indicators.