独活寄生汤治疗肝肾亏虚型膝骨关节炎的临床效果观察

摘要

Objective To analyze the clinical effect of Duhuo Jisheng decoction on knee osteoarthritis (KOA) with deficiency of liver and kidney.Methods A total of 42 patients with KOA from November 2013 to November 2015 in Renmin Hospital,Hubei University of Medicine were randomly divided into control group(n =20) and observation group (n =22).The control group took glucosamine hydrochloride capsule 0.75 g/time,2 times/d;the observation group had Duhuo Jisheng decoction for oral medication (1 dose/d,twice a day in morning and evening) and fumigation.Therapeutic effect was evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analogue Scale (VAS) after 12 weeks of treatment.The content of interleukin-1 (IL-1) in knee synovial fluid was determined by radioimmunoassay.Results WOMAC score,VAS score and IL-1 level had no significant differences between groups before treatment (P ＞ 0.05).WOMAC score,VAS score and IL-1 level were significantly decreased after treatment in both groups [control group:(34 ±7)scores vs (42 ±9) scores,(2.1 ± 1.3)scores vs (4.2 ± 1.7) scores,(386 ±40)ng/L vs (472 ± 47)ng/L;observation group:(26 ± 7) scores vs (42 ± 9) scores,(1.7 ± 1.1) scores vs (4.1 ± 1.9) scores,(316 ± 31) ng/L vs (469 ± 48) ng/L] (P ＜ 0.05).WOMAC score,VAS score and IL-1 level after treatment in observation group were significantly lower than those in control group (P ＜ 0.05).Conclusion Duhuo Jisheng decoction has good curative effect on knee osteoarthritis with deficiency of liver and kidney;it can alleviate symptoms and reduce level of IL-1 in synovial fluid.%目的 观察独活寄生汤治疗肝肾亏虚型膝骨关节炎(KOA)的临床效果.方法 选取2013年11月至2015年11月湖北医药学院附属人民医院骨关节外科收治的KOA患者42例,采用简单随机分组方法将患者分为对照组(20例)和观察组(22例);对照组口服盐酸氨基葡萄糖胶囊(0.75 g/次,2 次/d);观察组服用独活寄生汤(1剂/d,分早晚2次服)并取药渣再次煎煮熏洗患膝;2组均持续治疗12周.于治疗前后采用美国西部Ontario和McMaster大学骨关节炎指数(WOMAC)和疼痛视觉模拟量表(VAS)进行疗效评价.于治疗前后穿刺抽取膝关节液2ml,采用放射免疫法测定白细胞介素1(IL-1)含量.结果 治疗前2组WOMAC评分、VAS评分、关节液IL-1含量比较差异无统计学意义(均P＞0.05).治疗后2组WOMAC评分、VAS评分、关节液中IL-1含量均较治疗前明显下降[对照组:(34±7)分比(42±9)分、(2.1±1.3)分比(4.2±1.7)分、(386±40) ng/L比(472±47) ng/L,观察组:(26±7)分比(42±9)分、(1.7±1.1)分比(4.1±1.9)分、(316±31) ng/L比(469±48) ng/L],且观察组明显低于对照组,差异均有统计学意义(均P＜O.05).结论 独活寄生汤治疗肝肾亏虚型KOA效果较好,可有效改善患者症状并降低关节液中IL-1的含量.