芎附痛痹汤联合中药熏蒸治疗膝骨性关节炎的临床疗效观察

目的探讨芎附痛痹汤联合中药熏蒸对膝骨性关节炎（KOA）治疗效果及对血清炎性因子的影响。方法选择112例双侧KOA病人作为研究对象，采用随机数字表法分成观察组和对照组，各56例。对照组病人口服硫酸氨基葡萄糖治疗，观察组病人采用芎附痛痹汤联合中药熏蒸进行治疗。分别在治疗前和治疗8周后采用Lysholm评分和VAS评分评价关节功能和疼痛程度，采用酶联免疫吸附法测定血清炎症因子基质金属蛋白酶（MMP）-3、肿瘤坏死因子（TNF）-α和白细胞介素（IL）-17水平，观察治疗效果。结果治疗后，观察组的有效率（91.1%）明显高于对照组的有效率（75.0%）（P < 0.05）。治疗前，2组Lysholm评分、疼痛程度的VAS评分、血清MMP-3、TNF-α和IL-17水平比较差异均无统计学意义（P>0.05）；治疗后，2组的Lysholm评分较治疗前均有提升，VAS评分较治疗前均有下降，且观察组的Lysholm评分高于对照组，VAS评分低于对照组（P < 0.01）；2组血清MMP-3、TNF-α和IL-17水平较治疗前均有降低（P < 0.05~P < 0.01），且观察组MMP3、TNF-α和IL-17水平均低于对照组（P < 0.05~P < 0.01）。结论芎附痛痹汤联合中药熏蒸治疗KOA效果显著，且可以显著改善病人的关节功能、疼痛程度和血清炎性因子水平。

Clinical observation of Xiongfu Tongbi decoction combined with traditional Chinese medicine fumigation in the treatment of knee osteoarthritis

ObjectiveTo investigate the therapeutic effects of Xiongfu Tongbi decoction combined with traditional Chinese medicine fumigation on knee osteoarthritis(KOA) and serum levels of inflammatory factors.MethodsOne hundred and twelve patients with bilateral KOA were randomly divided into the observation group and control group(56 cases each group).The control group was treated with glucosamine sulfate by oral, and the observation group was treated with Xiongfu Tongbi decoction combined with traditional Chinese medicine fumigation.The degree of joint function and pain were evaluated using Lysholm score and VAS score before treatment and after 8 weeks of treatment.The serum levels of matrix metalloproteinase(MMP)-3, tumor necrosis factor(TNF)-α and interleukin-17 were measured using enzyme-linked immunosorbent assay(ELISA), and the therapeutic effects were observed.ResultsThe therapeutic response rate in observation group(91.1%) was significantly higher than that in control group(75.0%) (P < 0.05).Before treatment, the differences of Lysholm score and VAS score, and serum levels of MMP-3, TNF-α and IL-17 were not statistically significant between two groups(P>0.05).After treatment, the Lysholm score and VAS score in two groups increased and decreased, respectively(P < 0.01).After treatment, the Lysholm score and VAS score in observation group were higher and lower than that in control group, respectively(P < 0.01).After treatment, the serum levels of MMP-3, TNF-α and IL-17 in two groups decreased(P < 0.05 to P < 0.01), and the serum levels of MMP3, TNF-α and IL-17 in observation group were lower than those in control group(P < 0.05 to P < 0.01).ConclusionsThe effects of Xiongfu Tongbi decoction combined with traditional Chinese medicine fumigation on KOA is significant, and which can significantly improve the joint function, pain level and serum levels of inflammatory factors.