[1]寇赵淅,张向东,赵明宇△.平乐筋滞骨错手法联合筋骨止痛凝胶治疗早中期肾虚血瘀型膝骨关节炎的疗效评价[J].中国中医骨伤科杂志,2026,34(03):72-78.[doi:10.20085/j.cnki.issn1005-0205.260311]
　KOU Zhaoxi,ZHANG Xiangdong,ZHAO Mingyu.Efficacy Evaluation of Pingle Jinzhi Gucuo Manipulation Combined with Jingu Zhitong Gel in the Treatment of Knee Osteoarthritis during the Early and Middle Stages of Kidney Deficiency and Blood Stasis Type[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(03):72-78.[doi:10.20085/j.cnki.issn1005-0205.260311]
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平乐筋滞骨错手法联合筋骨止痛凝胶治疗早中期肾虚血瘀型膝骨关节炎的疗效评价()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年03期
页码:
72-78
栏目:
临床研究
出版日期:
2026-03-15

文章信息/Info

Title:
Efficacy Evaluation of Pingle Jinzhi Gucuo Manipulation Combined with Jingu Zhitong Gel in the Treatment of Knee Osteoarthritis during the Early and Middle Stages of Kidney Deficiency and Blood Stasis Type
文章编号:
1005-0205(2026)03-0072-07
作者:
寇赵淅1; 张向东1; 赵明宇1△
1河南省洛阳正骨医院(河南省骨科医院)(郑州,450016)
Author(s):
KOU Zhaoxi1; ZHANG Xiangdong1; ZHAO Mingyu1△
1Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Zhengzhou 450016,China.
关键词:
筋滞骨错;  筋骨止痛凝胶;  手法;  膝骨关节炎;  疗效评价
Keywords:
Jinzhi Gucuo;  Jingu Zhitong gel;  manipulation;  knee osteoarthritis;  efficacy evaluation
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.260311
文献标志码:
A
摘要:
目的:观察评价平乐筋滞骨错手法联合筋骨止痛凝胶治疗早中期肾虚血瘀型膝骨关节炎的临床疗效。方法:招募符合纳入标准的早中期肾虚血瘀型膝骨关节炎患者68例,随机分成对照组和观察组,每组各34例。对照组选用平乐筋滞骨错手法,观察组选用平乐筋滞骨错手法联合筋骨止痛凝胶。手法治疗1次/d,筋骨止痛凝胶涂抹患处1次/d,2 g/次,疗程2周。分别于治疗前、治疗结束、治疗结束后4周对两组患者的NRS评分、WOMAC评分进行比较分析; 于治疗结束后,比较两组患者的中医证候疗效评定结果及总有效率。结果:两组患者治疗前NRS评分、WOMAC评分和中医证候评分差异无统计学意义(P>0.05),有可比性。治疗结束和治疗结束后4周,两组患者NRS评分、WOMAC评分均较治疗前有显著降低; 两组组间比较,观察组患者NRS评分、WOMAC评分降低幅度更明显,优于对照组,差异有统计学意义(P<0.05)。治疗结束,对照组临床控制2例、显效4例、有效22例、无效6例,观察组临床控制4例、显效10例、有效17例、无效3例,观察组中医证候疗效评定结果优于对照组,差异有统计学意义(P<0.05); 并且观察组患者的总有效率(91.18%)高于对照组(82.35%)。结论:平乐筋滞骨错手法联合筋骨止痛凝胶治疗早中期肾虚血瘀型膝骨关节炎效果显著,不仅能有效缓解疼痛,还能改善膝关节功能,优于单纯应用平乐筋滞骨错手法,值得临床推广应用。
Abstract:
Objective:To observe and evaluate the clinical efficacy of Pingle Jinzhi Gucuo manipulation combined with Jingu Zhitong gel in the treatment of knee osteoarthritis(KOA)during the early and middle stages of the kidney deficiency and blood stasis type.Methods:A total of 68 KOA patients with kidney deficiency and blood stasis type during the early and middle stages were recruited and randomly divided into control group and observation group,with 34 cases in each group.The control group was received Pingle Jinzhi Gucuo manipulation,while the observation group was selected Pingle Jinzhi Gucuo manipulation combined with Jingu Zhitong gel; Manual treatment was performed once a day,and the affected area was applied with Jingu Zhitong gel once a day,2 g each time,for 2 weeks.The NRS score and WOMAC index of the two groups were compared before treatment,after treatment,and 4 weeks after treatment.After the end of treatment,the TCM syndrome scores and the total effective rate of the two groups were compared.Results:There was no statistical difference in NRS score,WOMAC index,and TCM syndrome score between the two groups before treatment(P>0.05).At the end of treatment and 4 weeks after treatment,the NRS score and WOMAC index of both groups were significantly lower than those before treatment.Compared between the two groups,the NRS score and WOMAC index in the observation group decreased more significantly(P<0.05),which was better than in the control group.After treatment,there were 2 cases of clinical control,4 cases of obvious effect,22 cases of effective,and 6 cases of ineffective in the control group,and 4 cases of clinical control,10 cases of obvious effect,17 cases of effective and 3 cases of ineffective in the observation group.The evaluation results of TCM syndrome efficacy in the observation group were superior to those in the control group,with statistical significance(P<0.05).The total effective rate of the observation group(91.18%)was higher than that of the control group(82.35%).Conclusion:The combination of Pingle Jinzhi Gucuo and Jingu Zhitong gel has a significant effect during the early and middle stage of kidney deficiency and blood stasis type KOA.It can not only effectively relieve pain,but also improve knee joint function,and is superior to the use of Pingle Jinzhi Gucuo alone.This combined therapy is worthy of clinical promotion.

参考文献/References:

[1] TANG S A,ZHANG C Q,OO W M,et al.Osteoarthritis[J].Nature Reviews Disease Primers,2025,11:10.
[2] 郑升鹏,李政,杨冬梅,等.1990-2021年中国膝骨性关节炎疾病负担分析及预测[J].中国慢性病预防与控制,2025,33(3):173-177.
[3] 陈军涛,许辉,周运峰,等.基于“筋骨失衡”理论探讨膝骨关节炎发病机制及推拿治疗研究进展[J].中华中医药杂志,2024,39(11):6026-6031.
[4] 赵明宇,鲍铁周,赵启,等.基于平乐正骨“筋滞骨错”理论推拿治疗膝关节骨性关节炎疗效评价[J].中华中医药杂志,2017,32(3):1372-1374.
[5] 彭红玉,刘婧,李璐,等.基于NLRP3/IL-1β通路探讨筋骨止痛凝胶治疗膝骨性关节炎的作用机制[J].中草药,2023,54(8):2502-2508.
[6] 史周华,何雁.中医药统计学与软件应用[M].北京:中国中医药出版社,2015:102-106.
[7] 中华医学会骨科学分会关节外科学组,中国医师协会骨科医师分会骨关节炎学组,国家老年疾病临床医学研究中心(湘雅医院),等.中国骨关节炎诊疗指南(2021年版)[J].中华骨科杂志,2021,41(18):1291-1314.
[8] 国家食品药品监督管理局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:349-353.
[9] HJERMSTAD M J,FAYERS P M,HAUGEN D F,et al.Studies comparing numerical rating scales,verbal rating scales,and visual analogue scales for assessment of pain intensity in adults:a systematic literature review[J].Journal of Pain and Symptom Management,2011,41(6):1073-1093.
[10] COPSEY B,THOMPSON J Y,VADHER K,et al.Problems persist in reporting of methods and results for the WOMAC measure in hip and knee osteoarthritis trials[J].Quality of Life Research,2019,28(2):335-343.
[11] 郑昱新,葛继荣,刘文刚,等.痛宁凝胶外用治疗轻中度膝骨关节炎肾虚筋脉瘀滞证的随机、双盲、安慰剂对照、多中心临床研究[J].中医正骨,2022,34(6):17-24.
[12] MOBASHERI A,LOESER R.Clinical phenotypes,molecular endotypes and theratypes in OA therapeutic development[J].Nature Reviews Rheumatology,2024,20(9):525-526.
[13] 何强,梅杰,孙欣.膝骨关节炎发病及临床症状发展与中医体质类型相关性分析[J].中国中医骨伤科杂志,2023,31(10):23-28.
[14] 邢润麟,廖太阳,王培民.衰老视角阐释膝骨关节炎虚实夹杂病机的科学内涵[J].世界中医药,2023,18(23):3382-3385.
[15] BERENBAUM F.New horizons and perspectives in the treatment of osteoarthritis[J].Arthritis Research & Therapy,2008,10(2):S1.
[16] SCARVELL J M,GALVIN C R,PERRIMAN D M,et al.Kinematics of knees with osteoarthritis show reduced lateral femoral roll-back and maintain an adducted position.A systematic review of research using medical imaging[J].Journal of Biomechanics,2018,75:108-122.
[17] LOHNES J,URQUHART N,WONG I,et al.Do individuals with knee osteoarthritis walk with distinct knee biomechanics and muscle activation characteristics?An investigation of knee osteoarthritis,hip osteoarthritis,and asymptomatic groups[J].Gait & Posture,2023,99:14-19.
[18] 杨玉鑫,马笃军,彭力平,等.中医药防治膝骨关节炎肿胀作用机制[J].辽宁中医药大学学报,2024,26(5):71-77.
[19] 谭旭仪,邝高艳,卢敏.膝骨关节炎的“虚、瘀、毒”病机特点探析[J].中国实验方剂学杂志,2018,24(24):201-206.
[20] 艾健,房敏,孙武权,等.“筋骨失衡,以筋为先”理论在膝关节病中的应用探讨[J].中华中医药杂志,2014,29(8):2404-2406.
[21] 叶子丰,邝高艳,邱礼国,等.卢敏教授基于“筋束骨”理论论治膝骨关节炎[J].辽宁中医杂志,1-13[2025-09-22].https://link.cnki.net/urlid/21.1128.R.20250805.1652.024.
[22] 吴廷换,周辉,陈兴恺.清宫正骨手法联合尪痹片治疗膝关节骨性关节炎疗效观察[J].中国中医骨伤科杂志,2017,25(1):38-41.
[23] 李鼎鹏,谢兴文,赵继荣,等.陇中正骨学术流派及其特色诊疗理念概述[J].中华中医药杂志,2020,35(3):1094-1097.
[24] 卫晓恩.不忘初心 从本论治——浅谈中西医治疗膝骨关节炎[J].中国中西医结合杂志,2021,41(7):778-781.
[25] 赵明宇,廉杰,鲍铁周,等.平乐正骨“筋滞骨错”理论再析[J].中医正骨,2015,27(4):74-75.
[26] 张家豪,赵明宇,张向东,等.基于中医筋骨构架学说探讨膝骨关节炎的辨治思路[J].中医正骨,2025,37(8):71-75.
[27] 吕凯红,胡玉梅,钱梦雨,等.筋骨止痛凝胶化学成分分析[J].中成药,2024,46(3):1025-1034.
[28] 李璐,李家晴,刘文君,等.筋骨止痛凝胶中功效物质的体外透皮扩散行为研究[J].中国中药杂志,2024,49(8):2158-2168.
[29] 康知然,龚利,戴大城.股四头肌结构功能改变在膝骨关节炎发病中的研究进展[J].实用老年医学,2021,35(10):1067-1071.
[30] CHEVALIER A,VAN OVERMEIRE A,VERMUE H,et al.Effect of iliotibial band and gastrocnemius activation on knee kinematics[J].The Knee,2023,40:238-244.
[31] 陈国茜,陈泽华,叶翔凌,等.基于肌肉功能和质量探讨肌肉与膝骨关节炎关系的研究进展[J].中华物理医学与康复杂志,2022,44(5):471-475.
[32] WANG W J,LIU F,ZHU Y W,et al.Sagittal alignment of the spine-pelvis-lower extremity axis in patients with severe knee osteoarthritis:a radiographic study[J].Bone & Joint Research,2016,5(5):198-205.
[33] 鲁潇莹,李阳,李一瀛,等.轻度下肢不等长儿童步态参数对称性特征分析[J].医用生物力学,2024,39(6):1175-1181.
[34] 李锡,杨立英,张永旺,等.三种中医理筋正骨手法治疗膝骨关节炎随机对照研究[J].中国中西医结合杂志,2024,44(11):1307-1313.
[35] 彭翼,许超,张彬,等.膝关节牵伸术修复膝关节软骨的研究进展[J].中国骨伤,2022,35(12):1200-1206.
[36] ZHENG J J,WAN W J,DUAN C.Impact of fixed-point rotational reduction of the spine on pain scores and lower limb motor function in patients with lumbar facet joint disorder[J].BMC Musculoskeletal Disorders,2025,26(1):376.
(收稿日期:2024-12-15)

备注/Memo

备注/Memo:
基金项目:中华中医药学会骨病防治交叉研究项目(2023-GBJC-02)
△通信作者 E-mail:zmyym2003@163.com
更新日期/Last Update: 2026-03-15