中医综合疗法治疗膝骨关节炎临床疗效观察及生存质量评价

目的 观察中医综合疗法治疗膝骨关节炎的疗效及其对生存质量的影响.方法 将148例膝骨关节炎患者按照简单随机原则分为治疗组（75例）和对照组（73例）,治疗组采用骨刺颗粒内服、消炎膏外敷及日常生活指导,对照组采用布洛芬胶囊口服、奇正消痛贴膏外用及日常生活指导.以西安大略和麦克马斯特大学骨关节炎指数（Western Ontario and McMaster Universities osteoarthritis index,WOMAC）及〈中医病证诊断疗效标准〉中＂骨痹＂的疗效标准评价疗效,并采用36条目简明健康状况调查表（36-item short-form health survey,SF-36）对患者的生存质量进行评估.结果 治疗10 d及30 d后,治疗组总有效率均显著高于对照组（P〈0.05）;两组WOMAC评分均显著低于治疗前（P〈0.01）,且治疗组WOMAC评分显著低于对照组（P〈0.01）.与治疗前比较,治疗30 d后两组SF-36各维度评分均显著升高（P〈0.01）.治疗组各维度评分改善值显著高于对照组（P〈0.05,或P〈0.01）.结论 中医综合疗法不仅能够改善膝骨关节炎的疼痛不适症状,而且能够改善关节活动度及躯体功能,提高患者生存质量.

Clinical Effect of Integrated Traditional Chinese Medicine Therapy and Its Impact on Quality of Life in Patients with Knee Osteoarthritis

Objective To investigate the clinical effect of integrated traditional Chinese medicine therapy and its impact on the quality of life in patients with knee osteoarthritis. Methods A total of 148 patients with knee osteoarthritis were randomly divided into treatment group （n~75） and control group （n= 73）. The treatment group received oral administration of Guci Granules, external application of anti-inflamma- tory cream, and guidance for daily life, while the control group received oral administration of ibuprofen Capsule, external application of Cheezheng pain-relieving plaster, and guidance for daily life. The treat- ment outcomes were evaluated by Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） and the response criteria for bone bi-disease in Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine, and the quality of life was evaluated by 3＆item short-form health survey （SF-36）. Results After 10 and 30 days of treatment, the treatment group had a significantly higher overall response rate than the control group （P〈0.05） ; both groups had significantly decreased WOMAC scores （P〈0. 01）, and the treatment group had significantly lower WOMAC scores than the control group （P〈0.01）. After 30 days of treatment, both groups had significantly increased scores on all the dimensions of SF-36 （P〈0.01）; the treatment group had significantly more improve- ments in the scores on all the dimensions of SF-36 than the control group （P〈0. 05 or P〈0. 01）. Conclusion Integrated traditional Chinese medicine therapy can not only reduce knee pain and discomfort symptoms, but also improve the joint activity and physical function, thus improving the quality of life in patients with knee osteoarthritis.