[1]邱峰,胡国鹏△,石钧文,等.通络治痹方联合经筋手法治疗肝肾亏虚、痰瘀互结证早中期膝骨关节炎的随机对照研究[J].中国中医骨伤科杂志,2026,34(08):38-45.[doi:1005-0205(2026)08-0038-08]
　QIU Feng,HU Guopeng,SHI Junwen,et al.A Clinical Randomized Controlled Study on the Treatment of Early and Middle Stage Knee Osteoarthritis with Liver and Kidney Insufficiency and Phlegm and Blood Stasis Intermingling Syndrome by Tongluo Zhibi Formula Combined with Jingjin Manipulation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(08):38-45.[doi:1005-0205(2026)08-0038-08]
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通络治痹方联合经筋手法治疗肝肾亏虚、痰瘀互结证早中期膝骨关节炎的随机对照研究()

《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:
38-45
栏目:
临床研究
出版日期:
2026-08-10

文章信息/Info

Title:
A Clinical Randomized Controlled Study on the Treatment of Early and Middle Stage Knee Osteoarthritis with Liver and Kidney Insufficiency and Phlegm and Blood Stasis Intermingling Syndrome by Tongluo Zhibi Formula Combined with Jingjin Manipulation
文章编号:
10.20085/j.cnki.issn1005-0205.260806
作者:
邱峰1; 胡国鹏2△; 石钧文1; 毛银枫1; 周雍博1; 蔡建平3
1无锡市新吴区中医医院(江苏 无锡,214026)
2无锡市惠山区中医医院
3南京中医药大学附属无锡医院
Author(s):
QIU Feng1; HU Guopeng2△; SHI Junwen1; MAO Yinfeng1; ZHOU Yongbo1; CAI Jianping3
1Wuxi Xinwu District Hospital of Traditional Chinese Medicine,Wuxi 214026,Jiangsu China; 2Wuxi Huishan District Hospital of Traditional Chinese Medicine,Wuxi 214026,Jiangsu China; 3Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine,Wuxi 214071,Jiangsu China.
关键词:
膝骨关节炎;  肝肾亏虚;  痰瘀互结;  通络治痹方;  经筋手法;  随机对照试验
Keywords:
knee osteoarthritis;  insufficiency of liver and kidney;  intermingling of phlegm and blood stasis;  Tongluo Zhibi formula;  manipulation of sinew meridians;  randomized controlled trial
分类号:
R684.3
DOI:
1005-0205(2026)08-0038-08
文献标志码:
A
摘要:
目的:探讨基于“筋骨肉并重”理论指导下通络治痹方联合经筋手法治疗肝肾亏虚、痰瘀互结证早中期膝骨关节炎的临床疗效。方法:将2025年1-10月单侧膝骨关节炎患者152例随机分成对照组和观察组(各76例),其中对照组脱落10例、观察组脱落6例。对照组66例,男27例,女39例; 左侧34例,右侧32例; 年龄为40～75岁,平均为(59.87±10.28)岁; 病程为8～35个月,平均为(19.59±7.31)个月; X线片K-L分级为0级12例,Ⅰ级30例,Ⅱ级15例,Ⅲ级9例; 采用塞来昔布、氨基葡萄糖口服结合理疗。观察组70例,男26例,女44例; 左侧34例,右侧36例; 年龄为40～75岁; 平均为(59.44±9.23)岁,病程为8～42个月,平均为(19.61±7.53)个月; X线片K-L分级为0级15例,Ⅰ级36例,Ⅱ级12例,Ⅲ级7例; 采用通络治痹方联合经筋手法治疗。比较两组患者治疗前及治疗后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、起立-步行试验(TUG)、步态参数(步长、步速、双支撑相)、患侧股四头肌及腓肠肌肌张力、生活质量调查简表(SF-36)评分,并评估安全性及不良事件。结果:观察组和对照组WOMAC评分中疼痛、僵硬、关节功能评分及总分均较治疗前明显改善,差异有统计学意义(P<0.05),且观察组改善更为明显,差异有统计学意义(P<0.05)。观察组和对照组经治疗后起立-步行试验及步长、步速、双支撑相明显改善,差异有统计学意义(P<0.05),且观察组起立-步行试验及步长、双支撑相改善情况优于对照组,差异有统计学意义(P<0.05),而步速方面则差异无统计学意义(P>0.05)。观察组和对照组治疗前患侧股四头肌、腓肠肌肌张力对应的位移值及SF-36评分差异均无统计学意义(P>0.05),经治疗后两组患者患侧股四头肌、腓肠肌肌张力对应的位移值及SF-36评分均较治疗前明显提高,差异有统计学意义(P<0.05),且观察组改善情况相较对照组则更为显著,差异有统计学意义(P<0.05)。两组患者均未出现严重不良事件,安全性良好。结论:通络治痹方联合经筋手法能有效改善肝肾不足、痰瘀互结证早中期膝骨关节炎患者的临床症状,改善患侧下肢肌张力,提高患者步行能力,进而改善患者的生存质量,且安全性良好。
Abstract:
Objective:To explore the clinical efficacy of the Tongluo Zhibi formula combined with Jingjin manipulation in the treatment of early and middle-stage knee osteoarthritis(KOA).Methods:From January 2025 to October 2025,152 patients with unilateral KOA were randomly assigned to either a control group or observation group,with 76 patients in each group.Among them,10 cases dropped out from the control group and 6 cases from the observation group.The control group comprised 66 participants,including 27 males and 39 females; 34 cases involved the left knee and 32 the right knee; aged 40 to 75 years old,with an average age of(59.87±10.28)years old; disease duration of 8 to 35 months,with an average of(19.59±7.31)months; X-ray K-L grades were 0 in 12 cases,grade Ⅰ in 30 cases,grade Ⅱ in 15 cases,and grade Ⅲ in 9 cases.They were treated with oral celecoxib and glucosamine combined with physical therapy.The observation group had 70 cases,including 26 males and 44 females; 34 cases on the left and 36 cases on the right; aged 40 to 75 years old,with an average age of(59.44±9.23)years old; disease duration of 8 to 42 months,with an average of(19.61±7.53)months; X-ray K-L grades were 0 in 15 cases,grade Ⅰ in 36 cases,grade Ⅱ in 12 cases,and grade Ⅲ in 7 cases.They were treated with the Tongluo Zhibi formula combined with Jingjin manipulation therapy.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,Timed Up and Go(TUG)test,gait parameters(step length,step speed,double support phase),muscle tension of the quadriceps and gastrocnemius on the affected side,and the Short Form 36 Health Survey(SF-36)scores were compared before and after treatment in both groups.Safety and adverse events were also evaluated.Results:Both the observation group and the control group showed significant improvements in WOMAC scores for pain,stiffness,joint function,and total scores,compared to before treatment(P<0.05),and the observation group had more significant improvements(P<0.05).After treatment,both groups showed significant improvements in TUG test,step length,step speed,and double support phase(P<0.05).The observation group had better improvements than the control group in the TUG test,step length,and double support phase(P<0.05),whereas no significant difference was observed in gait speed(P> 0.05).Before treatment,there were no statistically significant differences in the displacement values of muscle tension of the quadriceps and gastrocnemius on the affected side and SF-36 scores between the two groups(P> 0.05).After treatment,both groups showed significant improvements in the displacement values of muscle tension of the quadriceps and gastrocnemius on the affected side and SF-36 scores compared to before treatment(P<0.05); however,the observation group had more significant improvements than the control group(P<0.05).No serious adverse events occurred in either group,and the safety was good.Conclusion:The Tongluo Zhibi formula combined with Jingjin manipulation can effectively improve the clinical symptoms of early and middle-stage KOA patients,improve the muscle tension of the affected lower extremity,enhance the patients' walking ability,and thereby improve their quality of life,with good safety.

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(收稿日期:2025-12-07)

备注/Memo

备注/Memo:
基金项目:江苏省中医药学会科研县域联动项目(XYLD2024011)
江苏省第四批省名老中医药专家传承工作室项目(苏中医科教〔2021〕7号)
无锡市青年托举人才行动项目(TJXD-2025-221)
无锡市中医药管理局科技项目(ZYKJ202123)
△通信作者 E-mail:2635830698@qq.com
更新日期/Last Update: 2026-08-15