作　　者： (袁家骏）; (罗程）; (黄毅）; (刘魏）; (张舟）; (丁谷渊）; (肖鲁伟）; (童培建）;

机构地区： 浙江中医药大学,浙江杭州310053

出　　处： 《中医正骨》 2017年第8期26-32,共7页

摘　　要： 目的:观察口服自拟补肾活血汤治疗早期膝骨关节炎的临床疗效。方法:将70例早期膝骨关节炎患者随机分为2组,每组35例,分别采用口服自拟补肾活血汤和塞来昔布胶囊治疗。自拟补肾活血汤口服每日1剂,早晚服用;塞来昔布胶囊口服每日1次,每次200 mg,餐后服用;15 d为1个疗程,共6个疗程。分别于治疗前、治疗1个月后及治疗3个月后,记录并比较2组患者膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国膝关节协会评分(American knee society score,KSS)、膝关节软骨T2值以及血清蛋白聚糖和血清Ⅱ型胶原的表达量。结果:(1)膝关节疼痛VAS评分。时间因素和分组因素存在交互效应(F=14.564,P=0.001);2组患者膝关节疼痛VAS评分总体比较,组间差异有统计学意义,即存在分组效应(F=17.326,P=0.000);治疗前后不同时间点间膝关节疼痛VAS评分的差异有统计学意义,即存在时间效应(F=89.267,P=0.000);2组患者膝关节疼痛VAS评分随时间均呈降低趋势(F=80.933,P=0.000;F=25.824,P=0.000),但2组的降低趋势不完全一致;治疗前2组患者膝关节疼痛VAS评分的组间差异无统计学意义[(5.46±0.82)分,(5.57±0.95)分,t=-0.836,P=0.859];治疗1个月后、治疗3个月后补肾活血汤组膝关节疼痛VAS评分均低于塞来昔布胶囊组[(3.74±0.95)分,(4.34±0.94)分,t=-2.149,P=0.019;(1.94±0.97)分,(3.11±1.16)分,t=-4.385,P=0.000]。(2)KSS评分。时间因素和分组因素存在交互效应(F=13.453,P=0.006);2组患者KSS评分总体比较,组间差异有统计学意义,即存在分组效应(F=18.536,P=0.000);治疗前后不同时间点间KSS评分的差异有统计学意义,即存在时间效应(F=64.329,P=0.000);2组患者KSS评分随时间均呈增高趋势(F=75.632,P=0.000;F=16.738,P=0.000),但2组的增高趋势不完全一致;治疗前2组患者KSS评分的组间差异无统计学意义[(55.91±5.68)分,(53.29±7.12)分,t=1.152,P=0.653)];治疗1个月后、治疗3个月后补肾活血� Objective：To observe the clinical curative effects of oral application of self-made Bushen Huoxue Tang （补肾活血汤, BSHXT） for the treatment of early knee osteoarthritis （KOA）. Methods：Seventy patients with early KOA were randomly divided into 2 groups ,35 cases in each group. The patients were treated with oral application of self-made BSHXT（ group A）and celecoxib capsules（ group B） respectively. The self-made BSHXT was taken one dose a day in the morning and evening, and the celecoxib capsules were taken once a day for 200 mg at a time after meals for consecutive 6 courses of treatment, 15 days for each course. The knee pain visual analogue scale （ VAS ） scores, American knee society scores （KSS） , T2 values of knee articular cartilage and the expression of serum proteoglycans and ser- um collagen type II were recorded and compared between the 2 groups before the treatment and after 1 - and 3 - month treatment respec- tively. Results： There was interaction between time factor and group factor in knee pain VAS scores （ F = 14. 564, P = 0. 001 ）. There was statistical difference in knee pain VAS scores between the 2 groups in general, in other words, there was group effect （F = 17. 326, P = 0.000）. There was statistical difference in knee pain VAS scores between different timepoints before and after treatment, in other words, there was time effect（ F=89. 267 ,P = 0. 000）. The knee pain VAS scores presented a time -dependent decreasing trend in both of the 2 groups （ F = 80. 933, P = 0. 000 ; F = 25. 824, P = 0. 000 ） , while the 2 groups were inconsistent with each other in the decreasing trend of knee pain VAS scores. There was no statistical difference in knee pain VAS scores between the 2 groups before the treatment （5.46 ＋/- 0.82 vs 5.57 ＋/- 0. 95 points,t = - 0. 836,P = 0. 859）. The knee pain VAS scores were lower in group A compared to group B after 1 - and 3 -month treatment（3.74 ＋/-0.95 vs 4.34 ＋/-0.94 points,t = -2. 149,P =0. 019;1.94 ＋/

关 键 词： 骨关节炎 膝 中药疗法 补肾活血汤 蛋白聚糖类 胶原 型 临床试验