关节镜有限清理术联合补肾壮骨汤治疗膝骨性关节炎疗效及对NO、 IL-1β、TGF-β1水平的影响

摘要

目的 探讨关节镜有限清理术联合补肾壮骨汤治疗膝骨性关节炎(KOA)疗效及对一氧化氮(NO)、白细胞介素lβ(IL-11β)、转化生长因子β1(TGF-β1)水平影响.方法 将96例KOA患者随机分为2组,对照组48例给予关节镜有限清理术治疗,研究组48例给予关节镜有限清理术联合补肾壮骨汤治疗,2组术后均持续治疗4周.记录2组治疗前后相关临床症状评分,比较2组临床疗效,检测2组治疗前后NO、IL-1β、TGF-B1水平,观察2组治疗期间不良反应发生情况.结果 治疗后,2组晨僵评分、膝关节疼痛评分、关节活动度评分和总评分均明显降低(P均＜0.05),且研究组均明显低于对照组(P均＜0.05);研究组治疗总有效率明显高于对照组(P＜0.05);2组NO、IL-1β水平均明显降低(P均＜0.05),TGF-β1水平均明显升高(P均＜0.05),且研究组NO、IL-1β及TGF-β1水平变化幅度均显著强于对照组(P均＜0.05);2组治疗期间均未发生明显不良反应.结论 关节镜有限清理术联合补肾壮骨汤治疗KOA可有效降低NO、IL-1β水平,升高TGF-β1水平,疗效显著,值得临床推广应用.%Objective It is to observe the effect of arthroscopic limited debridement combined with Bushen Zhuanggu decoction on knee osteoarthritis (KOA) and on the levels of NO,IL-1 β,TGF-β1.Methods 96 patients with KOA were randomly divided into control group (n =48) treated with arthroscopic limited debridement and study group (n =48) treated with arthroscopic limited debridement combined with Bushen Zhuanggu decoction.Both postreatment lasted for 4 weeks.The changes of correlated clinical symptoms,levels of NO,IL-1β,TGF-β1 before and after treatment were observed,curative effects were evaluated and side effects were recorded in both groups.Results After treatment,the scores of morning stiffness,knee join pain,joint motor degree and total scores were significantly decreased in both groups,and the decrease in study group was more significant (P ＜ 0.05).The total effective rate of study group was higher than that of control group (P ＜ 0.05).The levels of NO,IL-1β were lower while that of TGF-β1 was higher after treatment than that before treatment in both groups (P ＜ 0.05),and the decrease or increase in study group were more significant (P ＜ 0.05).No side effect was found during treatment in both groups.Conclusion Arthroscopic limited debridement combined with Bushen Zhuanggu decoction which could decrease the levels of NO and IL-1β and increase TGF-β1 has good curative effect on KOA and is worthy of application and popularization in clinic.