[1]苑成发,韩松△,俞鹏飞,等.加味补肾活血汤治疗肾虚血瘀型膝骨关节炎临床疗效观察[J].中国中医骨伤科杂志,2022,30(09):36-42.
　YUAN Chengfa,HAN Song,YU Pengfei,et al.Clinical Observation of Modified Bushen Huoxue Decoction in Treating Knee Osteoarthritis of Kidney Deficiency and Blood Stasis Type[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(09):36-42.
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加味补肾活血汤治疗肾虚血瘀型膝骨关节炎临床疗效观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年09期
页码:
36-42
栏目:
临床研究
出版日期:
2022-09-15

文章信息/Info

Title:
Clinical Observation of Modified Bushen Huoxue Decoction in Treating Knee Osteoarthritis of Kidney Deficiency and Blood Stasis Type
文章编号:
1005-0205(2022)09-0036-07
作者:
苑成发1; 韩松2△; 俞鹏飞2; 陈国锋1; 王少甫1; 王琦3
1南京中医药大学附属宿迁市中医院(江苏 宿迁,223800)
2南京中医药大学附属苏州市中医医院
3南京中医药大学
Author(s):
YUAN Chengfa1; HAN Song2△; YU Pengfei2; CHEN Guofeng1; WANG Shaofu1; WANG Qi3
1Suqian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suqian 223800,Jiangsu China; 2Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,China; 3Nanjing University of Chinese Medicine,Nanjing 210046,China.
关键词:
膝骨关节炎;  肿瘤坏死因子;  骨形态发生蛋白;  肾虚血瘀;  加味补肾活血汤
Keywords:
knee osteoarthritis;  tumor necrosis factor;  bone morphogenetic proteins;  kidney deficiency and blood stasis;  modified Bushen Huoxue decoction
分类号:
R684.3
文献标志码:
A
摘要:
目的:研究加味补肾活血汤治疗肾虚血瘀型膝骨关节炎的临床疗效。方法:选取肾虚血瘀型膝骨关节炎患者120例,采用随机数字表法分为治疗组和对照组(各60例)。治疗组口服加味补肾活血汤,对照组口服硫酸氨基葡萄糖治疗。比较两组不同治疗时期血清肿瘤坏死因子(Tumor Necrosis Factor,TNF)及骨形态发生蛋白(Bone Morphogenetic Proteins,BMPs )指标变化; 比较两组治疗前后组内及组间中医证候评分、总有效率、Lysholm膝关节功能评分、WOMAC评分变化差异。结果:两组BMP-2比较,两组患者时间因素和分组因素存在交互效应(P<0.001),两组患者总体BMP-2值比较存在分组效应(P<0.001),治疗后4周和治疗后8周的血清BMP-2值,治疗组均高于对照组(P<0.001)。两组患者治疗前后不同时间节点BMP-2值比较存在时间效应(P<0.001)。两组不同时间节点BMP-2值均呈上升趋势,差异有统计学意义(P<0.001)。两组TNF-α比较,两组患者时间因素和分组因素存在交互效应(P<0.001),两组患者总体TNF-α值比较存在分组效应(P<0.001),治疗后4周和治疗后8周的血清TNF-α值治疗组均高于对照组(P<0.001); 两组患者治疗前后不同时间节点TNF-α值比较存在时间效应(P<0.001)。两组不同时间节点TNF-α值均呈下降趋势,差异有统计学意义(P<0.001)。两组Lysholm评分比较,两组患者时间因素和分组因素存在交互效应(P=0.004); 治疗后4周和治疗后8周治疗组的评分明显高于对照组(P<0.001); 两组患者总体评分比较差异有统计学意义(治疗组高于对照组),即存在分组效应(P<0.001); 两组患者治疗前后不同时间节点评分比较存在时间效应(P<0.001)。两组不同时间节点Lysholm值均呈上升趋势,差异有统计学意义(P<0.001)。两组WOMAC评分比较,两组患者时间因素和分组因素无交互效应(P=0.091); 治疗后4周和治疗后8周治疗组的评分明显低于对照组(P<0.001); 两组患者总体评分比较差异有统计学意义(治疗组低于对照组),即存在分组效应(P<0.001); 两组患者治疗前后不同时间节点评分比较存在时间效应(P<0.001)。两组不同时间节点评分均呈下降趋势,差异有统计学意义(P<0.001)。两组中医证候评分及总有效率评分比较,两组内中医证候评分,治疗8周后均显著低于治疗前(P<0.001); 治疗组治疗8周后中医证候总评分低于对照组,差异有统计学意义(P<0.001); 治疗组治疗8周后总有效率高于对照组,差异有统计学意义(P<0.001)。结论:加味补肾活血汤治疗肾虚血瘀型膝骨关节炎,可减少软骨基质降解,抑制炎性反应,增加软骨细胞修复,促进骨生成,对缓解膝关节肿胀疼痛有较好的疗效,并能改善膝关节功能,疗效确切。
Abstract:
Objective:To study the clinical efficacy of modified Bushen Huoxue decoction on the treatment of osteoarthritis of kidney deficiency and blood stasis type.Methods:120 cases of knee osteoarthritis of kidney deficiency and blood stasis type were randomly divided into treatment group(60 cases)and control group(60 cases).The treatment group was treated with modified Bushen Huoxue decoction and the control group was treated with glucosamine sulfate.The changes of serum tumor necrosis factor(TNF)and bone morphogenetic proteins(BMPs)were compared between the two groups at different treatment points,and the differences of TCM scores,total effective rate,Lysholm knee function scores and WOMAC scores before and after treatment were compared between the two groups.Results:Compared with BMP-2,there was an interaction effect between time factors and grouping factors in the two groups(P<0.001),and a grouping effect in the comparison of overall BMP-2 values between the two groups(P<0.001).The serum BMP-2 values at 4 weeks and 8 weeks after treatment in the treatment group were higher than that in the control group(P<0.001).There was a time effect in the comparison of BMP-2 values at different time points before and after treatment between the two groups(P<0.001).BMP-2 increased at different time points in the two groups,and the difference had statistical significance(P<0.001).The comparison of TNF-α between the two groups showed that there was an interaction effect between time factors and grouping factors in the two groups(P<0.001).There was a grouping effect in the comparison of overall TNF-α values between the two groups(P<0.001),and the serum TNF-α values at 4 weeks after treatment and 8 weeks after treatment in the treatment group were higher than that in the control group(P<0.001).There was a time effect in the comparison of TNF-α values at different time points before and after treatment between the two groups(P<0.001).TNF-α showed a downward trend at different time points in the two groups,and the difference had statistical significance(P<0.001).The comparison of Lysholm scores between the two groups showed that there was an interaction effect between time factors and grouping factors in the two groups(P=0.004).The scores in the treatment group were significantly higher than those in the control group at 4 weeks and 8 weeks after treatment(P<0.001).There was a statistical difference in the overall scores between the two groups(the treatment group was higher than the control group),that is,there was a grouping effect(P<0.001).There was a time effect in the comparison of scores at different time points before and after treatment between the two groups(P<0.001).Lysholm scores increased at different time points in the two groups,and the difference had statistical significance(P<0.001).The comparison of WOMAC scores between the two groups showed that there was no interaction effect between time factors and grouping factors in the two groups(P=0.091).The scores in the treatment group were significantly lower than those in the control group at 4 weeks and 8 weeks after treatment(P<0.001).There was statistical difference in the overall scores between the two groups(the treatment group was lower than the control group),that is,there was grouping effect(P<0.001).There was time effect in the comparison of scores at different time points before and after treatment between the two groups(P<0.001).The scores at different time points showed a decreasing trend in both groups,and the difference was statistically significant(P<0.001).The comparison of TCM symptom scores and total effective rate scores between the two groups showed that the TCM symptom scores within the two groups after 8 weeks of treatment were significantly lower than those before treatment(P<0.001).The total TCM symptom scores in the treatment group after 8 weeks of treatment were lower than those in the control group,and the difference was statistically significant(P<0.001).The total effective rate in the treatment group after 8 weeks of treatment was higher than that in the control group,and the difference was statistically significant(P<0.001).Conclusion:Bushen Huoxue decoction can reduce the degradation of cartilage matrix,inhibit inflammatory reaction,increase chondrocyte repair and promote osteogenesis on the treatment of knee joint swelling and pain of kidney deficiency and blood stasis type.It has a better efficacy on relieving knee joint swelling and pain,and can improve knee joint function.The efficacy is satisfied.

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备注/Memo

备注/Memo:
基金项目:宿迁市科技计划项目(S202011)
△通信作者 E-mail:hansong8024@126.com
更新日期/Last Update: 2022-09-10