超微肿痛贴联合独活寄生汤治疗膝骨关节炎的疗效观察

目的观察超微肿痛贴联合独活寄生汤治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效及其对骨代谢标志物的影响。方法选取2019年4月至2019年12月湖南省中医药研究院附属医院骨伤科住院部的70例KOA患者,随机均等分为观察组与对照组,各35例,观察组予超微肿痛贴外敷联合独活寄生汤内服治疗,对照组予独活寄生汤内服治疗,两组均以14 d为1个疗程。治疗1个疗程后进行疗效评价,采用西安大略麦克马斯特大学骨关节炎指数(the Western Ontario and McMaster Universities osteoarthritis index,WOMAC)评分对治疗前后膝关节疼痛、僵硬和功能活动度进行评价,对骨代谢标志物骨钙素(bone gla protein,BGP)、骨保护素(osteoprotegerin,OPG)及骨特异性碱性磷酸酶(bone specific alkaline phosphatase,BALP)]水平变化情况进行评价。结果观察组有效33例,无效2例,有效率94.29%;对照组有效26例,无效9例,有效率74.29%(P<0.05);治疗后与对照组比较,观察组患者WOMAC评分降低(P<0.05),骨代谢检测指标BGP、OPG及BALP水平均明显升高(P<0.05)。结论超微肿痛贴外敷联合独活寄生汤内服可有效改善KOA患者生理功能、疼痛、僵硬等,其可能机制是通过促进骨代谢以保护软骨功能,进而减缓KOA进程,值得临床推广应用。

Observation of Curative Effect on Knee Osteoarthritis Treated by Ultramicro Swelling and Pain Paste Combined with Duhuo Jisheng Decoction

Objective To observe the clinical effect and effect on bone metabolism markers on knee osteoarthritis(KOA)treated by ultramicro swelling and pain paste combined with Duhuo Jisheng Decoction.Methods 70 patients with KOA were selected from the department of orthopedics and traumatology of Hunan Academy of Traditional Chinese Medicine Affiliated Hospital from April 2019 to December 2019,and randomly divided into the observation group and the control group,35 cases in each group.The observation group was treated with ultramicro swelling and pain paste combined with internal administration of Duhuo Jisheng Decoction,while the control group was treated with internal administration of Duhuo Jisheng Decoction.Both groups were treated with 14 days as a course of treatment,and the efficacy was evaluated after one course of treatment.The Western Ontario and McMaster Universities osteoarthritis index(WOMAC)score was used to evaluate the pain,stiffness and functional activity of knee before and after treatment,and the changes of bone metabolic markersbone gla protein(BGP),osteoprotegerin(OPG)and bone specific alkaline phosphatase(BALP)]were evaluated.Results In the observation group,33 cases were effective and 2 cases were ineffective,the effective rate was 94.29%.In the control group,26 cases were effective and 9 cases were ineffective,with an effective rate of 74.29%(P<0.05).After treatment,compared with the control group,WOMAC score in the observation group were decreased(P<0.05),and the levels of BGP,OPG and BALP in bone metabolism were significantly increased(P<0.05).Conclusion External application of ultramicro swelling and pain paste combined with Duhuo Jisheng Decoction can effectively improve the physiological function,pain and stiffness of patients with KOA.The possible mechanism is to protect the function of cartilage by promoting bone metabolism,thus slowing down the process of KOA,which is worthy of clinical promotion and application.