[1]陶帅△ 姜宏 戴瑜 王铠 印红兵 龚华惠.基于天癸理论的补肾活血方治疗绝经后膝骨关节炎的临床疗效观察[J].中国中医骨伤科杂志,2021,29(10):22-27.
　TAO Shuai JIANG Hong DAI Yu WANG Kai YIN HongbingGONG Huahui.Clinical Observation of Bushen Huoxue Decoction for theTreatment of Postmenopausal Knee OsteoarthritisBased on Tiankui Theory[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(10):22-27.
点击复制

基于天癸理论的补肾活血方治疗绝经后膝骨关节炎的临床疗效观察()
分享到：

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

卷:
第29卷
期数:
2021年10期
页码:
22-27
栏目:
临床研究
出版日期:
2021-10-15

文章信息/Info

Title:
Clinical Observation of Bushen Huoxue Decoction for theTreatment of Postmenopausal Knee OsteoarthritisBased on Tiankui Theory
文章编号:
1005-0205(2021)10-0022-06
作者:
陶帅1△ 姜宏2 戴瑜1 王铠1 印红兵1 龚华惠1
1南京中医药大学泰州附属医院(江苏 泰州,225300)2南京中医药大学苏州附属医院
Author(s):
TAO Shuai1△ JIANG Hong2 DAI Yu1 WANG Kai1 YIN Hongbing1GONG Huahui1
1Taizhou Hospital of TCM Affiliated to Nanjing University of Traditional Chinese Medicine,Taizhou 225300, Jiangsu China; 2Suzhou Hospital of TCM Affiliated to Nanjing University of Traditional Chinese Medicine,Suzhou 215000, Jiangsu China.
关键词:
天癸;  补肾活血方;  绝经;  膝骨关节炎;  疗效
Keywords:
Tiankui;  Bushen Huoxue decoction;  menopause;  knee osteoarthritis;  curative efficacy
分类号:
R681.5
文献标志码:
A
摘要:
目的:基于天癸理论观察补肾活血方治疗绝经后膝骨关节炎的临床疗效。方法:选取绝经后膝骨关节炎患者70例,采用随机数字表法分为治疗组和对照组,最终纳入67例完成研究,其中治疗组33例给予补肾活血方治疗,对照组34例给予西乐葆治疗,观察两组患者治疗前后血清学E2、TNF-α及WOMAC评分、骨关节炎中医证候分级量化评分的变化,并进行中医临床疗效评定。结果:补肾活血方可提高患者血清中E2表达,抑制TNF-α的表达,显著降低WOMAC评分,差异有统计学意义(P<0.01),尤其对中医证候关节酸软乏力、关节冷痛喜暖恶寒、头晕耳鸣等症状改善优势明显,同时其可明显降低改良Kupperman指数评分,差异有统计学意义(P<0.05)。结论:补肾活血方治疗绝经后膝骨关节炎有临床优势,尤其对绝经后女性伴有全身不适症状者疗效更佳,可能存在对下丘脑-垂体轴的良性调节作用。
Abstract:
Objective:To observe the clinical efficacy and advantages of Bushen Huoxue decoction on the treatment of postmenopausal knee osteoarthritis based on Tiankui theory. Methods:70 patients with postmenopausal knee osteoarthritis were selected and divided into treatment group and control group by random number table method. 67 patients were finally included to complete the study, among which 33 patients in the treatment group were given Bushen Huoxue decoction, and 34 patients in the control group were given Celebrex. The changes of serum E2, TNF-α, WOMAC scores and quantitative scores of TCM syndrome grading of osteoarthritis in two groups were observed before and after treatment, and the clinical efficacy of TCM was evaluated. Results:Bushen Huoxue decoction improved the patient’s E2 expression in serum, inhibited the expression of TNF-α, and significantly reduced the WOMAC score(P<0.01). In particular, it had obvious advantage for improving Chinese medicine syndromes such as joint weakness and fatigue, cold and pain in joints like warmth and aversion to cold, dizziness, tinnitus. At the same time, Bushen Huoxue decoction obviously reduced the modified Kupperman index score, and the difference was statistically significant(P<0.05). Conclusion:Bushen Huoxue decoction has clinical advantages on the treatment of postmenopausal knee osteoarthritis, especially for postmenopausal women with general discomfort symptoms. It may play a role in regulating the hypothalamic-pituitary axis.

参考文献/References:

[1] MARTíN M, CASTA?EDA S.Estrogens,osteoarthritis and inflammation[J].Joint Bone Spine,2013,80(4):368-373.
[2] SRIKANTH V K, FRYER J L, ZHAI G,et al.A meta-analysis of sex differences prevalence,incidence and severity of osteoarthritis[J].Osteoarthritis Cartilage,2005,13(9):769-981.
[3] 孙小燕,张瑞,王丽蓉,等.初潮年龄对女性绝经年龄及围绝经期综合征影响的横断面研究[J].中华生殖与避孕杂志,2018,38(4):299-304.
[4] 陈卫衡.膝骨关节炎中医诊疗指南(2020年版)[J].中医正骨,2020,32(10):1-14.
[5] 中华医学会骨科学分会关节外科学组.骨关节炎诊疗指南(2018年版)[J].中华骨科杂志,2018,38(12):705-710.
[6] BELLAMY N, BUCHANAN W W, GOLDSMITH C H,et al.Validation study of the WOMAC:a health status instrument for measuring clinically important patient relevant outcomes following total hip or knee arthroplasty in osteoarthritis[J].J Orthop Rheumatol,1988,1:95-108.
[7] 阎小萍.常见风湿病诊治手册[M].北京:中国医药科技出版社,2011.
[8] TAO M,SHAO H,LI C,et al.Correlation between the modified Kupperman Index and the Menopause Rating Scale in Chinese women[J].Patient Prefer Adherence,2013,7:223-229.
[9] ABE T,YAMAYA Y,SUZUKI M,et al.Statistical clustering of women complaining of climacteric syndrome by cluster analysis[J].Acta Obstet,1979,31:607-614.
[10] 南京中医药大学.黄帝内经素问译释[M].上海:上海科学技术出版社,2009:5.
[11] 袁祥生,李现林.李现林教授治疗女性围绝经期骨关节炎经验总结[J].风湿病与关节炎,2016,5(8):49-50.
[12] 李永婷,石广霞,屠建锋,等.针灸治疗膝骨关节炎选穴规律分析[J].辽宁中医杂志,2017,44(10):2179-2182.
[13] 高翔,吴弢,莫文,等.施杞治疗膝骨关节炎经验[J].中华中医药杂志,2011,26(10):2294-2295.
[14] 张锁,王波,吴效科,等.天癸与脏腑功能调控[J].中华中医药杂志,2010,25(7):1018-1020.
[15] 吴柯柯,潘建科,杨伟毅,等.曹学伟教授辩证论治围绝经期妇女膝骨关节炎的经验总结[J].按摩与康复医学,2018,9(5):92-94.
[16] 易黎,武润哲,白玲玲.“天癸”辨析[J].河南中医,2019,39(5):665-667.
[17] 邹如政,邹薇.论天癸与中医生殖[J].中华中医药杂志,2017,32(11):4876-4879.
[18] 肖亚平,曾杰,焦琳娜,等.补肾中药对骨质疏松症的治疗及其信号通路调节作用的研究进展[J].中国中药杂志,2018,43(1):21-30.
[19] 陈彦飞,赵勇,李元浩,等.从“肝肾同源”论雌激素与膝骨性关节炎的相关性[J].环球中医药,2018,11(4):566-568.
[20] 蔡心银,张紫佳.植物雌激素药理作用及相关中药的研究进展[J].现代中药研究与实践,2020,34(2):75-78.
[21] 古金华,吴娅琳,赵平.黑骨藤追风活络胶囊治疗风寒湿痹型膝骨关节炎40例[J].中国中医骨伤科杂志,2020,28(2):75-76.
[22] 朱纪阳,叶秀兰,姜玉雯,等.施氏热痹方治疗湿热痹阻型膝骨关节炎滑膜炎的多中心研究[J].中国中医骨伤科杂志,2019,27(12):30-34.
[23] 周晓莉,乔平平.盘龙七片治疗寒湿痹阻型膝骨关节炎32例[J].中国中医骨伤科杂志,2018,26(12):68-69.
[24] 李晓曦,陈宇恒,唐秀凤,等.基于雌激素作用的淫羊藿女贞子配伍对绝经后骨质疏松症大鼠的影响研究[J].中国中医骨伤科杂志,2019,27(9):1-6.
[25] TIAN L,SU Z,MA X,et al.Inhibition of miR-203 ameliorates osteoarthritis cartilage degradation in the postmenopausal rat model:involvementof estrogen receptor α[J].Hum Gene Ther Clin Dev,2019,30(4):160-168.
[26] TANG J,LIU T,WEN X,et al.Estrogen-related receptors:novel potential regulators of osteoarthritis pathogenesis[J].Mol Med,2021,27(1):5.
[27] 乐燕.老年妇女个性特征心理弹性及绝经后症状发生情况调查及相关性分析[J].中国妇幼保健,2021,36(10):2337-2339.
[28] NISHIMURA H, KAWASAKI M, MATSUURA T,et al.Acute mono-arthritis activates the neurohypophysial system and hypothalamo-pituitary adrenal axis in rats[J].Front Endocrinol(Lausanne),2020,11:43.
[29] T?NüK �瘙 塁 B, SERIN E, AYHAN F F,et al.The effects of physical therapeutic agents on serum levels of stress hormones in patients with osteoarthritis[J].Medicine(Baltimore),2016,95(35):e4660.

备注/Memo

备注/Memo:
基金项目:江苏省泰州市科技支撑计划(社会发展项目)
(TS201909)
△通信作者 E-mail:taoshuai130@163.com
更新日期/Last Update: 1900-01-01