[1]刘思冶,闫 奇,汤吉祥,等.膝痹通方治疗早期膝骨关节炎肝肾亏虚证临床研究[J].陕西中医,2023,(3):307-311.[doi:DOI:10.3969/j.issn.1000-7369.2023.03.008]
 LIU Siye,YAN Qi,TANG Jixiang,et al.Clinical study on Xibitong prescription in treating knee osteoarthritis of early Ganshen Kuixu type[J].,2023,(3):307-311.[doi:DOI:10.3969/j.issn.1000-7369.2023.03.008]
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膝痹通方治疗早期膝骨关节炎肝肾亏虚证临床研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年3期
页码:
307-311
栏目:
临床研究
出版日期:
2023-03-05

文章信息/Info

Title:
Clinical study on Xibitong prescription in treating knee osteoarthritis of early Ganshen Kuixu type
作者:
刘思冶闫 奇汤吉祥张洪美李 彦艾 奇荆 琳
(中国中医科学院望京医院,北京100102)
Author(s):
LIU SiyeYAN QiTANG JixiangZHANG HongmeiLI YanAI QiJING Lin
(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)
关键词:
膝骨关节炎 肝肾亏虚证 膝痹通方 基质金属蛋白酶13 视觉模拟评分法 软骨基质降解
Keywords:
Knee osteoarthritis Ganshen Kuixu type Xibitong prescription Matrix metalloproteinase 13 Visual analogue scale score Degradation of cartilage matrix
分类号:
R 684.3
DOI:
DOI:10.3969/j.issn.1000-7369.2023.03.008
文献标志码:
A
摘要:
目的:探讨膝痹通方治疗早期膝骨关节炎肝肾亏虚证的临床疗效。方法:选取100例早期膝骨关节炎肝肾亏虚证患者,随机分为对照组、试验组各50例。试验组采用膝痹通方口服,对照组采用维固力联合扶他林口服。比较治疗前、治疗后、治疗后2周、治疗后4周两组WOMAC、VAS、Lequesne指数评分、基质金属蛋白酶13(MMP-13)水平。结果:试验组的治疗总有效率为86.0%,高于对照组的70.0%,差异有统计学意义(P<0.05)。治疗后两组的WOMAC评分、Lequesne总评分、VAS评分、MMP-13水平均低于治疗前,差异有统计学意义(均P<0.05)。试验组在治疗后、治疗后2周、治疗后4周的WOMAC总评分、VAS评分、Lequesne总评分、MMP-13表达均低于对照组,差异有统计学意义(均P<0.05)。结论:膝痹通方治疗早期膝骨关节炎肝肾亏虚证疗效较好,能改善患者膝关节功能,降低血清MMP-13表达,具有骨关节炎软骨基质的降解作用,有效阻止膝骨关节炎进展。
Abstract:
Objective:To investigate clinical efficacy of Xibitong prescription in treatment of knee osteoarthritis of early Ganshen Kuixu type.Methods:A total of 100 patients with knee osteoarthritis of early Ganshen Kuixu type were selected.They were randomly divided into control group and experimental group,50 cases in each group.The experimental group were taken orally with Xibitong prescription,and the control group were taken by weiguli combined with voltaren orally.The two groups of WOMAC,VAS,Lequesne,MMP-13 level were compared before treatment,after treatment,2 weeks and 4 weeks after treatment.Results:The effective rate of treatment in the experimental group was 86.0%,which was lower than 70.0% in the control group.The total effective rate of the two groups was statistically significant(P<0.05).After treatment,the WOMAC score and Lequesne total score,VAS score,and MMP-13 levels were lower than before treatment,difference statistically significant(all P<0.05).The total WOMAC score,VAS score,Lequesne score and MMP-13 expression of the experimental group were lower than those in the control group after treatment,2 weeks and 4 weeks after treatment,difference statistically significant(all P<0.05).Conclusion:Xibitong prescription has clear curative effect in the treatment of knee osteoarthritis in early Ganshen Kuixu type.It can reduce the expression level of serum MMP-13.It has significant effect on reducing degradation of osteoarthritis cartilage matrix,effectively prevent progression of osteoarthritis.

参考文献/References:

[1] 刘德玉,袁普卫.李堪骨伤科临证经验集[M].北京:人民卫生出版社,2012:126.
[2] 裴福兴,陈安民.骨科学[M].北京:人民卫生出版社,2016:308-309.
[3] 中华中医药学会.骨性关节炎[J].风湿病与关节炎,2013,2(2):71-72.
[4] 陆艳红,石晓兵.膝骨关节炎国内外流行病学研究现状及进展[J].中国中医骨伤科杂志,2012,20(6):81-84.
[5] Kielly J,Davis EM,Marra C.Practice guidelines for pharmacists:The management of osteoarthritis[J].Can Pharm Journal,2017,150(3):156-168.
[6] 何名江,张洪美,单鹏程,等.补肾除湿方治疗早期膝骨关节炎肝肾亏虚证的临床研究[J].中华中医药杂志,2020,35(4):2109-2113.
[7] 中华医学会骨科学分会关节外科学组.骨关节炎诊疗指南[J].中华骨科杂志,2018,38(12):705-715.
[8] 中国中医药研究促进会骨科专业委员会,中国中西医结合学会骨伤科专业委员会关节工作委员会.膝骨关节炎中医诊疗专家共识[J].中医正骨,2015,27(7):4-5.
[9] 曹彭凯,王晓猛,白伟侠,等.2018年版《骨关节炎诊疗指南》解读[J].河北医科大学学报,2018,39(11):1241-1243.
[10] 燕铁斌.骨科康复评定与治疗技术[M].北京:人民军医出版社,2011:681.
[11] 曹袁嫒.心脏手术患者围麻醉期液体治疗的研究进展[J].心血管病学进展,2011,32(4):545-547.
[12] 马碧涛,金立伦,滕蔚然,等.急慢性膝骨关节炎的红外热像图特征及与VAS评分的相关性研究[J].中国中医骨伤科杂志,2017,25(2):28-31.
[13] 张钰敏,陈志伟,方晓明,等.火龙灸配合电针治疗寒湿型退行性膝骨关节炎临床观察[J].上海针灸杂志,2019,38(3):322-326.
[14] 涂雪松,刘晓安,胡利霞.温针灸治疗膝关节骨性关节炎的临床随机对照研究[J].针灸临床杂志,2016,32(6):38-40.
[15] 国家食品药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:349-353.
[16] 袁 芳,侯秀娟,刘小平,等.补益肝肾活血通络法治疗膝骨关节炎的理论探讨[J].中华中医药杂志,2016,31(3):891-893.
[17] 惠增龙,陈光明.补肾强筋汤治疗肝肾不足型膝骨关节炎临床研究[J].陕西中医,2018,39(9):1207-1209.
[18] 刘晓荣,许 彬,贾朋伟,等.活络止痛膏外敷联合微波治疗膝骨关节炎疗效观察[J].陕西中医,2015,36(7):861-862.
[19] 韦 尼,薛智丰,陈自佳,等.补肾通络颗粒对膝骨关节炎大鼠血清细胞因子及关节软骨含水率的影响[J].风湿病与关节炎,2015,4(10):5-9,38.
[20] 赵舟益,段 戡.从补肾蠲痹通络法论治中老年膝骨关节炎后期并骨质疏松症[J].中医临床研究,2017,9(29):23-25.
[21] 邢乃赞,和园园.补肾舒筋方联合玻璃酸钠腔内注射治疗对老年膝骨关节炎病情进程的影响[J].临床医学研究与实践,2016,1(19):64-65.
[22] 陈书文.99Tc-MDP联合乌头汤加味治疗类风湿性关节炎的疗效观察[J].中国医药导刊,2015,17(2):161-162.
[23] 张洪美,邱成新,尚 海,等.膝痹通方治疗膝骨关节炎临床疗效研究[J].辽宁中医药大学学报,2017,19(9):5-7.
[24] 刘素蓉,王继红,王 敏,等.补肾益脑汤治疗缺血性脑血管病100例临床分析[J].陕西医学杂志,2006,35(8):1013-1015.
[25] 许存庚.归芪活血胶囊联合硫酸氨基葡萄糖治疗颈椎病的临床疗效观察[J].世界中医药,2019,14(9):2313-2315.
[26] Rong Z,Cheng L,Ren Y,et al.Interleukin-17F signaling requires ubiquitination of interleukin-17 receptor via TRAF6[J].Cell Signal,2007,19(7):1514-1520.
[27] 李卫平,胥方元,蹇 睿,等.电针对实验性兔膝骨关节炎模型白细胞介素-1β和基质金属蛋白酶-13表达的影响[J].中国康复医学杂志,2013,28(2):139-142.
[28] 陈 琼,赵明才,陈 悦,等.姜黄素对骨关节炎软骨细胞增殖及分泌MMP-13、IL-6的影响[J].现代中西医结合杂志,2013,22(5):459-461.
[29] 侯亚平,陈太金.骨痹汤对膝骨关节炎患者滑液中MMP-13、IL-1、TNF-α、TIMP-1的影响[J].世界中医药,2012,7(6):488-490.
[30] 侯亚平.膝骨关节炎患者滑液中炎症因子的表达及其与中医证型的相关性分析[J].湖南中医药大学学报,2014,34(4):29-31.
[31] Singh A,Rajasekaran N,Hartenstein B,et al.Collagenase-3 deficiency protects C57BL/6 mice from antibody-induced arthritis[J].Arthritis Research & Therapy,2013,15(6):222.

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备注/Memo

备注/Memo:
基金项目:中央本级重大增减支项目(2060302); 首都卫生发展科研专项项目(2020-2-4161)
更新日期/Last Update: 2023-03-13