综合性医院中医正骨科膝关节骨关节炎患者门诊治疗情况调查分析
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摘要
目的:分析综合性医院中医正骨科膝关节骨关节炎门诊治疗现状,为规范膝关节骨关节炎综合性医院的中西医结合治疗提供参考。方法:收集在广东省人民医院中医正骨科门诊就诊的膝关节骨关节炎患者的临床资料,对治疗资料进行统计学分析。结果:274例膝关节骨关节炎患者中95.62%接受了健康教育,89.42%受到运动指导,51.46%建议控制体重,10.58%建议行动辅助。症状改善药中口服非甾体抗炎药(NSAIDs)使用率为34.31%,关节腔注射玻璃酸钠使用率为25.18%。病情改善药物中,口服氨基酸葡萄糖的使用率为55.11%,口服活性维生素D使用率为24.09%。内服中成药使用率为52.92%,中药汤剂使用率为3.28%,院内制剂中药软膏外敷为37.96%。结论:该综合性医院中医正骨科门诊注重膝关节骨关节炎非药物治疗方法;症状改善药以口服NSAIDs为主,病情改善药主要为口服氨基酸葡萄糖;口服中成药和外用院内制剂中药软膏是主要中医药治疗方式,体现了中西医结合的治疗特点。
Objective: To analyze the current situation of KOA outpatient treatment in traditional Chinese medicine(TCM) orthopaedics department of general hospital, and to provide reference for standardizing the integration of traditional Chinese and Western medicine for the treatment of KOA. Methods: The clinical data of KOA patients in TCM orthopaedics department of Guangdong general hospital, were collected and statistical analyzed. Results : In 274 patients with KOA, 95.62% received health education; 89.42% received exercise guidance; 51.46% recommended weight control, and 10.58% suggested action assistance. The most commonly used symptoms improved drug were oral non steroidal anti-inflammatory drugs(NSAIDs)(34.31%); intra-articular injection of sodium hyaluronate was 25.18%. In disease-modifying osteoarthritis drug, the use rate of glucosamine was 55.11% and oral active vitamin D was 24.09%. The use rate of Chinese patent medicine was 52.92%, and only 3.28% of TCM decoction. The external application of TCM ointment of hospital preparation was 37.96%.Conclusion: The treatment of general hospital TCM orthopedics KOA outpatient focuses on non drug therapy;The main symptom improvement drug was oral NSAIDs. The main drug for improvement is oral GS. Oral Chinese patent medicine and external application of Chinese medicine ointment are traditional Chinese medicine treatment. It embodies the characteristics of the integration of traditional Chinese and Western medicine.
Objective: To analyze the current situation of KOA outpatient treatment in traditional Chinese medicine(TCM) orthopaedics department of general hospital, and to provide reference for standardizing the integration of traditional Chinese and Western medicine for the treatment of KOA. Methods: The clinical data of KOA patients in TCM orthopaedics department of Guangdong general hospital, were collected and statistical analyzed. Results : In 274 patients with KOA, 95.62% received health education; 89.42% received exercise guidance; 51.46% recommended weight control, and 10.58% suggested action assistance. The most commonly used symptoms improved drug were oral non steroidal anti-inflammatory drugs(NSAIDs)(34.31%); intra-articular injection of sodium hyaluronate was 25.18%. In disease-modifying osteoarthritis drug, the use rate of glucosamine was 55.11% and oral active vitamin D was 24.09%. The use rate of Chinese patent medicine was 52.92%, and only 3.28% of TCM decoction. The external application of TCM ointment of hospital preparation was 37.96%.Conclusion: The treatment of general hospital TCM orthopedics KOA outpatient focuses on non drug therapy;The main symptom improvement drug was oral NSAIDs. The main drug for improvement is oral GS. Oral Chinese patent medicine and external application of Chinese medicine ointment are traditional Chinese medicine treatment. It embodies the characteristics of the integration of traditional Chinese and Western medicine.
引文
[1]薛庆云,王坤正,裴福兴,等.中国40岁以上人群原发性骨关节炎患病状况调查[J].中华骨科杂志,2015,35(12):1206-1212.
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[4]郑双,徐建华,黄淑婷,等.某综合性医院148例膝骨关节炎就医及治疗现状分析[J].中华疾病控制杂志,2015,19(1):91-92,106.
[5]Botting R M.Vane’s discovery of the mechanism of action ofaspirin changed our understanding of its clinical pharmacology[J].Pharmacol Rep,2010,62(3):518-525.
[6]Shivaprakash G P,Pallavi L.Unlocking the mystery of paracetamolme chanism of action and existance of cox-3-A review[J].Int JUnivers Pharm Bio Scie,2013,2(6):317-324.
[7]Bruyere O,Pavelka K,Rovati L C,et al.Total jointreplacement after glucosamine sulphate treatment in knee osteoarthritis:results of a mean 8-year observation of patientsfrom two previous 3-year,randomised,placebo-controlled trials[J].Osteoarthritis Cartilage,2008,16(2):254-260.
[8]Chaganti R K,Parimi N,Cawthon P,et al.Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men:the osteoporotic fractures in men study[J].Arthritis Rheum,2010,62(2):511-514.
[9]Mc Alindon T E,Felson D T,Zhang Y,et al.Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study[J].Ann Intern Med,1996,125(5):353-359.
[2]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6)∶416-419.
[3]杨艺,李志昌,林剑浩,等.从门诊处方看骨关节炎指南的现实意义[J].北京大学学报(医学版),2013,45(2):255-259.
[4]郑双,徐建华,黄淑婷,等.某综合性医院148例膝骨关节炎就医及治疗现状分析[J].中华疾病控制杂志,2015,19(1):91-92,106.
[5]Botting R M.Vane’s discovery of the mechanism of action ofaspirin changed our understanding of its clinical pharmacology[J].Pharmacol Rep,2010,62(3):518-525.
[6]Shivaprakash G P,Pallavi L.Unlocking the mystery of paracetamolme chanism of action and existance of cox-3-A review[J].Int JUnivers Pharm Bio Scie,2013,2(6):317-324.
[7]Bruyere O,Pavelka K,Rovati L C,et al.Total jointreplacement after glucosamine sulphate treatment in knee osteoarthritis:results of a mean 8-year observation of patientsfrom two previous 3-year,randomised,placebo-controlled trials[J].Osteoarthritis Cartilage,2008,16(2):254-260.
[8]Chaganti R K,Parimi N,Cawthon P,et al.Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men:the osteoporotic fractures in men study[J].Arthritis Rheum,2010,62(2):511-514.
[9]Mc Alindon T E,Felson D T,Zhang Y,et al.Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study[J].Ann Intern Med,1996,125(5):353-359.