[1]王振华 胡月△.益肾通痹方联合膝关节镜清理术对早中期膝关节骨性关节炎IL-1β,MMPs-9水平、血液流变学指标及免疫功能的影响[J].中国中医骨伤科杂志,2018,26(08):34-38.
　WANG Zhenhua HU Yue.Influence of Yishen Tongbi Decoction Combined with Arthroscopic Debridement on IL-1β and MMPs-9 Levels, Hemorheology and Immune Function in Early and Middle Stage of Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(08):34-38.
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益肾通痹方联合膝关节镜清理术对早中期膝关节骨性关节炎IL-1β,MMPs-9水平、血液流变学指标及免疫功能的影响()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年08期
页码:
34-38
栏目:
临床研究
出版日期:
2018-08-02

文章信息/Info

Title:
Influence of Yishen Tongbi Decoction Combined with Arthroscopic Debridement on IL-1β and MMPs-9 Levels, Hemorheology and Immune Function in Early and Middle Stage of Knee Osteoarthritis
文章编号:
1005-0205(2018)08-0034-05
作者:
王振华1 胡月1△
1重庆市垫江县中医院骨二科(重庆,408300)
Author(s):
WANG Zhenhua1 HU Yue1△
1The Second Department of Orthopedics,Dianjiang Hospital of Traditional Chinese Medicine,Dianjiang 408300,China.
关键词:
益肾通痹方;  膝关节镜清理术;  膝关节骨性关节炎;  血液流变学;  免疫功能
Keywords:
Keywords:Yishen Tongbi decoction;  arthroscopic debridement;  knee osteoarthritis;  hemorheology;  immune function
分类号:
R684.3
文献标志码:
A
摘要:
目的:观察益肾通痹方联合膝关节镜清理术对早中期膝关节骨性关节炎(KOA)白介素-1β(IL-1β)、基质金属蛋白酶-9(MMPs-9)水平、血液流变学及免疫功能的影响。方法:选取本院收治的KOA患者126例作为研究对象,按照随机数字表法分为观察组和对照组各63例,两组均给予健康教育、饮食指导等基础干预,在此基础上对照组给予膝关节镜清理术,观察组在对照组基础上联合益肾通痹方治疗。观察两组中医症候积分、膝关节功能、临床疗效,检测患者IL-1β,MMPs-9水平、血液流变学指标、免疫功能。结果:治疗后两组中医症候积分显著低于治疗前,差异有统计学意义(P<0.05),且观察组显著低于对照组,差异有统计学意义(P<0.05); 治疗后两组疼痛、僵硬、功能评分显著低于治疗前,差异有统计学意义(P<0.05),且观察组显著低于对照组,差异有统计学意义(P<0.05); 观察组总有效率92.06%显著高于对照组77.78%,差异有统计学意义(P<0.05); 治疗后两组IL-1β和MMPs-9水平显著低于治疗前,差异有统计学意义(P<0.05),且观察组显著低于对照组,差异有统计学意义(P<0.05); 治疗后两组全血黏度低切值、血浆黏度、全血黏度高切值、红细胞聚集指数显著低于治疗前,差异有统计学意义(P<0.05),且观察组显著低于对照组,差异有统计学意义(P<0.05); 治疗后两组CD3+,CD4+及CD4+/CD8+显著高于治疗前,差异有统计学意义(P<0.05),且观察组显著高于对照组,差异有统计学意义(P<0.05),两组CD8+显著低于治疗前,差异有统计学意义(P<0.05),且观察组显著低于对照组,差异有统计学意义(P<0.05)。结论:益肾通痹方联合膝关节镜清理术可有效改善早中期KOA患者IL-1β,MMPs-9水平和血液流变学指标,提高免疫功能和临床疗效。
Abstract:
Abstract Objective: To observe the influence of Yishen Tongbi decoction combined with arthroscopic debridement on IL-1β and MMPs-9 Levels, hemorheology and immune function in early and middle stage of knee osteoarthritis.Methods: According to the random number table, 126 cases of KOA treated in our hospital were divided into observation group and control group, 63 cases in each group.The 2 groups were given basic intervention such as health education and diet guidance.On this basis, the control group received knee arthroscopic debridement, and the observation group was treated with Yishen Tongbi decoction on the basis of the control group.The TCM symptom score, knee function and clinical efficacy of the 2 groups were observed, and IL-1β and MMPs-9 levels, hemorheology and immune function were detected.Results: After treatment, TCM symptom scores of the two groups were significantly lower than those before treatment(P<0.05), and those in the observation group were significantly lower than those in the control group(P<0.05).After treatment, pain, stiffness and function scores of the two groups were significantly decreased(P<0.05), and those in the observation group were lower than those in the control group(P<0.05).The total effective rate of the observation group was 92.06%, which was significantly higher than 77.78% of the control group(P<0.05).IL-1β and MMPs-9 levels of the two groups were significantly decreased after treatment(P<0.05), and those in the observation group were lower than those in the control group(P<0.05).After treatment, whole blood low-shearing viscosity, plasma viscosity, whole blood high-shearing viscosity and erythrocyte aggregation index of the 2 groups were significantly lower than those before treatment(P<0.05), and those in the observation group was significantly lower than those in the control group(P<0.05).CD3+, CD4+ and CD4+/CD8+ of the two groups were significantly increased after treatment(P<0.05), and those in the observation group were significantly higher than those in the control group(P<0.05).CD8+ of the two groups was significantly decreased after treatment(P<0.05), and that in the observation group was significantly lower than that in the control group(P<0.05).Conclusion: Yishen Tongbi decoction combined with arthroscopic debridement can effectively improve IL-1β and MMPs-9 levels and hemorheology in KOA patients at early and middle stage, and improve immune function and clinical efficacy.

参考文献/References:

[1] 楚利涛,卢勇,邓迎杰,等.关节镜清理术结合中药内服治疗膝骨性关节炎38例[J].河南中医,2011,31(10):1169-1170. [2] 张斌山,蔡立民,袁胜超.关节通片结合关节镜清理术治疗早中期膝关节骨性关节炎临床观察[J].新中医,2013,45(8):88-89. [3] 任景,李涛,于苗,等.针灸联合独活寄生汤治疗膝关节骨性关节炎疗效观察及对微炎性反应指标的影响[J].世界中医药,2016,11(10):2113-2115. [4] 李宁,李应福,蒋国鹏,等.益肾通痹方治疗膝关节骨性关节炎的临床研究[J].中国中医骨伤科杂志,2016,24(4):15-17. [5] 中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中国矫形外科杂志,2014,27(3):28-30. [6] 中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:228-229. [7] 国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,1994. [8] 蔡立民,谭志超,张斌山,等.关节镜清理术结合中药治疗早中期膝关节骨性关节炎的疗效研究[J].广州中医药大学学报,2014,31(6):898-901. [9] 汪宝军,王竹风.除痹洗剂对膝关节骨性关节炎关节液自由基水平及IL-1β、TNF-a的影响[J].北京中医药,2011,30(10):737-739. [10] 李磊.关节镜有限清理术联合补肾壮骨汤治疗膝骨性关节炎疗效及对NO、IL-1β、TGF-β1水平的影响[J].现代中西医结合杂志,2017,26(19):2081-2083. [11] 罗坚,王祥华.全膝关节置换联合云南白药治疗膝关节骨性关节炎的疗效及对ESR、血清CRP、MMP-9水平的影响[J].中国老年学杂志,2017,37(9):2247-2248. [12] 樊建军,董乐乐,连建强,等.关节镜治疗膝关节骨性关节炎疗效观察[J].中国骨与关节损伤杂志,2012,27(4):348-349. [13] 王正,吕明安,刘安平,等.关节镜清理配合中药内服治疗早、中期膝关节骨性关节炎临床观察[J].甘肃中医学院学报,2013,30(3):38-40. [14] 张玉龙.活血通痹汤联合运动疗法治疗早中期膝关节骨性关节炎近期疗效观察[J].山西中医,2017,33(2):41-42. [15] 张留安.针刀联合益胃健骨汤内服治疗膝关节骨性关节炎临床研究[J].中医学报,2017,32(4):647-650. [16] 乐智卿,陶平,乐树生,等.温针灸配合益肾通络方治疗膝关节骨性关节炎临床疗效观察[J].光明中医,2016,31(5):618-620. [17] 周华杰.补肾强筋活血法治疗早中期膝关节骨性关节炎43例临床观察[J].中医药导报,2012,18(2):112-113. [18] 刘洪波,韩平,靖春颖.健骨伸筋汤对膝关节骨性关节炎患者血液流变学影响的临床观察[J].贵阳中医学院学报,2015,37(4):28-31.

备注/Memo

备注/Memo:
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更新日期/Last Update: 2018-08-02