摘要
研究背景：膝骨性关节炎(osteoarthritis,OA)是一种以膝关节软骨退行性变和关节周围骨质增生为病理性特征的慢性进行性骨关节病,临床以关节疼痛、肿胀、僵硬及功能障碍等为主要表现,从而给患者带来了生活和工作上的诸多不便,严重影响生活质量。随着人口老龄化程度的加剧,OA发病率也呈逐年上升趋势。祖国医学多将其归属于“骨痹”,近些年来无论是中医还是现代医学在该疾病的理论和临床方面均进行了较为深入的研究。目前,西药的治疗效果一般,且副作用较多,花费巨大,给患者带来了精神和经济负担。中医药治疗本病疗效较为显著,且无明显毒副作用,费用低廉,在临床上受到广大患者欢迎。
目的：本临床研究旨在通过运用“康膝汤”治疗膝骨关节炎,经对比观察,探讨“康膝汤”在临床上对膝骨关节炎的疗效。
方法：选择因膝OA至江苏省中西医结合医院骨伤科门诊就诊的病人42例。将42例患者分为治疗组(康膝汤组)22例和对照组(西药组)20例。运用疼痛视觉模拟量表(VAS)与膝骨性关节炎严重性指数(Lequesne),观察治疗前后疼痛及临床疗效。
结果：Lequesne评分,治疗组有效16例,无效6例,总有效率72.73%；对照组有效18例,无效2例,总有效率90%,两组在改善临床疗效上无明显差异(P>0.05)。VAS评分,治疗组显效3例,有效9例,无效10例,总有效率54.55%；对照组显效11例,有效7例,无效2例,总有效率90%,治疗组与对照组在减轻疼痛程度上差异有显著统计意义(P<0.01)。
结论：“康膝汤”及西药(西乐葆+留普安)在改善膝OA患者疼痛及临床症状方面均有显著疗效；但西药在控制患者膝关节疼痛方面优于“康膝汤”。
Background:Knee osteoarthritis is chronic progressive joint disease for pathological features of knee cartilage degeneration and joint surrounding bone hyperplasia.Its main clinical performance is joint pain, swelling stiff and dysfunction,and it brings patients the inconvenience of life and work, even affects the quality of life seriously.With the degree of population aging increasing,incidence of osteoarthritisincreased year by year.Traditional chinese medicine attributed the disease mainly to "Gubi'In recent years,Both Chinese medicine and modern medicine have conducted more thorough research in the aspects theory and clinical of disease.Currently,Treatment of western medicine is not effective as will,meanwhile accompanied by sorts of side effects and mass of cost, gave patients has brought the spirit and economic burden,bringing about mental and economic burden. Chinese medicine treatment is more efficacious in this disease,with no obvious side effects and low-cost, is welcomed by the majority of patients in clinical.
Objective:This clinical research was designed to treat osteoarthritis by the use of "Kang Xi Tang",through contrast observation,to explore its curative effect of knee osteoarthritis.
Methods:42 patients from Jiangsu Province Hospital on Integration of Chinese and Western Medicine are divided into treatment group (Kang Xi Tang)with 22 cases and the control group (western medicine) with 20 cases.To observe pain and clinical efficacy before and after treatment by the use of visual analogue scale(VAS) score and Lequesne knee score.
Result:Lequesne knee score,16 cases effective and 6 cases non-effective in treatment group,the total effective rate is 72.73%;in the control group,the treatment produces 18 cases effective and 2 cases non-effective,the total effective rate is 90%.In comparision,there is no significant difference in imporving the clinical efficacy(P>0.05).VAS score,3 cases significantly effective,9 cases effective and 10 cases non-effective in treatment group,the total effective rate is 54.55%; 11 cases significantly effective,7. cases effective and 2 cases non-effective in the control group,the total effective rate is 90%.In comparision,there is no significant difference in imporving the clinical efficacy(P>0.05).In comparision,there is a significant difference in relieving pain(P<0.01).
Conclusion:Both "Kang Xi Tang" and western medicine(Celebrex and Liupuan) have a significant effect on relieving pain and imporving clinical symptoms for patients with knee OA.However,western medicine produces better efficacy than "Kang Xi Tang" on the knee pain of patients.
引文
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