| 宋寒冰,吕冰,陈启鹏,王飞,梁仕博.独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎的临床疗效[J].中国医药导报,2024,21(3):149-152 |
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| 独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎的临床疗效 |
| Clinical efficacy of Duhuo Jisheng Decoction combined with Chitinose on knee osteoarthritis with cold and damp obstruction |
| 收稿日期：2023-07-05 |
| DOI：10.20047/j.issn1673-7210.2024.03.31 |
| 关键词: 独活寄生汤 几丁糖注射液 膝骨关节炎 洛索洛芬钠片 |
| Key Words: |
| 基金项目:黑龙江省自然科学基金优秀青年项目（YQ2020 H028）；黑龙江省中医药科研项目（ZHY19-033） |
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| 摘要:目的 观察独活寄生汤联合几丁糖治疗寒湿痹阻型膝骨关节炎的临床效果。 方法 选取2023年1月至8月黑龙江中医药大学附属第一医院门诊的60例膝骨关节炎患者，采用随机数字表法将其分为观察组和对照组，各30例。观察组采用独活寄生汤（加水煎煮，200 ml/剂，1剂/d，早晚两次温服，连续服用3周）联合几丁糖注射液（2 ml/次，1次/周，共3周）治疗，对照组口服洛索洛芬钠片（120 mg/次，3次/d）联合几丁糖注射液（2 ml/次，1次/周，共3周）治疗。评价两组临床疗效。比较两组治疗前后中医症状评分、西安大略和麦克马斯特大学骨关节炎指数评分（WOMAC评分）、视觉模拟评分法（VAS）评分，血清白细胞介素-1（IL-1）、肿瘤坏死因子-α（TNF-α）的水平和血清环氧合酶（COX-2）和前列腺素（PGE2）的改善情况，并对两组患者于治疗后六周进行电话追踪和随访观察复发率。 结果 观察组临床疗效优于对照组，差异有统计学意义（P＜0.05）。治疗后，两组VAS评分低于治疗前，且观察组低于对照组，差异有统计学意义（P＜0.05）。治疗后，两组WOMAC评分较治疗前降低，且观察组低于对照组，差异有统计学意义（P＜0.05）。治疗后，两组IL-1、TNF-α水平较治疗前降低，且观察组低于对照组，差异有统计学意义（P＜0.05）。治疗后两组血清COX-2、PGE2降低，且观察组低于对照组，差异有统计学意义（P＜0.05）。两组复发率比较，差异无统计学意义（P＞0.05）。 结论 独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎有显著疗效，并且能恢复膝关节功能，提高生活质量。 |
| Abstract:Objective To observe the clinical effect of Duhuo Jisheng Decoction combined with Chitinose in treating knee osteoarthritis with cold and damp obstruction. Methods From January to August 2023, 60 patients with knee osteoarthritis in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine were selected, and they were divided into observation group and control group by random number table method, with 30 cases in each group each. The observation group was treated with Duhuo Jisheng Decoction (decocted with water, 200 ml/dose, once a day, twice warm in the morning and evening) combined with Chitosan Injection (2 ml/time, once a week, for three weeks), while the control group was treated with Loxoprofen Sodium Tablets (120 mg each time, three times a day) combined with Chitosan Injection (2 ml/time, once a week, for three weeks) treatment. The therapeutic effectiveness of the two groups was evaluated. Traditional Chinese medicine symptom score, the western Ontario and McMaster Universities osteoarthritis index score (WOMAC score), visual analogue scale (VAS) score, and serum interleukin-1 (IL-1), tumor necrosis factor-α(TNF-α), cyclooxygenase (COX-2) and prostaglandin (PGE2) levels were compared between the two groups before and after treatment, patients in both groups were followed up by telephone at six weeks after treatment to observe the recurrence rate. Results The clinical efficacy of the observation group was better than that of the control group, and the difference was statistically significant (P＜0.05). After treatment, VAS scores of the two groups were lower than before treatment, and the observation group was lower than the control group, the differences were statistically significant (P＜0.05). After treatment, WOMAC scores in both groups were lower than before treatment, and the observation group was lower than the control group, the differences were statistically significant (P＜0.05). After treatment, the levels of IL-1 and TNF-α in both groups were lower than before treatment, and the observation group was lower than the control group, the differences were statistically significant (P＜0.05). After treatment, the serum COX-2 and PGE2 of the two groups were significantly decreased, and the serum COX-2 and PGE2 of the observation group were significantly lower than those of the control group, the differences were statistically significant (P＜0.05). There was no significant difference in recurrence rate between the two groups (P＞0.05). Conclusion Duhuojisheng Decoction combined with Chitose Injection can significantly improve the clinical symptoms of knee osteoarthritis, restore the function of knee joint and improve the quality of life. |
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