[1]朱纪阳 叶秀兰△ 姜玉雯 谢智晋 倪寿晨 吴锦泽 张霆 施杞.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.
　ZHU Jiyang YE Xiulan JIANG Yuwen XIE Zhijin NI Shouchen WU Jinze ZHANG Ting SHI Qi.Multi-center Clinical Study on the Treatment of Synovitis of Knee Osteoarthritis with Damp-heat Syndrome Type by Shi's Rebi Prescription[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(12):30-34.
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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()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年12期
页码:
30-34
栏目:
临床研究
出版日期:
2019-12-04

文章信息/Info

Title:
Multi-center Clinical Study on the Treatment of Synovitis of Knee Osteoarthritis with Damp-heat Syndrome Type by Shi's Rebi Prescription
文章编号:
1005-0205(2019)12-0030-05
作者:
朱纪阳1 叶秀兰1△ 姜玉雯2 谢智晋3 倪寿晨4 吴锦泽1 张霆1 施杞1
1上海中医药大学附属龙华医院(上海,200032) 2上海市徐汇区凌云街道社区卫生服务中心 3上海市长宁区天山路街道社区卫生服务中心 4上海市杨浦区长白社区卫生服务中心
Author(s):
ZHU Jiyang1 YE Xiulan1△ JIANG Yuwen2 XIE Zhijin3 NI Shouchen4 WU Jinze1 ZHANG Ting1 SHI Qi1
1Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China; 2Lingyun Community Health Service Center in Xuhui District,Shanghai 200237,China; 3Tianshan Road Community Health Service Center in Changning District,Shanghai 200051,China; 4Changbai Community Health Service Center in Yangpu District,Shanghai 200093,China.
关键词:
施杞;  热痹方;  湿热痹阻型;  滑膜炎;  膝骨关节炎
Keywords:
Shiqi;  Rebi prescription;  damp-heat syndrome;  synovitis;  knee osteoarthritis
分类号:
R684.3
文献标志码:
A
摘要:
目的:研究施杞教授经验方热痹方对湿热痹阻型膝骨关节炎滑膜炎的临床疗效及其安全性。 方法:将90例湿热痹阻型膝骨关节炎滑膜炎患者随机分为治疗组和对照组,各45例。治疗组口服热痹方颗粒配合塞来昔布模拟剂胶囊治疗,对照组口服塞来昔布胶囊配合热痹方颗粒模拟剂治疗,治疗均为3周,观察两组治疗前后VAS评分、WOMAC指数、膝关节肤温、膝关节压痛、膝关节肿胀度及SF-36评分,并进行疗效评价,12周时随访。 结果:经过3周治疗后,两组患者膝关节疼痛均有改善(P<0.01),治疗3周后两组VAS评分差异无统计学意义(P>0.05),12周随访时治疗组VAS评分改善明显优于对照组(P<0.05)。两组患者治疗3周后膝关节WOMAC总分均有降低(P<0.01),两组间差异无统计学意义(P>0.05),12周随访时治疗组WOMAC总分改善明显优于对照组(P<0.05)。两组患者治疗后膝关节肤温均有降低(P<0.01),治疗3周后及12周随访时两组间差异无统计学意义(P>0.05)。治疗3周后膝关节肿胀度差异有统计学意义(P<0.01),治疗组缓解膝关节肿胀疗效优于对照组(P<0.01),12周随访时两组患者膝关节肿胀度差异无统计学意义(P>0.05)。两组患者关节压痛治疗前后差异有统计学意义(P<0.01),治疗3周后膝关节压痛程度差异有统计学意义(P<0.05),12周随访组间差异无统计学意义(P>0.05)。两组患者在治疗后SF-36总评分差异无统计学意义(P>0.05)。治疗组的痊愈数及总有效率均明显优于对照组(P<0.01)。 结论:热痹方可改善湿热痹阻型膝骨关节炎滑膜炎患者的疼痛、肿胀等症状,其疗效与安全性和塞来昔布无差异,并在停药后呈现较好的远期疗效,为治疗该病的理想方药。
Abstract:
Objective:To study the clinical efficacy and safety of Rebi prescription, a herbal prescription based on clinical experience of professor Shiqi, in treating synovitis of knee osteoarthritis with damp-heat syndrome. Methods: Ninety synovitis of knee osteoarthritis patients with damp-heat syndrome type were averagely and randomly divided into two treatment(n=45)and control group(n=45)in double-blind control trial. Patients in the treatment group was given medicine with Rebi prescription and simulant celecoxib but control group was given celecoxib and simulant Rebi prescription for 3 weeks in each group. VAS score, WOMAC index comprehensive evaluation, knee skin temperature, knee tenderness, knee swelling and SF-36 were observed before and after 3 weeks' treatment as well as follow up visit during the 12 weeks. Results: After 3 weeks' treatment, knee pain was improved in both groups(P<0.01), and there was no significant difference in VAS score between the two groups after treatment for 3 weeks(P>0.05), but it improved significantly at 12 weeks follow-up as compared with control group(P<0.05). The WOMAC total scores of knee joints were decreased after treatment for 3 weeks(P<0.01), and there was no significant difference between the two groups(P>0.05), but the treatment group was significantly better than that of the control group at 12 weeks follow-up(P<0.05). The skin temperature of knee joints was decreased after treatment(P<0.01), and there was no significant difference between the two groups after treatment for 3 weeks and 12 weeks(P>0.05). There was a significant difference in knee swelling between the two groups after treatment for 3 weeks(P<0.01). The treatment group was better than the control group in relieving knee swelling(P<0.01). There was no significant difference in knee swelling between the two groups at 12 weeks follow-up(P>0.05). There was significant difference in knee tenderness between the two groups before and after treatment(P<0.01), and there was significant difference in knee tenderness after 3 weeks of treatment(P<0.05), but there was no significant difference between the 12 weeks follow-up group(P>0.05). There was no significant improvement in SF total score after treatment(P>0.05). The number of cures and total effective rate in the treatment group were significantly better than those in the control group(P<0.01).Conclusion: Rebi prescription is effective for synovitis of knee osteoarthritis with damp-heat syndrome type. Its efficacy and safety have no difference with celecoxib in a better long-term effect after withdrawal.

参考文献/References:

[1] AKMESE R, YILDIZ K I, ISIK C,et al. Combined arthroscopic synovectomy and radiosynoviorthesis in the treatment of chronic non-specific synovitis of the knee[J]. Archives of Orthopaedic and Trauma Surgery,2013,133(11):1567-1573. [2] 中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华关节外科杂志(电子版),2007,1(4):254-256. [3] 中华中医药学会骨伤科分会.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. [4] 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. [5] 段永峰,张根印.健膝汤治疗76例膝关节滑膜炎临床观察[J].陕西中医学院学报,2008,31(2):25-26. [6] LI Y N, FAN M L, LIU H Q,et al. Dihydroartemisinin derivative DC32 inhibits inflammatory response in osteoarthritic synovium through regulating Nrf2/NF-kappaB pathway[J]. International Immunopharmacology,2019,74:105701. [7] BHOSALE U A, QURAISHI N, YEGNANARAYAN R,et al. A cohort study to evaluate cardiovascular risk of selective and nonselective cyclooxygenase inhibitors(COX-Is)in arthritic patients attending orthopedic department of a tertiary care hospital[J]. Nigerian Medical Journal,2014,55(5):417-422. [8] 梁翼,李敏,高志.膝关节创伤性滑膜炎中西医诊疗进展[J].华西医学,2010,25(6):1189-1192. [9] BAERLOCHER M O, SAAD W E, DARIUSHNIA S,et al. Quality improvement guidelines for percutaneous vertebroplasty[J]. Journal of Vascular and Interventional Radiology,2014,25(2):165-170. [10] YILMAZ E. The evaluation of the effectiveness of intra-articular steroid, tenoxicam, and combined steroid-tenoxicam injections in the treatment of patients with knee osteoarthritis[J]. Clinical Rheumatology,2019,doi:10.1007/s 10067-019-04641-y. [11] SZENTESI M, NAGY Z, GEHER P,et al. A prospective observational study on the long-term results of(90)Yttrium citrate radiosynoviorthesis of synovitis in osteoarthritis of the knee joint[J].European J of Nuclear Medicine and Molecular Imaging,2019,46(8):1633-1641. [12] RUDNIK-JANSEN I, SCHRIJVER K, WOIKE N,et al. Intra-articular injection of triamcinolone acetonide releasing biomaterial microspheres inhibits pain and inflammation in an acute arthritis model[J].Drug Delivery,2019,26(1):226-236. [13] LO P C, LIN F C, TSAI Y C,et al. Traditional Chinese medicine therapy reduces the risk of total knee replacement in patients with knee osteoarthritis[J]. Medicine,2019,98(23):e15964. [14] 庞坚,詹红生,石印玉.石印玉中医骨伤科学教案:膝骨关节炎的诊治[J].上海中医药大学学报,2010,24(4):5-10. [15] 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. [16] 杨晓峰,谢子康,陈超,等.当归拈痛汤加减内服联合熏蒸治疗50例膝关节滑膜炎的效果观察[J].中国继续医学教育,2017,9(18):177-178. [17] 李立军.当归拈痛汤加减内服联合熏蒸治疗膝关节滑膜炎280例[J].中国现代药物应用,2016,10(6):255-256.

备注/Memo

备注/Memo:
基金项目:上海市卫生和计划生育委员会课题(201640019)△通信作者 E-mail:13818824983@163.com△通信作者 E-mail:13818824983@163.com(收稿日期:2019-10-08)
更新日期/Last Update: 2019-12-04