Department of orthopedics, the First Affiliated Hospital of Anhui University of traditional Chinese medicine, Anhui Hefei China
杜藤颗粒综合玻璃酸钠关节注射对风寒湿痹型膝骨性关节炎临床疗效观察及炎症因子关联中药分析

摘要

目的 评价中药杜藤颗粒口服联合玻璃酸钠关节腔注射协同治疗膝骨性关节炎的临床效应，以 求在临床上治疗风寒湿痹型膝骨关节炎提供一定的理论支撑。方法 收集安徽中医药大学第一附属医院骨伤 科 2021.01-2021.12 病房及门诊病例 85 例，均为避免手术治疗转而寻求保守治疗方案者，随机分为两组，治 疗组 45 例，对照组 40 例，治疗组采用杜藤颗粒口服，250ml/次，一天两次（分别于早晚饭后半小时加热至 60 度服用），同时配合予以玻璃酸钠关节腔内注射 1 支/周，仅仅以玻璃酸钠关节腔内注射 1 支/周作为相关 对照，两组均为 5 周的疗程，经过干预前后的临床效应评分指标的变化，对比两组干预医治前后膝关节 VA S 评分，WOMAC 评分、Lysholm 评分的改变情况，并运用 Coremine Medical 医学检索平台输入已知进行 研究的相关基因，探索与杜藤颗粒中相关联系密切的中药。结果 两组患者治疗后 VAS、WOMAC、Lyshol m 评分、总有效率均较本组治疗前增高，且对照组较治疗组治疗后上述评分更低(P＜0.05);并且得到相关前 沿炎症因子当中与需要研究的方药当中紧密相关的中药分别是雷公藤、青风藤、三七。结论 杜藤颗粒口服 联合膝关节玻璃酸钠关节腔注射治疗膝骨性关节炎属风寒湿痹类证有较为确切的疗效。

Abstract

Objective: To provide some theoretical guidance and support for the clinical treatment of wind cold dampness arthritic knee osteoarthritis by traditional Chinese medicine in the future.
Methods: 85 cases of orthopedics and traumatology department of the First Affiliated Hospital of Anhui University of traditional Chinese medicine from January 2021 to December 2021 were collected. In order to avoid surgical treatment and seek conservative treatment, they were randomly divided into two groups, 45 cases in the treatment group and 40 cases in the control group. The treatment group was treated with Duteng Granulate orally,, combined with intra-articular injection of sodium hyaluronate , Only one intra-articular injection of sodium hyaluronate per week was used as the relevant control for 5-week course . The changes of clinical effect score indexes before and after the intervention were compared. The changes of knee VAS, WOMAC 、active range and Lysholm score before and after the intervention were compared.
Results: after treatment, VAS, WOMAC，active range and Lysholm score of the two groups were higher than those before treatment, and the above scores in the control group were lower than those in the treatment group (P ＜0.05);
Conclusion  : Duteng Granulate combined with intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis belongs to wind cold dampness arthralgia syndrome, which has a more definite curative effect.