中药蜡疗、熏蒸联合西药治疗膝骨关节炎临床研究
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R684.3

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浙江省科学技术资助项目(LY19H270001);湖州市科学技术局资助项目(2017GYB36)


Clinical Study on Chinese Herbal Fumigation and Paraffin Therapy Combined with Routine Western Medicine for Knee Osteoarthritis
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    摘要:

    目的:观察中药熏蒸、蜡疗联合西药常规治疗膝骨关节炎(KOA) 的临床疗效。方法:将78 例KOA 患者随机分为对照组33 例与研究组45 例。对照组给予硫酸氢铵葡萄糖钾胶囊口服、玻璃酸钠关节腔内注射治疗,研究组在对照组的基础上联合中药熏洗、蜡疗治疗,2 组疗程均为28 d。观察比较2 组临床疗效,治疗前后临床症状积分、膝关节特种外科医院(HSS) 评分、疼痛数字法(NRS) 评分及关节液基质金属蛋白酶-3 (MMP-3) 水平。结果:研究组总有效率为95.56%,对照组为75.76%,2 组比较,差异有统计学意义(P<0.05)。治疗前,2 组临床症状积分比较,差异无统计学意义(P>0.05)。治疗14 d,2 组临床症状积分均较治疗前下降(P<0.05),但组间比较,差异无统计学意义(P>0.05);治疗28 d,2 组临床症状积分均较治疗14 d 下降(P<0.05),且研究组临床症状积分低于对照组(P<0.05)。治疗前,2 组HSS 评分、NRS 评分比较,差异无统计学意义(P>0.05)。治疗后,2 组HSS 评分高于治疗前(P<0.05),NRS 评分低于治疗前(P<0.05);且研究组HSS 评分高于对照组,NRS 评分低于对照组,差异均有统计学意义(P<0.05)。治疗前,2 组MMP-3 水平比较,差异无统计学意义(P>0.05)。治疗后,2 组MMP-3 水平均较治疗前下降(P<0.05),且研究组MMP-3 水平低于对照组(P<0.05)。研究组不良反应发生率为15.56%,对照组为9.09%,2 组比较,差异无统计学意义(P>0.05)。结论:中药熏蒸、蜡疗联合西药治疗KOA 疗效良好,可有效缓解疼痛,改善膝关节功能,降低MMP-3 水平。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Chinese herbal fumigation and paraffin therapy combined with routine western medicine for KOA. Methods:A total of 78 cases of KOA patients were randomly divided into the control group and the study group, 33 and 45 cases in each group respectively. The control group was given the oral administration of glucosamine potassium sulfate capsules and intra- articular injection of sodium hyaluronate, and the study group was additionally given Chinese herbal fumigation and paraffin therapy based on the treatment of the control group. Both groups were treated for 28 days. The clinical effect was observed and compared between the two groups. Scores of clinical symptom and knee joint in the Hospital for Special Surgery(HSS) and Numerical Rating Scale(NRS) as well as level of matrix metalloproteinase- 3(MMP- 3) in synovial fluid were observed and compared in the two groups before and after treatment. Results: The total effective rates were 95.56% and 75.76% in the study group and in the control group respectively, the difference being significant(P<0.05). Before treatment,there was no significant difference being found in the comparison of clinical symptom scores between the two groups(P>0.05). On the 14th day of treatment,clinical symptom scores in the two groups were significantly decreased when compared with those before treatment(P<0.05),but there was no significance in the difference between the two groups(P>0.05). On the 28th day of treatment, clinical symptom scores in the two groups were decreased when compared with those on the 14th day of treatment(P<0.05), and the score in the study group was lower than that in the control group(P<0.05). Before treatment,there was no significant difference being found in the comparison of scores of HSS and NRS between the two groups(P>0.05). After treatment,scores of HSS in the two groups were higher than those before treatment(P<0.05),and NRS scores were lower(P<0.05);score of HSS in the study group was higher than that in the control group,and score of NRS was lower,differences being significant(P<0.05). Before treatment,there was no significant difference being found in the comparison of levels of MMP- 3 between the two groups(P>0.05). After treatment,levels of MMP- 3 in the two groups were decreased when compared with those before treatment(P<0.05), and the level in the study group was lower than that in the control group(P<0.05). The incidence of adverse reactions was 15.56% in the study group, and 9.09% in the control group, there being no significance in the difference(P>0.05). Conclusion: The therapy of Chinese herbal fumigation and paraffin therapy combined with routine medicine has good curative effect in the treatment of KOA, which can effectively relieve pain, strengthen knee joint function,and decrease level of MMP-3.

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范惠霞,樊志丽,朱炜.中药蜡疗、熏蒸联合西药治疗膝骨关节炎临床研究[J].新中医,2021,53(10):76-80

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  • 在线发布日期: 2021-05-24
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