[1]陈蓓 郑英杰 陈艳平 石晓兵.牛蒡子汤联合石氏推拿治疗痰湿阻络型膝骨关节炎的临床研究[J].中国中医骨伤科杂志,2019,27(10):14-18.
　CHEN Bei ZHENG Yingjie CHEN Yanping SHI Xiaobing.Clinical Study of Niubangzi Decoction Plus Shishi Massage in Treating Phlegm-dampness Blocking Collaterals Type Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(10):14-18.
点击复制

牛蒡子汤联合石氏推拿治疗痰湿阻络型膝骨关节炎的临床研究()
分享到：

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

卷:
第27卷
期数:
2019年10期
页码:
14-18
栏目:
临床研究
出版日期:
2019-10-10

文章信息/Info

Title:
Clinical Study of Niubangzi Decoction Plus Shishi Massage in Treating Phlegm-dampness Blocking Collaterals Type Knee Osteoarthritis
文章编号:
1005-0205(2019)10-0014-05
作者:
陈蓓1 郑英杰1 陈艳平1 石晓兵1
1上海中医药大学附属曙光医院宝山分院(上海,201900)
Author(s):
CHEN Bei1 ZHENG Yingjie1 CHEN Yanping1 SHI Xiaobing1
1Baoshan Branch,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201900,China.
关键词:
牛蒡子汤;  石氏推拿;  膝关节骨性关节炎;  痰湿阻络证;  膝关节功能
Keywords:
Niubangzi decoction;  Shishi massage;  knee osteoarthritis;  syndrome of phlegm-dampness blocking collaterals;  joint function
分类号:
R684.3
文献标志码:
A
摘要:
目的:探讨牛蒡子汤联合石氏推拿治疗痰湿阻络型膝关节骨性关节炎(KOA)的临床疗效。方法:选取2017年5月至2018年10月在本院就诊的108例痰湿阻络型KOA患者,采用随机数字表法随机分成观察组54例和对照组54例。观察组采取牛蒡子汤联合石氏推拿治疗,对照组则给予关节腔内注射玻璃酸钠治疗,所有患者均治疗5周。对比两组临床疗效、治疗前后膝关节功能(西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分)、生活质量(关节炎生活质量测量量表2-短卷(AIMS2-SF)评分)、炎症因子(白介素IL-1,IL-6)、肿瘤坏死因子(TNF-α)水平变化以及副作用发生情况。结果:观察组总有效率为98.15%(53/54),与对照组的83.33%(45/54)相比显著升高,差异有统计学意义(P<0.05)。两组治疗后WOMAC骨关节炎指数中各维度(疼痛程度、僵硬状态、日常生活受限)评分及其总分均较治疗前显著减少,差异有统计学意义(P<0.05),且观察组降低更显著,差异有统计学意义(P<0.05)。两组治疗后AIMS2-SF中各维度(症状、躯体、影响等5个维度)评分及其总分均较治疗前显著增高,差异有统计学意义(P<0.05),而观察组上升更显著,差异有统计学意义(P<0.05)。两组治疗后各项炎症因子(IL-1,IL-6及TNF-α)血清浓度均较治疗前显著下降,差异有统计学意义(P<0.05),但观察组减低更显著,差异有统计学意义(P<0.05)。观察组不良反应率3.70%(2/54)较对照组1.85%(1/54),差异无统计学意义(P>0.05)。结论:牛蒡子汤联合石氏推拿治疗痰湿阻络型KOA能有效促进患者临床症状的缓解,提高膝关节功能,改善生活质量,疗效确切,且安全性较高。
Abstract:
Objective:To explore the clinical efficacy of Niubangzi decoction plus Shishi massage in treating knee osteoarthritis(KOA)of syndrome of phlegm-dampness blocking collaterals.Methods:The subjects of this study,108 KOA patients with syndrome of phlegm-dampness blocking collaterals admitted in our hospital from May 2017 to October 2018,were divided into observation group 54 cases and control group 54 cases on the basis of random number table.The observation group was treated with combination of Niubangzi decoction and Shishi massage,while the control group sodium hyaluronate injection into the articular cavity.All patients were treated for 5 weeks.The clinical efficacy,changes of joint function(the Western Ontario and McMaster Universities(WOMAC)score for osteoarthritis index)and life quality(the Arthritis Measurement Scales 2-Short Form(AIMS2-SF)score)as well as inflammatory factors(interleukin IL-1,IL-6,tumor necrosis factor(TNF-α)levels)before and after treatment,and occurrence of side effect were compared between the two groups.Results:The overall effective rate of the observation group was 98.15%(53/54),much higher than 83.33%(45/54)of the control group(P<0.05).After treatment the scores in each WOMAC dimension(pain degree,stiffness,physical restrictions in daily life)and their total scores of the two groups decreased remarkably as compared with those before the treatment(P<0.05),and the decrease the observation group saw was more obvious(P<0.05).The scores in each AIMS2-SF dimension(5 dimensions including syndromes,body,influence etc)and their total scores of the two groups after treatment were much higher than those before the treatment(P<0.05),and the rise the observation group saw was more obvious(P<0.05).After treatment both groups saw obviously lower inflammatory factor levels(IL-1,IL-6,TNF-α)than they did before the treatment,and the drop the observation group witnessed was more significant(P<0.05).The incidence of side effect of the observation group was 3.70%(2/54),seeing no big difference from 1.85%(1/54)of the control group(P>0.05).Conclusion:In treating KOA patients of syndrome of phlegm-dampness blocking collaterals,the combination of Niubangzi decoction and Shishi massage can significantly relieve clinical symptoms in patients,improve their joint function and better their life quality,proving to be effective and safe.

参考文献/References:

[1] TIULPIN A,THEVENOT J,RAHTU E,et al.Automatic knee osteoarthritis diagnosis from plain radiographs:a deep learning-based approach[J].Sci Rep,2018,8(1):1727. [2] 江建春,邱德华,王敖明,等.石仰山教授论治慢性筋骨病经验[J].中国中医骨伤科杂志,2014,22(2):67-69. [3] 张明才,石印玉,陈东煜,等.“石氏伤科”颈椎“骨错缝筋出槽”矫正手法技术规范[J].上海中医药杂志,2015,49(5):4-7. [4] 中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华骨科杂志,2007,27(10):793-796. [5] 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. [6] LEQUESNE M.Indices of severity and disease activity for osteoarthritis[J].Semin Arthritis Rheum,1991,20(Suppl2):48-54. [7] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:30-31. [8] NIU J,CLANCY M,ALIABADI P,et al.Metabolic syndrome,its components,and knee osteoarthritis:the framingham osteoarthritis study[J].Arthritis & Rheumatology,2017,69(6):1194-1203. [9] 王斌,邢丹,董圣杰,等.中国膝骨关节炎流行病学和疾病负担的系统评价[J].中国循证医学杂志,2018,18(2):134-142. [10] 黄明辉,宋进良,陈彦军,等.膝骨性关节炎(骨痹)患者中医体质与临床证型的调查研究[J].世界中医药,2017,12(7):1580-1586. [11] 石琤,蔡奇文,郭天旻,等.石氏牛蒡子汤治疗腰椎间盘突出症的临床经验[J].中成药,2015,37(6):1390-1392. [12] 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. [13] FIELD T.Knee osteoarthritis pain in the elderly can be reduced by massage therapy,yoga and tai chi:a review[J].Complement Ther Clin Pract,2016,22:87-92. [14] PANINA S B,KROLEVETS I V,MILYUTINA N P,et al.Circulating levels of proinflammatory mediators as potential biomarkers of post-traumatic knee osteoarthritis development[J].J Orthop Traumatol,2017,18(4):349-357. [15] 李冠,甘丽娇,钟妙容.TNF-α与β1,4-GalT-Ⅰ在骨关节炎滑膜炎症过程中的关系研究[J].临床和实验医学杂志,2016,15(2):137-139.

备注/Memo

备注/Memo:
基金项目:上海市卫生和计划生育委员会科研课题项目 (201640393) 上海市中医药事业发展三年行动计划项目 (ZYSNXD-CC-MZY047)
更新日期/Last Update: 2019-10-10