玻璃酸钠关节腔注射配合口服独活寄生汤方治疗膝关节骨性关节炎的临床研究

发布时间：2018-06-28 11:32

本文选题：独活寄生汤 + 膝关节骨性关节炎　；参考：《安徽中医药大学》2015年硕士论文

【摘要】：目的:通过观察玻璃酸钠关节腔注射配合口服独活寄生汤在治疗膝关节骨性关节炎患者治疗前后及随访半年的关节功能评分,探讨玻璃酸钠关节腔注射和独活寄生口服在治疗膝骨关节炎的机制。方法:依据标准选取患者75例,年龄在41岁至70岁之间,均行膝关节正侧位片,显示关节间隙有不同程度狭窄,胫骨髁、股骨髁、髌骨有不同程度增生,抽血查类风湿性因子,为阴性,关节疼痛症状较重,上下楼、运动后症状加重,均诊断为膝关节骨性关节炎。结合症状体征,未达手术指标,患者要求行保守治疗。将患者随机分为治疗组和对照组I与对照组II,每组各25例,治疗组予以玻璃酸钠(玻璃酸钠注射液采用山东博士伦福瑞达制药有限公司生产,商品名为施沛特)关节腔注射和口服独活寄生汤,对照组I为单纯玻璃酸钠关节腔注射,对照组II为单纯口服独活寄生汤。玻璃酸钠注射方法为每周1次,连用5周为一个疗程。独活寄生汤(独活9g,其余中草药饮片各6g,由安徽中医药大学第一附属医院药剂室制备)的服用方法是每日1剂,水煎取汁,每次饭后半小时温服,每日两次。连续服用35天,为一疗程。两组方法于治疗前后及治疗半年后记录患者的膝关节疼痛感觉,日本骨科协会评分及关节运动功能,对所观察的结果进行比较、分析。结果:1.三组患者治疗前膝关节疼痛程度、性别、年龄等具有随机性,经配对t检验后,无显著差异(P0.05);2.三组患者治疗后及治疗半年后,关节疼痛症状皆好于治疗前,关节活动情况也好于治疗前,有显著性差异(P0.01或P0.05),从而表明三种治疗方法均能治疗膝关节骨性骨关节炎,但玻璃酸钠关节腔注射配合独活寄生汤和其它两组相比,明显优于其它两组,对膝关节骨性关节炎的治疗更有临床意义;3.治疗组接受治疗后及半年随访,关节活动度及关节疼痛情况明显好于对照组I和对照组II(P0.01或P0.05)。结论:玻璃酸钠关节腔注射配合独活寄生汤对改善膝关节骨性关节炎患者的症状具有明显效果,无明显不良反应,患者关节疼痛症状消失或减轻,关节活动正常,且此安全、有效、价格经济、治疗方便,值得临床选用。
[Abstract]:Objective: to observe the joint function scores of patients with knee osteoarthritis before and after treatment with sodium hyaluronate injection and oral Duhuozheng decoction for half a year. To investigate the mechanism of sodium hyaluronate injection and oral parasitism in the treatment of knee osteoarthritis. Methods: 75 patients, aged from 41 to 70 years old, were selected according to the standard. All the patients underwent anterior and lateral knee joint radiographs. The results showed that the joint space was narrow, tibial condyle, femoral condyle and patella were proliferated in different degrees. All of them were diagnosed as osteoarthritis of knee joint. Combined with symptoms and signs, the patients did not reach the surgical targets, patients required conservative treatment. The patients were randomly divided into treatment group (n = 25), control group (n = 25) and control group (n = 25). The treatment group was treated with sodium hyaluronate (sodium hyaluronate injection). The commercial name is Shipeite) the articular cavity injection and the oral Duhuozheng decoction, the control group I is the simple hyaluronate sodium joint cavity injection, the control group II is the simple oral Duhuozhongtang. Sodium hyaluronate was injected once a week for 5 weeks as a course of treatment. Duhuo parasitic decoction (Duhuo 9g, other Chinese herbal medicines 6g each, prepared by the pharmacy room of the first affiliated Hospital of Anhui University of traditional Chinese Medicine) is taken 1 dose per day, decoction, half an hour after each meal, two times a day. Take it continuously for 35 days as a course of treatment. The knee joint pain, the score of Japanese Orthopedic Association and the function of joint movement were recorded before and after treatment and half a year after treatment. The results were compared and analyzed. The result is 1: 1. The degree of knee joint pain, sex, age and so on were random before treatment in the three groups. There was no significant difference after paired t test (P0.05). After treatment and half a year after treatment, the symptoms of joint pain in the three groups were better than those before treatment, and the joint motion was better than that before treatment (P0.01 or P0.05), which indicated that all the three treatments could treat osteoarthritis of knee joint. But the injection of sodium hyaluronate and Duhuozheng decoction were better than the other two groups, and the treatment of osteoarthritis of knee joint had more clinical significance. After treatment and half a year follow-up, the joint motion and joint pain in the treatment group were significantly better than those in the control group I and control group II (P0.01 or P0.05). Effective, economical price, convenient treatment, worthy of clinical selection.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R684.3

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