独活寄生汤联合除痹汤熏洗治疗KOA疗效的超声评价

摘要

目的 探讨独活寄生汤联合除痹汤熏洗治疗膝关节骨性关节炎(KOA)的临床疗效,及超声的效果评价.方法 将78例KOA患者随机分为联合组(39例)和对照组(39例).对照组给予除痹汤熏洗,联合组独活寄生汤联合除痹汤熏洗,疗程为8周.比较两组患者临床症状、中医症候、炎性因子改变.采用彩色多普勒超声观察治疗后膝关节病理及血流信号变化.结果 治疗后,联合组WOMAC评分、中医证候积分、CRP明显低于对照组(P<0.05).治疗后,两组滑膜厚度和关节腔积液高度均明显降低,而联合组的降低幅度均明显优于对照组(P<0.05).治疗后,联合组2~3级血流比例明显减少,且显著低于对照组(P<0.05).结论 独活寄生汤联合除痹汤熏洗治疗KOA患者可改善临床症状,控制炎症反应;超声技术可识别膝关节病理变化及血流信号改变,及时评估临床疗效.%Objective To explore the clinical effect of Duhuo jisheng decoction and Chubi decoction fumigation in treating knee osteoarthritis (KOA)by ultrasound. Methods 78 patients with KOA were randomly divided into combined group and control group. Control group(39 cases)was treated with Chubi Decoction fumigation,and combined group(39 cases)was treated with Duhuo jisheng decoction and Chubi decoction fumigation. The treatment course was 8 weeks in both groups. The changes of clinical symptoms,TCM symptoms and inflammatory factors were compared between the two groups. The change of pathology of knee joint and thrombus were observed by ultrasound. Results After treatment,the WOMAC score, TCM syndrome score,CRP in combined group were significantly lower than those in control group(P<0.05).After treatment,thickness of synovial membrane and height of articular cavity effusion in both groups were significantly reduced,and the margin in combined group were significantly better than that in control group(P<0.05). The proportion of blood flow of 2~3 grade in combined group was significantly reduced than before treatment, and significantly lower than that in control group(P<0.05). Conclusion Duhuo jisheng decoction and Chubi decoction fumigation can improve the clinical symptoms,control inflammatory response;ultrasound can contribute to evaluate pathological changes and blood flow changes,timely grasp the clinical curative effect.