中药熏蒸联合鹿瓜多肽治疗老年急性膝骨关节炎患者的临床研究

摘要

目的 观察中药熏蒸联合鹿瓜多肽治疗老年急性膝骨关节炎(KOA)患者临床疗效及对血液流变性、血管内皮生长因子(VEGF)和膝关节功能的影响并探讨其作用机制. 方法 患者134例按照随机数字表法分为两组,均给予健康教育、饮食、运动等基础干预,在此基础上对照组给予鹿瓜多肽治疗,观察组在对照组基础上联合中药熏蒸治疗.观察两组中医证候积分、症状缓解时间、膝关节功能、临床疗效、血液流变学指标,同时检测VEGF水平. 结果 治疗后两组中医证候积分均低于治疗前(P＜0.05), 且观察组低于对照组(P＜0.05);观察组疼痛缓解时间、晨僵缓解时间、肿胀缓解时间均短于对照组(均P＜0.05);治疗后两组疼痛、功能、活动度、稳定性评分均高于治疗前(均P＜0.05),且观察组均高于对照组(均P＜0.05);观察组总有效率为94.03%,高于对照组的80.60%(P＜0.05);治疗后两组全血黏度高切值、纤维蛋白原、全血黏度低切值、血浆黏度均低于治疗前(均P＜0.05),且观察组均低于对照组(均P＜0.05);治疗后两组VEGF水平均低于治疗前(均P＜0.05),且观察组低于对照组(P＜0.05). 结论 中药熏蒸联合鹿瓜多肽可有效改善老年急性KOA患者血液流变学指标和膝关节功能,提高临床疗效.%Objective: To explore the influence of Chinese herbal fumiqation combined with cervus and cu-cumis polypeptide on clinical efficacy,hemorheoloqy,vascular endothelial qrowth factor (VEGF) and function of knee joint of elderly patients with acute knee osteoarthritis (KOA). Methods: 134 cases of elderly patients with KOA were divided into the observation qroup and the control qroup accordinq to random number table method. Both two qroups were qiven basic intervention such as health education,diet and exercise,on the basis of which, the control qroup were qiven cervus and cucumis polypeptide treatment,and the observation qroup were combined with Chinese herbal fumiqation on the basis of the control qroup. The control qroup were qiven routine nursinq in-tervention,and the observation qroup were qiven full featured rehabilitation nursinq of traditional Chinese medicine intervention on the basis of the control qroup. TCM syndrome scores,symptom relief time,knee function, clinical efficacy and hemorheoloqical indexes were observed,and VEGF level was detected in the two qroups. Re-sults: After treatment,TCM symptom scores were siqnificantly lower than those before treatment in the two qroups (P＜0.05),and those in the observation qroup were siqnificantly lower than those in the control qroup (P＜0.05). Pain relief time,remission time and relieve swellinq time of morninq stiffness of the observation qroup was siqnifi-cantly lower than that of the control qroup(P＜0.05). After treatment,the scores of pain,function,activity and sta-bility were siqnificantly hiqher than those before treatment in the two qroups(P＜ 0.05),and those in the observa-tion qroup were siqnificantly hiqher than those in the control qroup (P＜0.05). Total efficiency of the observation qroup was 94.03%,siqnificantly hiqher than that of the control qroup (80.60%)(P＜ 0.05). After treatment,whole blood viscosity at hiqh shear value of fibrinoqen,whole blood viscosity at low shear rate and plasma viscosity were siqnificantly lower than those before treatment (P＜0.05),and those in the observation qroup were siqnificantly lower than those in the control qroup(P＜0.05). After treatment,VEGF level was siqnificantly lower than that be-fore treatment in the two qroups (P＜0.05),and that in the observation qroup was siqnificantly lower than that in the control qroup(P＜0.05). Conclusion: Chinese herbal fumiqation combined with cervus and cucumis polypep-tide can effectively improve blood rheoloqy and knee function of elderly patients with acute KOA,and improve clinical efficacy.