[1]张建林 任睿双△.加味益肾强骨汤联合三步推拿点穴手法治疗膝骨性关节炎的临床研究[J].中国中医骨伤科杂志,2018,26(01):34-38.
 ZHANG Jianlin REN Ruishuang.Clinical Study of Modified Yishenqianggu Soup Combined with Three-step Massage in the Treatment of Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(01):34-38.
点击复制

加味益肾强骨汤联合三步推拿点穴手法治疗膝骨性关节炎的临床研究()
分享到:

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

卷:
第26卷
期数:
2018年01期
页码:
34-38
栏目:
临床研究
出版日期:
2018-01-15

文章信息/Info

Title:
Clinical Study of Modified Yishenqianggu Soup Combined with Three-step Massage in the Treatment of Knee Osteoarthritis
文章编号:
1005-0205(2018)01-0034-05
作者:
张建林1 任睿双1△
1陕西宝鸡市中医医院骨关节二科(陕西 宝鸡,721000) 通信作者 E-mail:49290051@163.com
Author(s):
ZHANG Jianlin1 REN Ruishuang1
1The Second Department of Joint Surgery, Baoji Traditional Chinese Medicine Hospital, Baoji 721000,Shaanxi China.
关键词:
加味益肾强骨汤 三步推拿点穴手法 膝骨性关节炎
Keywords:
Keywords: modified Yishenqianggu soup three-step massage knee osteoarthritis
分类号:
R684.3
文献标志码:
A
摘要:
目的:探究加味益肾强骨汤联合三步推拿点穴手法对膝骨性关节炎患者的临床效果。方法:选取2015年8月至2017年2月本院82例膝骨性关节炎患者,依据随机数表法分为观察组与对照组,各41例。对照组41例予以玻璃酸钠+三步推拿点穴手法治疗,观察组41例予以加味益肾强骨汤+三步推拿点穴手法治疗。治疗时间为4个疗程,统计观察两组治疗效果及不良反应发生情况,并对比治疗前及疗程结束后两组血清炎性因子[肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6)及白细胞介素-1(IL-1)]水平、膝关节活动度、功能评分变化情况。结果:观察组治疗总有效率95.12%(39/41)远高于对照组78.05%(32/41),差异有统计学意义(P<0.05); 两组治疗前膝关节活动度及功能评分差异均无统计学意义(P>0.05); 与对照组相比,观察组治疗后膝关节活动度及功能评分均较高,差异有统计学意义(P<0.05); 与对照组相比,观察组治疗后TNF-α,IL-1及IL-6水平均较低,差异有统计学意义(P<0.05); 治疗过程中,两组均未出现恶心呕吐、皮肤过敏等不良反应。结论:加味益肾强骨汤与三步推拿点穴手法联合治疗膝骨性关节炎,可有效改善患者膝关节活动度及功能,减轻炎症反应症状,治疗效果较为显著,且安全性较高,在临床治疗中具有推广价值。
Abstract:
Abstract Objective:To explore the clinical effect of modified Yishenqianggu soup combined with Three-step massage in the treatment of knee osteoarthritis. Methods:We select 82 patients with knee osteoarthritis in our hospital from August 2015 to February 2017, and they were divided into observation group and control group according to the random number table, 41 cases in each group. The control group was treated with sodium hyaluronate combined with the Three-step massage, while the observation group was treated with modified Yishenqianggu soup combined with Three-step massage. During four courses of treatment time, the therapeutic effect and the occurrence of adverse reactions were observed.(TNF-α), interleukin-6(IL-6)and interleukin-1(IL-1)levels, Knee mobility, functional score and changes of life quality were measured before and after treatment. Results: The total effective rate of observation group 95.12%(39/41)is much higher than that of the control group 78.05%(32/41), and the difference was statistically significant(P<0.05). There was no statistically significant difference between the activity and function scores of the two groups(P<0.05). Compared with the control group, the activity and function score of the knee joint was higher in observation group, and the difference was statistically significant(P<0.05). Compared with the control group, the levels of TNF-α, Il-1 and Il-6 were lower in the observation group after treatment, and the difference was statistically significant(P<0.05). During the treatment, neither group showed any adverse reactions such as nausea, vomiting, and skin irritation. Results:The total effective rate was 95.12%(39/41)in the observation group, which was much higher than that in the control group(78.05%, 32/41), and the difference was statistically significant(P<0.05).There was no significant difference in knee mobility and functional score between the two groups(P>0.05).Compared with the control group, the activity and function scores of the knee in the observation group were higher than those in the control group, the difference was statistically significant(P<0.05).Compared with the control group, the levels of TNF-, IL-1 and IL-6 in the observation group were lower, the difference was statistically significant(P<0.05).Compared with the control group, the quality of life scores of the observation group after treatment were higher, the difference was statistically significant(P<0.05).During the course of treatment, there were no adverse reactions such as nausea and vomiting, skin allergy and so on. Conclusion:Modified Yishenqianggu soup combined with Three-step massage can effectively improve the knee joint activity and function, reduce the inflammatory response and improve the quality of life. The treatment effect is obvious, and the safety is much higher.

参考文献/References:

[1] 邝高艳,严可,欧梁,等.加味独活寄生合剂配合冲击波对老年膝骨性关节炎疼痛的影响[J].中国老年学杂志,2017,37(7):1708-1709.
[2] Silverwood V,Blagojevic-Bucknall M,Jinks C,et al.Current evidence on risk factors for knee osteoarthritis in older adults:a systematic review and meta-analysis[J].Osteoarthritis and Cartilage,2015,23(4):507-515.
[3] 熊南山,李建海,黄念芳,等.氨基葡萄糖联合玻璃酸钠治疗膝骨性关节炎的疗效观察[J].中国医院药学杂志,2014,34(3):221-224.
[4] 王兵,董桂芝,鞠衍馨,等.臭氧与玻璃酸钠治疗膝骨性关节炎疗效的比较[J].中国骨与关节损伤杂志,2014,29(8):782-784.
[5] Jo CH,Lee YG,Shin WH,et al.Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee:a proof-of-concept clinical trial[J].Stem cells,2014,32(5):1254-1266.
[6] 吴汝平,赵品益.中医手法联合关节腔内注射玻璃酸钠治疗膝骨性关节炎临床分析[J].中华中医药学刊,2014,32(5):1219-1221.
[7] 中华医学会骨科学分会.骨关节炎诊治指南[J].中国矫形外科杂志,2014,27(3):28-30.
[8] 国家食品药品监督管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:149.
[9] 王恒树,张冲.自拟组方补肾固筋方对膝骨性关节炎兔血清及关节液白细胞介素-1、肿瘤坏死因子-α的影响[J].中国老年学杂志,2017,37(5):1079-1081.
[10] 国家中医药管理局.ZY/T001,1-001,9-94中医病症诊断疗效标准[S].中华人民共和国中医行业标准,1994:48-49.
[11] Qin Y,RongJie H.Observation of efficacy of Dextromethorphan hydrobromide capsule-s combined with fumaric acid azithromycin in treatment of chronic pharyngitis[J].Evaluatio-n and Analysis of Drug-Use in Hospitals of China,2015,15(11):1447-1449.
[12] 陈能,姚楠,许学猛,等.参麦注射液关节腔注射对兔膝骨关节炎IL-1β、IL-6、TNF-α表达的影响[J].广东药学院学报,2016,32(3):339-343.
[13] Orozco L,Munar A,Soler R,et al.Treatment of knee osteoarthritis with auto-logous mesenchymal stem cells:a pilot study[J].Transplantation,2013,95(12):1535-1541.
[14] 湛梅圣,张彬,龚新益,等.活血化瘀汤对膝骨性关节炎患者血清中IL-1、IL-6、TNF-α水平的影响[J].中医学报,2016,31(1):129-131.
[15] 王洪涛,石坚,刘行高.活血寄生汤联合针灸推拿治疗膝骨性关节炎临床疗效的探讨[J].中国医药导刊,2016,18(4):389-390.
[16] 邓鹏鹏,钟晓君,张伟强,等.膝骨性关节炎中医辨证的聚类分析及证候特征研究[J].云南中医学院学报,2014,37(3):47-50.
[17] 何力,苏凤哲.膝骨关节炎中医治疗进展[J].中医临床研究,2014,6(21):95-97.
[18] 丁心香,王爱国,信金党,等.膝骨性关节炎中医药治疗进展[J].山东中医杂志,2016,35(3):267-269.
[19] 许松涛,于之明,周炳怀.膝关节镜治疗膝骨性关节炎患者疗效的影响因素研究[J].安徽医药,2014,18(6):1114-1116.
[20] 田绮俊,卢红.三步推拿点穴手法配合中药熏洗治疗膝关节骨关节炎[J].四川中医,2017,35(1):182-183.
[21] 邹旦,陈泽文.益肾强骨汤治疗膝关节骨性关节炎32例[J].中国中医药现代远程教育,2016,14(5):72-74.

备注/Memo

备注/Memo:
基金项目:陕西省社会发展科技攻关项目(2015SF078)
更新日期/Last Update: 2018-01-15