蠲痹止痛方内服与熏洗治疗膝关节滑膜炎60例

目的:评价蠲痹止痛方内服与熏洗在中西医结合综合治疗膝关节滑膜炎的方案中的疗效分析。方法:将122例患者采用随机按数字表法分为观察组60例和对照组62例。对照组行关节穿刺,抽取关节腔积液后注入曲安奈得注射液和玻璃酸纳注射液各20 mg,1次/7 d,共2次,并口服塞来昔布胶囊,0.2 g/次,1次/d。观察组在对照组治疗的基础上采用蠲痹止痛方内服与熏洗,两组疗程均为4周。记录治疗前后疼痛、肿胀和关节活动评分,记录疼痛缓解时间和消失时间,进行治疗前后Bristol膝关节评分,检测治疗前后血沉(ESR)和C-反应蛋白(CRP)水平。结果:经Ridit分析,观察组临床疗效优于对照组,差异有统计学意义(P0.05);观察组疼痛、肿胀和关节活动度评分低于对照组(P0.01);观察组平均疼痛缓解时间和消失时间均短于对照组(P0.05);观察组ESR和CRP水平低于对照组(P0.05);治疗后Bristol膝关节各维度评分和总分均比治疗前显著升高(P0.01),观察组除畸形外其他评分均高于对照组(P0.05,P0.01);观察组优良率达70%,高于对照组的51.2%(P0.05)。结论:蠲痹止痛方内服与熏洗配合西药治疗膝关节滑膜炎,缓解疼痛和肿胀症状,促进了关节功能的恢复,在中西医结合的综合治疗方案中起到了较好的效果。

Juanbi Zhitong Decoction by Orally Taking and Fumigation on Gonarthromeningitis in 60 Cases

Objective: To evaluate the curative effect of Juanbi Zhitong decoction by orally taking and fumigation on gonarthromeningitis according to Chinese and western medicine scheme. Method: One hundred and twenty-two patients were randomly divided into control group (62 cases) and observation group (60 cases) by random number table. Patients in control group received joint puncture and triamcinolone acetonide injection and hyaluronic acid sodium injection each for 20 mL after arthroedema was pumped, 1 time/7 days, for totally 2 times, and patients also orally took celecoxib capsules, 0.2 g/time, 1 time/day. Based on the treatment of control group, patients in observation group received additional Juanbi Zhitong decoction by orally taking and fumigation. Course of treatment was 4 weeks in both groups. Before and after treatment, scores of pain, swell and joint motion, as well as pain remission and disappearing time were recorded. Scores of Bristol knee-joint were graded, and levels of erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP) were detected both before and after treatment. Result: Ridit analysis showed that the clinical effect in observation group was superior to that in control group, with significantly statistical difference (P<0.05). Scores of pain, swelling and joint motion in observation group were lower than those in control group (P<0.01). Average remission and disappearing time of pain in observation group was shorter than that in control group (P<0.05). Levels of ESR and CRP were lower than those in control group (P<0.05). After treatment, compared with the data before treatment, various dimensional scores of Bristol knee-joint and total scores increased obviously (P<0.01), and those scores in observation group were higher than the data in control group except the score of malformation (P<0.05, P<0.01). And excellent and good rate in observation group was 70% higher than 51.2% in control group (P<0.05). Conclusion: Juanbi Zhitong decoction by orally taking and fumigation combined with western medicine can relive symptoms of pain and swell, promote the recovery of joint function and improve quality in the treatment of gonarthromeningitis. It has a good effect in Chinese and western medicine scheme.