[1]许坤 张洁帆 陈元川 陈博 曹月龙 庞坚△.退肿通痹汤治疗膝骨关节炎积液性滑膜炎脾失健运证的疗效观察[J].中国中医骨伤科杂志,2021,29(12):26-31.
　XU Kun ZHANG Jiefan CHEN Yuanchuan CHEN Bo.Efficacy of Tuizhong Tongbi Decoction on Treatment of Spleen Dysmotility in Effusion-Synovitis of Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(12):26-31.
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退肿通痹汤治疗膝骨关节炎积液性滑膜炎脾失健运证的疗效观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年12期
页码:
26-31
栏目:
临床研究
出版日期:
2021-12-15

文章信息/Info

Title:
Efficacy of Tuizhong Tongbi Decoction on Treatment of Spleen Dysmotility in Effusion-Synovitis of Knee Osteoarthritis
文章编号:
1005-0205(2021)12-0026-06
作者:
许坤1; 2 张洁帆1; 2 陈元川1; 2 陈博1; 2 曹月龙1; 2 庞坚1; 2△
Author(s):
XU Kun1; 2 ZHANG Jiefan1; 2 CHEN Yuanchuan1; 2 CHEN Bo1; 2
1Shi’s Center of Orthopedics and Traumatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200120,China; 2Institute of Traumatology and Orthopedics,Shanghai Academy of Traditional Chinese Medicine,Shanghai 200120,China.
关键词:
退肿通痹汤;  膝骨关节炎;  脾失健运证;  积液性滑膜炎;  临床疗效
Keywords:
Tuizhong Tongbi decoction;  knee osteoarthritis;  spleen dysfunction syndrome;  effusive synovitis;  clinical efficacy
分类号:
R684.3
文献标志码:
A
摘要:
目的:观察退肿通痹汤治疗膝骨关节炎积液性滑膜炎的临床疗效。方法:选取2019年6月至2020年6月就诊的膝骨关节炎积液性滑膜炎(脾失健运证)患者66例,采用随机信封法分为治疗组和对照组(各33例)。对照组口服双氯芬酸钠胶囊,治疗组口服退肿通痹汤。两组均连续治疗2周后观察临床疗效。结果:两组患者治疗前膝关节周径和积液转移试验(BS)、浮髌试验(PT)查体阳性率比较,差异无统计学意义(P>0.05)。治疗后治疗组膝关节周径与对照组比较明显缩小,差异有统计学意义(P<0.05); 治疗组BS、PT查体阳性查出率与对照组比较明显减少,差异有统计学意义(P<0.05)。两组患者治疗前KOOS肿胀子积分、WOMAC疼痛子积分、WOMAC僵硬子积分、WOMAC功能障碍子积分和WOMAC总分比较,差异无统计学意义(P>0.05)。治疗组患者治疗后KOOS肿胀子积分、WOMAC疼痛子积分、WOMAC僵硬子积分、WOMAC功能障碍子积分和WOMAC总分均较治疗前明显降低,差异有统计学意义(P<0.05); 对照组患者治疗后KOOS肿胀子积分、WOMAC疼痛子积分、WOMAC功能障碍子积分和WOMAC总分均较治疗前明显降低,差异有统计学意义(P<0.05),但WOMAC僵硬子积分差异无统计学意义(P>0.05)。治疗后治疗组KOOS肿胀子积分、WOMAC僵硬子积分与对照组比较明显降低,差异有统计学意义(P<0.05)。两组患者均无不良事件发生。结论:退肿通痹汤治疗膝骨关节炎积液性滑膜炎(脾失健运证)能明显缓解患者的临床症状,且无不良反应,值得临床进一步推广应用。
Abstract:
Objective:To observe the clinical efficacy of Tuizhong Tongbi decoction on the treatment of knee osteoarthritis effusion-synovitis.Methods:A total of 66 patients with splenic denervation due to knee osteoarthritis from June 2019 to June 2020 were selected and divided into treatment and control groups by random envelope method,with 33 patients in each group.The control group was given diclofenac sodium capsules orally,and the treatment group was given Tuizhong Tongbi decoction orally.The clinical efficacy was observed after 2 weeks of continuous treatment in both groups.Results:No significant difference was found between the two groups in the percentage of knees and positive rate for bulge sign(BS)and patellar tap(PT)checkers before treatment(P>0.05).After treatment,the percentage of knees and positive rate for BS and PT checkers in the treatment group was significantly smaller compared with the control group(P<0.05).There were no significant differences between the two groups in the scores of the KOOS swelling subscore,WOMAC pain subscore,WOMAC stiffness subscore,WOMAC dysfunction subscore,and WOMAC total score before treatment(P>0.05).The patients in the treatment group had significantly lower scores of the KOOS swelling subscore,WOMAC pain subscore,WOMAC stiffness subscore,WOMAC dysfunction subscore and WOMAC total score after treatment(P<0.05).The patients in the control group had significantly lower scores of the KOOS swelling subscore,WOMAC pain subscore,WOMAC dysfunction subscore and WOMAC total score than those in the treatment group(P<0.05),but the WOMAC stiffness subscore was not significantly different(P>0.05).After the treatment,the KOOS swelling subscore,WOMAC stiffness subscore were significantly lower(P<0.05)in the treatment group compared with the control group.There were no adverse events in either group.Conclusion:The treatment of spleen dysmotility in effusion-synovitis of knee osteoarthritis by Tuizhong Tongbi decoction can significantly relieve the patients’ clinical symptoms,without the occurrence of adverse events,which deserves further clinical promotion and application.

参考文献/References:

[1] HUANG S L, HE X J, WANG K Z.Joint replacement in China:progress and challenges[J].Rheumatology,2012,51(9):1525-1526.
[2] TANG X,WANG S,ZHAN S,et al.The prevalence of symptomatic knee osteoarthritis in china:results from the china health and retirement longitudinal study[J].Arthritis & Rheumatology,2016,68(3):648-653.
[3] WANG X,JIN X, BLIZZARD L,et al.Associations between knee effusion-synovitis and joint structural changes in patients with knee osteoarthritis[J].The Journal of Rheumatology,2017,44(11):1644-1651.
[4] WANG X,CICUTTINI F,JIN X,et al.Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis[J].Osteoarthritis and Cartilage,2017,25(8):1304-1312.
[5] YUQING Z, MICHAEL N, JINGBO N,et al.Fluctuation of knee pain and changes in bone marrow lesions,effusions,and synovitis on magnetic resonance imaging.[J].Arthritis and Rheumatism,2011,63(3):691-699.
[6] ATUKORALA I,KWOH C K,GUERMAZI A,et al.Synovitis in knee osteoarthritis:a precursor of disease?[J].Annals of the Rheumatic Diseases,2016,75(2):390-395.
[7] 詹红生,郑昱新.成人膝关节滑膜炎诊断与临床疗效评价专家共识[J].中国中医骨伤科杂志,2016,24(1):1-3.
[8] WANG Y,MARTEL-PELLETIER J,TEICHTAHL A,et al.The bulge sign-a simple physical examination for identifying progressive knee osteoarthritis:data from the osteoarthritis initiative[J].Rheumatology,2020,59(6):1288-1295.
[9] BERLINBERG A, ASHBECK E L, ROEMER F W,et al.Diagnostic performance of knee physical exam and participant-reported symptoms for MRI-detected effusion-synovitis among participants with early or late stage knee osteoarthritis:data from the osteoarthritis initiative[J].Osteoarthritis and Cartilage,2019,27(1):80-89.
[10] KELLGREN J H, LAWRENCE J S.Radiological assessment of osteoarthrosis[J].Annals of the Rheumatic Diseases,1957,16(4):494-502.
[11] CHEUNG R T H, NGAI S P C, HO K K W.Chinese adaptation and validation of the knee injury and osteoarthritis outcome score(KOOS)in patients with knee osteoarthritis[J].Rheumatology International,2016,36(10):1449-1454.
[12] XIE F,LI S,GOEREE R,et al.Validation of Chinese western Ontario and McMaster universities osteoarthritis index(WOMAC)in patients scheduled for total knee replacement[J].Quality of Life Research,2008,17(4):595-601.
[13] 庞坚,石印玉,曹月龙,等.膝骨关节炎中医观的再认识[J].上海中医药大学学报,2011,25(1):26-28.
[14] WANG Y,TEICHTAHL A J,PELLETIER J P,et al.Knee effusion volume assessed by magnetic resonance imaging and progression of knee osteoarthritis:data from the osteoarthritis initiative[J].Rheumatology,2019,58(2):246-253.
[15] MARICAR N,CALLAGHAN M J,PARKES M J,et al.Clinical assessment of effusion in knee osteoarthritis:a systematic review[J].Seminars in Arthritis and Rheumatism,2016,45(5):556-563.
[16] 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(6):705-715.
[17] 曹舸飞,何思君,宋迎红,等.圣愈汤合五苓散加减治疗膝骨关节炎合并滑膜炎的临床观察[J].实用中西医结合临床,2016,16(12):42-43.
[18] 蔡飞龙,邵强,黄秩峰.中西医结合治疗膝关节急性创伤性滑膜炎临床疗效探讨[J].中华中医药学刊,2015,33(12):3050-3052.
[19] HERTZOG M A.Considerations in determining sample size for pilot studies[J].Research in Nursing & Health,2008,31(2):180-191.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81674003,81774340)上海市慢性筋骨病临床医学研究中心(20MC1920600)上海市临床重点专科 “中医骨伤科学”(shslczdzk03901)1上海中医药大学附属曙光医院石氏伤科医学中心(上海,200120)2上海市中医药研究院骨伤科研究所△通信作者 E-mail:lidazul@126.com
更新日期/Last Update: 1900-01-01