宣痹汤治疗膝骨关节炎合并滑膜炎（湿热痹阻证）的临床观察

发布时间：2018-04-21 14:57

本文选题：宣痹汤 + 膝关节滑膜炎　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:观察宣痹汤治疗膝骨性关节炎合并滑膜炎的临床疗效,客观评价宣痹汤对膝关节滑膜炎(湿热痹阻型)的疗效,进一步临床推广应用。方法:将满足纳入标准的60名患者随机分为两组,治疗组与对照组各30例。治疗组口服宣痹汤,对照组口服滑膜炎颗粒,疗程8周。两组受试者接受药物治疗的同时,适当加强股四头肌肌力锻炼。治疗4周、8周分别记录两组患者症状体征评分、生化指标,观测不良反应及并发症,依据《中药新药临床研究指导原则》比较两组患者的症状、体征、生化指标、WOMAC总积分及整体功能,运用SPSS17.0软件进行统计学处理,评价总体疗效。结果:治疗4周、8周后两组WOMAC总评分改善率比较,评分均有显著减少,组间无明显差异(P0.05)。治疗4周治疗组有效率93.33%,控显率为16.70%,对照组有效率93.33%,控显率为20.00%,治疗组与对照组相比无显著性差异(P0.05)。治疗8周治疗组有效率93.33%,控显率为80.00%,对照组有效率96.67%,控显率为76.66%,两组比较无显著性差异(P0.05)。综合比较两组治疗结果,两组药物治疗膝骨性关节炎合并滑膜炎均有显著疗效。WOMAC评分三项比较:两组治疗4周、8周疼痛程度、僵硬程度、功能活动较治疗前均明显改善(P0.05),有显著性差异;治疗4周与8周疼痛、功能活动组间比较,有显著差异(P0.05),而僵硬程度比较无显著性差异(P0.05);两组疼痛程度、僵硬程度、功能活动在三个观察点组间比较,均无显著差异(P0.05)。肿胀程度比较:两组治疗4周、8周肿胀程度较治疗前均明显减轻(P0.05),有显著性差异;治疗4周、8周组内比较有显著差异(P0.05),组间比较无显著差异(P0.05)。说明两组药物均能明显缓解疼痛、减轻肿胀、改善膝关节僵硬及功能活动。结论:宣痹汤和滑膜炎颗粒治疗膝关节骨性关节炎合并滑膜炎(湿热痹阻型)均有较好疗效,有效控制膝关节肿胀、改善疼痛和僵硬程度,改善膝关节功能活动,提高患者生活质量,二者治疗滑膜炎疗效相当,值得临床推广应用。
[Abstract]:Objective: to observe the clinical effect of Xuanbi decoction in treating knee osteoarthritis with synovitis and evaluate the curative effect of Xuanbi decoction on knee joint synovitis (damp-heat arthralgia obstruction type). Methods: 60 patients who met the inclusion criteria were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was treated with Xuanbi decoction and the control group with synovitis granule for 8 weeks. Two groups of subjects received drug treatment, appropriate strengthening of quadriceps femoris muscle strength exercise. Symptoms and signs scores, biochemical indexes, adverse reactions and complications were recorded at 4 weeks and 8 weeks after treatment. The symptoms and signs of the two groups were compared according to the guiding principles of Clinical Research of New drugs of traditional Chinese Medicine. The total score and the whole function of the biochemical index WOMAC were analyzed by SPSS17.0 software to evaluate the overall curative effect. Results: after 4 weeks and 8 weeks of treatment, the improvement rate of total WOMAC score in the two groups was significantly reduced, and there was no significant difference between the two groups (P 0.05). In the treatment group, the effective rate was 93.33 and the control rate was 16.70. In the control group, the effective rate was 93.33 and the control rate was 20.00. There was no significant difference between the treatment group and the control group (P 0.05). The effective rate of the treatment group was 93.33 and the control rate was 80.00.The effective rate of the control group was 96.67 and the control rate was 76.666.There was no significant difference between the two groups (P 0.05). Compared with the results of two groups, the two groups had significant curative effect in treating knee osteoarthritis with synovitis. WOMAC scores were compared among three groups: pain degree and stiffness degree of the two groups were 4 weeks and 8 weeks after treatment. Compared with before treatment, there was a significant difference in functional activity between the four and eight weeks of treatment, but there was no significant difference in the degree of stiffness between the two groups, and the degree of pain and stiffness in the two groups were significantly higher than that in the control group (P < 0.05), but there was no significant difference between the two groups in the degree of pain and stiffness, and there was no significant difference between the two groups in the degree of pain, the degree of stiffness and the degree of stiffness. There was no significant difference in functional activities among the three observation points (P 0.05). Comparison of swelling degree: the swelling degree of the two groups was significantly reduced after 4 weeks and 8 weeks compared with that before treatment, and there was a significant difference between the two groups in 4 weeks and 8 weeks of treatment, and there was no significant difference between the two groups. The results showed that both groups could relieve pain, relieve swelling, improve knee stiffness and function. Conclusion: Xuanbi decoction and synovitis granule are effective in treating knee osteoarthritis with synovitis (damp-heat arthralgia obstruction type), which can effectively control the swelling of knee joint, improve the degree of pain and stiffness, and improve the function of knee joint. To improve the quality of life of patients, both treatment of synovitis is equivalent, worthy of clinical application.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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