[1]杨吉勇,周宜,陈伟坚,等.健脾法改善脾虚湿蕴型膝骨关节炎患者骨骼肌功能的前瞻性队列研究[J].中国中医骨伤科杂志,2026,34(08):21-29.[doi:10.20085/j.cnki.issn1005-0205.260804]
　YANG Jiyong,ZHOU Yi,CHEN Weijian,et al.Spleen-Invigorating Therapy for Muscle Function in Knee Osteoarthritis:A Prospective Cohort Study[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(08):21-29.[doi:10.20085/j.cnki.issn1005-0205.260804]
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健脾法改善脾虚湿蕴型膝骨关节炎患者骨骼肌功能的前瞻性队列研究()

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

卷:
第34卷
期数:
2026年08期
页码:
21-29
栏目:
临床研究
出版日期:
2026-08-10

文章信息/Info

Title:
Spleen-Invigorating Therapy for Muscle Function in Knee Osteoarthritis:A Prospective Cohort Study
文章编号:
1005-0205(2026)08-0021-09
作者:
杨吉勇1; 周宜1; 陈伟坚2; 3; 刘文刚2; 3△
1广州中医药大学第五临床医学院(广州,510095)
2广东省第二中医院(广东省中医药工程技术研究院)
3广东省中医药研究开发重点实验室
Author(s):
YANG Jiyong1; ZHOU Yi1; CHEN Weijian2; 3; LIU Wengang2; 3△
1The Fifth Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510095,China; 2Guangdong Second Hospital of Traditional Chinese Medicine(Guangdong Academy of Chinese Medical Engineering and Technology),Guangzhou 510095,China; 3Key Laboratory for Research and Development of Traditional Chinese Medicine of Guangdong Province,Guangzhou 510095,China.
关键词:
膝骨关节炎;  肌骨同病;  骨骼肌萎缩;  健脾法
Keywords:
knee osteoarthritis;  musculoskeletal comorbidity;  skeletal muscle atrophy;  spleen-invigorating therapy
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.260804
文献标志码:
A
摘要:
目的:评估健脾法治疗膝骨关节炎的临床疗效。方法:前瞻性纳入脾虚湿蕴型膝骨关节炎患者,根据是否口服参苓白术散加减方分为暴露组与对照组。所有患者均接受至少6周的随访,于入组时及末次随访时,评估股四头肌峰力矩/体重比、四肢骨骼肌指数、握力、五次起坐时间、疼痛视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及中医证候评分,并记录患者的锻炼依从性与实际随访时间。结果:共纳入155例患者,其中暴露组86例,对照组69例。两组患者在年龄、性别等基线资料差异有统计学意义(P<0.05)。经倾向评分匹配后,两组各48例患者基线均衡。组内比较显示,两组治疗后多数指标均较前显著改善,差异有统计学意义(P<0.05)。组间分析表明,暴露组在改善股四头肌峰力矩/体重比、WOMAC评分及脾虚证候评分方面优势显著,差异有统计学意义(P<0.05)。在进一步调整基线肌力、随访时间及依从性后,健脾法仍是股四头肌峰力矩的独立改善因素,差异有统计学意义(β=0.107,P<0.001)。结论:健脾法有助于缓解脾虚湿蕴型膝骨关节炎患者的关节疼痛,并在改善骨骼肌功能方面显示出一定优势,提示其在岭南地区基于辨证论治的膝骨关节炎综合管理中具有潜在应用价值,可为优化区域化中西医结合诊疗方案提供依据。
Abstract:
Objective:This study aimed to evaluate the clinical efficacy of the spleen-strengthening method in enhancing muscle function in knee osteoarthritis(KOA).Methods:Patients with KOA of the spleen deficiency with dampness exuberance pattern were prospectively enrolled and divided into an exposure group or a control group according to whether they received the modified Shenling Baizhu San decoction.All patients were followed up for at least 6 weeks.Assessments at baseline and the final follow-up included the quadriceps peak torque/body weight ratio,appendicular skeletal muscle index,handgrip strength,five-times-sit-to-stand test duration,VAS score,WOMAC score,and TCM syndrome score.Exercise compliance and actual follow-up time were also recorded.Results:A total of 155 patients were included(exposure group,n=86; control group,n=69).Baseline characteristics,such as age and sex,exhibited significant differences between the two groups(P<0.05).After propensity score matching,48 patients were included in each group,with balanced baseline characteristics.Intragroup comparisons showed significant improvement in most outcome indicators after treatment in both groups(P<0.05).Intergroup analysis revealed that the exposure group demonstrated superior improvement in the quadriceps peak torque/body weight ratio,WOMAC score,and spleen deficiency syndrome score compared to the control group(P<0.05).After further adjusting for baseline muscle strength,follow-up time,and compliance,the spleen-strengthening method was identified as an independent factor predicting improved quadriceps peak torque(β=0.107,P<0.001).Conclusion:The spleen-strengthening method can effectively alleviate joint pain and demonstrates unique advantages in improving skeletal muscle function in KOA patients with spleen deficiency and dampness exuberance.This highlights the clinical value of applying this method tailored to the Lingnan region's characteristics and provides a basis for optimizing regional integrated traditional Chinese and Western medicine diagnosis and therapeutic strategies.

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(收稿日期:2026-02-09)

备注/Memo

备注/Memo:
基金项目:广东省基础与应用基础研究基金面上项目(2023A1515012615)
广东省基础与应用基础研究省企联合项目(2022A1515220157)
广东省第二中医院卓越团队项目(SEZYY2023B16)
△通信作者 E-mail:liuwengang2022@gmail.com
更新日期/Last Update: 2026-08-15