针刀联合益胃健骨汤内服治疗膝关节骨性关节炎临床研究

目的:观察针刀联合益胃健骨汤内服治疗膝关节骨性关节炎的临床疗效。方法:随机将120例膝关节骨性关节炎患者分为对照组和观察组,每组各60例,均给予硫酸氨基葡萄糖胶囊口服。对照组在此基础上采用针刀治疗,每周1次,连续3周。观察组在对照组的基础上加服益胃健骨汤,每日1剂,共治疗8周。观察治疗前后两组患者Lysholm膝关节功能评分、疼痛视觉模拟评分(visual analogue scale,VAS)、中医证候评分和膝关节屈伸功能评分。检测治疗前后两组患者关节液白细胞介素-1β(interleukin-1β,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),基质金属蛋白酶-3(matrixmetalloproteinase-3,MMP-3),进行安全性评价。结果:观察组临床疗效有效率为98.33%,高于对照组的86.67%(P0.05);治疗后观察组Lysholmy评分分级优于对照组(P0.05);治疗后观察组Lysholm评分高于对照组,VAS评分、中医证候评分和膝关节屈伸功能评分低于对照组,差异有统计学意义(P0.01);治疗后观察组患者关节液IL-1β、TNF-α和MMP-3水平低于对照组,差异有统计学意义(P0.01);两组均未发现与中药相关不良反应。结论:针刀联合益胃健骨汤内服可减轻膝关节骨性关节炎患者临床症状,改善关节活动度,缓解疼痛,提高日常活动能力,并调节MMP-3、IL-1β、TNF-α等因子水平,临床疗效显著。

Clinical Research on Needle-knife Combined with Yiwei Jiangu Soup in the Treatment of Knee Osteoarthritis

Objective:To observe the clinical curative effect of needle-knife combined with Yiwei Jiangu Soup in the treatment of knee osteoarthritis.Methods:120 patients with knee osteoarthritis were randomly divided into the control group and the observation group,each of 60 cases,and all were treated with Glucosamine Sulfate Capsules.The control group was additionally given needle-knife therapy,one time a week for 3 weeks.The observation group was treated with Yiwei Jiangu Soup based on the control group,one dose a day,treatment for 8 weeks.Lysholm knee function score,pain visual analogue scale (VAS),TCM syndrome score and knee joint flexion and extension function score of the two groups of patients were observed before and after treatment.Joint fluid interleukin-1 beta (IL-1β),tumor necrosis factor alpha (TNF-α),matrix metalloproteinase-3 (MMP-3) of two groups of patients before and after treatment were detected,and the safety evaluation was carried out.Results:The clinical curative effect of observation group was 98.33％,higher than 86.67％ in the control group (P ＜ 0.05);after treatment,Lysholmy score of the observation group better than the control group (P ＜ 0.05);after treatment,Lysholm score of observation group was higher than that of the control group,VAS score,TCM syndrome score and knee function score in the observation group were lower than the control group,there was statistical significant differences (P ＜ 0.01);the observation group after treatment in patients with synovial fluid IL-1 beta,TNF-alpha and MMP-3 levels lower than the control group,the difference was statistically significant (P ＜ 0.01);the two groups were not found in traditional Chinese medicine and related adverse reactions.Conclusion:Needle-knife combined with Yiwei Jiangu Soup can relieve the clinical symptoms,improve joint mobility,relieve pain,improve the ability of daily activities,and adjusting the MMP-3 IL-1 beta,TNF-alpha and other factors,and the clinical effect is significant.