自拟熏洗方联合关节腔内透明质酸钠注射治疗膝关节骨性关节炎的疗效观察

摘要

Objective To observe the effect of the treatment on Knee Osteoarthritis by intra-articular injection of HA and oneself Steaming and Washing of Chinese herbal,and the influence on Inflammatory cytokines in the synovial fluid.Methods 80 patients with Knee Osteoarthritis from January 2012 to June 2013 in our hospital were randomly divided into 2 group ,each group has 40 cases.The Control group was given intrarticular sodium hyaluronate injection,and the observation group was given steaming and washing of Chinese herbal on the basis of the Control group for 6 weeks.The VAS score and Lequesne score were assessed,and the TNF-a and IL-6 of synovial fluid were detected.The Clinical efficacy were judged after treatment.Results the Lequesne score,VAS score, TNF-a,IL-6 of the observation group and the control group after treatment were significantly lower than those before treatment(P<0.05),the Lequesne score,VAS score,TNF-a,IL-6 of the observation group after treatment were significantly lower than the control group(P<0.05).The Clinical efficacy of the observation group and the control group were 95%and 75%. the Clinical efficacy of the observation group was significantly higher than the control group(χ2=10.278,P<0.05).Conclusion The treatment can directly target lesion onset synergies,enhance the effect of pain relief and functional recovery by intra-articular injection of HA and oneself Steaming and Washing of Chinese herbal.It is an ideal method for treating Knee Osteoarthritis,and its mechanism may be related to regulating the synovial fluid levels of inflammatory mediators,inhibiting the inflammatory response.%目的：观察自拟熏洗方联合关节腔内透明质酸钠注射治疗膝关节骨性关节炎的临床疗效及对关节液内炎症因子水平的影响。方法将2012年1月～2013年6月收治的80例膝关节骨性关节炎患者随机分为2组，每组各40例，对照组单纯关节腔内注射透明质酸钠治疗，观察组在对照组基础上再给予自拟熏洗方治疗，连用6周，治疗前后进行VAS评分、Lequesne评分，检测关节液中TNF-a及IL-6水平，评价两组临床疗效。结果观察组和对照组治疗后Lequesne评分、VAS评分、TNF-a、IL-6均较治疗前明显降低（P均＜0.05），观察组治疗后Lequesne评分、VAS评分、TNF-a、IL-6明显低于对照组（P均＜0.05）；观察组和对照组临床总有效率分别为95%和75%，观察组总有效率显著高于对照组（χ2＝10.278，P＜0.05）。结论中药熏洗联合关节腔内透明质酸钠注射能够直接针对患处协同起效，增强疼痛缓解与关节功能恢复效果，是治疗膝关节骨性关节炎的理想方法，其作用机制可能与其调节关节液中炎症介质水平，抑制炎性反应有关。