回旋正骨手法联合温阳通络胶囊治疗阳虚寒凝型膝骨关节炎的临床观察

目的 观察使用回旋正骨手法联合温阳通络胶囊治疗阳虚寒凝型膝骨关节炎（KOA）的短期疗效。方法 选取2018年10月—2020年2月于广东省第二中医院骨科门诊部收治的KOA患者71例，采用随机数字表法随机分为试验组（35例）和对照组（36例），试验组使用回旋正骨手法（每周1次，连续治疗4周）联合温阳通络胶囊（每日3次，每次2粒，服用4周）治疗，对照组口服塞来昔布胶囊（2次/日，100 mg/次）治疗。比较两组患者治疗前后的视觉模拟评分法（VAS）评分、西安大略和麦克马斯特大学骨性关节炎指数（WOMAC）评分、焦虑自评量表（SAS）和抑郁自评量表（SDS）评分，同时对两组患者进行疗效评价。结果 试验组痊愈率为14.29%，总有效率为91.43%，对照组痊愈率为13.89%，总有效率为86.11%。两组痊愈率和总有效率比较，差异无统计学意义（P > 0.05）。治疗后两组疗效指标均较治疗前明显改善，VAS、WOMAC分数均下降，差异均有统计学意义（P < 0.05），且两组之间VAS评分、WOMAC疼痛评分、僵硬评分比较，差异无统计学意义（P > 0.05），试验组WOMAC的生活能力部分评分较对照组下降更明显（P < 0.05）。治疗后两组SAS、SDS评分均较治疗前明显改善（P < 0.05），试验组SAS、SDS评分均较对照组改善更为明显（P < 0.05）。结论 回旋正骨手法配合口服温阳通络胶囊可有效减轻阳虚寒凝型KOA患者疼痛、改善关节功能，且对缓解患者抑郁、焦虑情绪有积极作用。

Clinical observation on the treatment of Huixuan Zhenggu manipulation and Wenyang Tongluo Capsule on knee osteoarthritis with yang deficiency and cold coagulation syndrome

Objective To observe the short-term curative effect of using Huixuan Zhenggu manipulation combined with Wenyang Tongluo Capsule to treat knee osteoarthritis (KOA) with yang deficiency and cold coagulation syndrome.Methods The 71 patients with KOA treated in the Orthopedic Outpatient Department of Guangdong Second Traditional Chinese Medicine Hospital from October 2018 to February 2020 were selected, and they were randomly divided into experimental group (35 persons) and control group (36 persons). The experimental group was treated with Huixuan Zhenggu manipulation (once a week for 4 weeks) combined with Wenyang Tongluo Capsule (3 times a day, 2 tablets per time for 4 weeks), and the control group was treated with celecoxib capsule(2 times a day, 100 mg/time). The Visual Analogue Scale(VAS) score, Western Ontario and McMaster University Osteoarthritis Index(WOMAC) score, Self Rating Anxiety Scale (SAS) and self Rating Depression Scale (SDS) of the two groups were compared before and after treatment, and the curative effect of the two groups was evaluated.Results The cure rate in the experimental group was 14.29%, and the total effective rate was 91.43%. The cure rate in the control group was 13.89%, and the total effective rate was 86.11%. There was no statistically significant difference in the cure rate and total effective rate between two groups(P > 0.05). After treatment, the efficacy indicators of the two groups were significantly improved compared with the previous, the VAS and WOMAC scores were all decreased, and the difference was statistically significant (P < 0.05). After treatment, there was no significant difference in VAS score, WOMAC pain score, and stiffness score between two groups (P > 0.05). The WOMAC score of living ability in the experimental group decreased more significantly than the control group(P < 0.05). After treatment, the SAS and SDS scores of the two groups were significantly improved compared with before treatment, and the difference was statistically significant(P < 0.05). Comparing the groups after treatment, the SAS and SDS scores of the experimental group were improved more significantly than those of the control group (P < 0.05).Conclusion The treatment of Huixuan Zhenggu manipulation combined with oral Wenyang Tongluo Capsule can effectively relieve pain and improve joint function in KOA patients with yang deficiency and cold coagulation syndrome, and it has a positive effects on alleviating depression and anxiety in patients.