中药综合疗法治疗膝关节骨性关节炎的临床观察
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摘要
目的:目前骨性关节炎的发病率逐年增高,在我国50岁以上人群中,骨性关节炎的患病率仅次于心血管疾病,位居第二位,且由于中国人口老龄化的到来,这个趋势仍将持续。膝关节骨性关节炎可给患者带来生活和工作上的不便,严重影响生存质量,但目前却没有较理想的治疗手段。因此探寻一种有效、简便、安全、经济的膝关节骨性关节炎治疗方法是必要的。通过中西医结合的临床对比观察研究,比较骨性关节炎患者采用中药综合疗法(中药汤剂口服+中药熏洗)和采用口服西药乐松(洛索洛芬钠片),局部涂擦辣椒碱软膏的临床疗效及安全性。
方法:全部病例均来自湖北省中医院骨科门诊,采集时间自2006年3月至2007年9月,根据病例纳入标准和病例排除标准,选择66膝关节骨性关节炎患者。随机平均分成治疗组和对照组,经统计学处理,两组患者年龄、性别、病情分布等无显著性差异,具有可比性。治疗组患者采用中药综合疗法(中药汤剂口服+中药熏洗),每日一剂。对照组患者口服西药乐松(洛索洛芬钠片),60mg/次,局部适量涂擦辣椒碱软膏,每日三次。两组患者均配合功能锻炼:鼓励患者作股四头肌锻炼。每次收缩3秒,然后放松,每次锻炼20分钟,每日3次。3周为1疗程,随诊时间3-6月,记录和比较治疗组及对照组患者膝关节症状的改善情况,数据采用SPSS10.0统计软件进行统计分析。
结果:治疗组与对照组治疗后各项指标均有明显的改善,治疗前后差异明显(P＜0.01)。其中治疗组33例患者中,控显率为57.58%,总有效率为93.94%;对照组33例患者中,控显率为24.24%,总有效率为72.72%。两组总疗效经统计学处理P＜0.05,具有显著性差异。治疗组疗后症状积分较前减少,经统计学处理P＜0.01,有显著性差异;对照组疗后症状较前较少,经统计学处理P＜0.01,有显著性差异;治疗后两组症状积分差值比较经统计学处理P＜0.01,有显著性差异,可认为治疗组治疗效果明显优于对照组。因此,中药综合疗法对治疗膝关节骨性关节炎疾病疗效更确切,与口服西药乐松,局部涂擦辣椒碱软膏相比疗效更明显,值得临床应用。其中休息疼痛、关节灼热、皮色发红、站立帮助、最大行走距离、走不平路,两组治疗后相比无明显差异(P＞0.05),而晨僵、关节压痛、下蹲困难等症状体征,两组间比较有显著性差异(P＜0.05),其中行走疼痛、关节肿胀以及上下阶梯组间比较具有极显著性差异(P＜0.01)。两组病例治疗后用药安全性相比差异无统计学意义。
结论:中药综合疗法对治疗膝关节骨性关节炎疾病疗效确切,与口服西药乐松相比疗效更明显,值得临床应用。但本组病例数略少,在反映结果的准确性及全面性上存在一定局限,仍需进一步探讨研究。
Objective:
At present, the incidence rate of osseous arthritis's disease advances year by year . Above 50 years old in the crowd, the osseous arthritis's prevalence rate is only inferior to the cardiovascular disease, is situated second in China, And as a result of China aging of population's arrival, this tendency will still continue. Knee joint osseous arthritis may bring inconvenient to the patient in the life and work, serious influence survival quality, But there is not a good way to deal it now .So it is necessary to find a kind effective, simple, security, economical way to treatment it. Through clinical contrast research with combination therapy of traditional Chinese medicine and western medicine, To contrast the clinical effect and safety of traditional Chinese medicine composite treatment with western medicine-Loxoprofen Sodium Tablets and Capsaicin Ointment.
Methods:
According to the standard of internalizing and depletion, select 66cases of Knee joint osseous arthritis patient, all of the cases from 2006.3-2007.9 in the Chinese medicine hospital of Hubei Province were divided into the treatment group and the control group randomly. After statistics processing, two groups of patient ages, the sex, the condition distribute the non-significance difference, has the commensurability. The treatment group was treated with traditional Chinese medicine composite treatment (The traditional Chinese medicine decoction oral administration, the traditional Chinese medicine smoke wash) Every day medicinal preparation The control group was treated with western medicine-Loxoprofen Sodium Tablets and Capsaicin Ointment. (60mg/time, daily three times). Two groups of patients coordinate the function exercise: Encourages the patient to make quadriceps femoris exercise. Each time contracts for 3 seconds, then the relaxation, each time exercises 20 minutes, daily 3 times The course of two groups were 3 weeks. The period of follow-up was between 3 months and 6 months. Recorded and compared the improvement of the treatment function. The statistical analysis was performed by SPSS 10.0.
Result:
Every index was improved obviously in the treatment group and the control group in both groups after the treatment with a significant difference (P<0.01) . And in the treatment group 33 example patients, controls obviously leads is 57.58%, the total effective rate is 93.94%; In the control group 33 example patients, controls obviously leads is 24.24%, the total effective rate is 72.72%. After statistics processing, two groups of Effectiveness distribute the significance differences. After the treatment group cures, before the symptom integral reduces, processes P<0.01 after statistics, has the significance difference; After the control group cures, before the symptom, are few, processes P<0.05 after statistics, has the significance difference; Treats the latter two group of symptom integral differential value comparison to process P<0.01 after statistics, has the significance difference, may think that the treatment group surpasses the control group obviously. So the traditional Chinese medicine composite treatment is more effective in treating OA than the treatment of western medicine-Loxoprofen Sodium Tablets and Capsaicin Ointment. And the rest ache ,Joint aestus, rubor, stands the help, to walk most greatly is away from, does not take the level road, after two groups treat, compares not obvious difference (P>0.05), But the early morning stiff and ladders as well as under squats symptom symptoms and so on difficulty, two groups of comparisons have the significance difference (P <0.05), Walking ache, the arthrocele and the high and low steps have the extremely significance difference (P<0.01)berween the two groups. And the two cases of drug safety after treatment compared to the difference was not statistically significant
Conclusion:
The traditional Chinese medicine composite treatment to treats the knee joint osseous arthritis disease curative effect to be accurate, compares the curative effect with the oral administration western medicine happy pine to be more obvious, is worth the clinical practice. However, the number of cases in this group slightly less, to reflect the results of the accuracy and comprehensiveness, there are certain limitations, need to explore further study
方法:全部病例均来自湖北省中医院骨科门诊,采集时间自2006年3月至2007年9月,根据病例纳入标准和病例排除标准,选择66膝关节骨性关节炎患者。随机平均分成治疗组和对照组,经统计学处理,两组患者年龄、性别、病情分布等无显著性差异,具有可比性。治疗组患者采用中药综合疗法(中药汤剂口服+中药熏洗),每日一剂。对照组患者口服西药乐松(洛索洛芬钠片),60mg/次,局部适量涂擦辣椒碱软膏,每日三次。两组患者均配合功能锻炼:鼓励患者作股四头肌锻炼。每次收缩3秒,然后放松,每次锻炼20分钟,每日3次。3周为1疗程,随诊时间3-6月,记录和比较治疗组及对照组患者膝关节症状的改善情况,数据采用SPSS10.0统计软件进行统计分析。
结果:治疗组与对照组治疗后各项指标均有明显的改善,治疗前后差异明显(P＜0.01)。其中治疗组33例患者中,控显率为57.58%,总有效率为93.94%;对照组33例患者中,控显率为24.24%,总有效率为72.72%。两组总疗效经统计学处理P＜0.05,具有显著性差异。治疗组疗后症状积分较前减少,经统计学处理P＜0.01,有显著性差异;对照组疗后症状较前较少,经统计学处理P＜0.01,有显著性差异;治疗后两组症状积分差值比较经统计学处理P＜0.01,有显著性差异,可认为治疗组治疗效果明显优于对照组。因此,中药综合疗法对治疗膝关节骨性关节炎疾病疗效更确切,与口服西药乐松,局部涂擦辣椒碱软膏相比疗效更明显,值得临床应用。其中休息疼痛、关节灼热、皮色发红、站立帮助、最大行走距离、走不平路,两组治疗后相比无明显差异(P＞0.05),而晨僵、关节压痛、下蹲困难等症状体征,两组间比较有显著性差异(P＜0.05),其中行走疼痛、关节肿胀以及上下阶梯组间比较具有极显著性差异(P＜0.01)。两组病例治疗后用药安全性相比差异无统计学意义。
结论:中药综合疗法对治疗膝关节骨性关节炎疾病疗效确切,与口服西药乐松相比疗效更明显,值得临床应用。但本组病例数略少,在反映结果的准确性及全面性上存在一定局限,仍需进一步探讨研究。
Objective:
At present, the incidence rate of osseous arthritis's disease advances year by year . Above 50 years old in the crowd, the osseous arthritis's prevalence rate is only inferior to the cardiovascular disease, is situated second in China, And as a result of China aging of population's arrival, this tendency will still continue. Knee joint osseous arthritis may bring inconvenient to the patient in the life and work, serious influence survival quality, But there is not a good way to deal it now .So it is necessary to find a kind effective, simple, security, economical way to treatment it. Through clinical contrast research with combination therapy of traditional Chinese medicine and western medicine, To contrast the clinical effect and safety of traditional Chinese medicine composite treatment with western medicine-Loxoprofen Sodium Tablets and Capsaicin Ointment.
Methods:
According to the standard of internalizing and depletion, select 66cases of Knee joint osseous arthritis patient, all of the cases from 2006.3-2007.9 in the Chinese medicine hospital of Hubei Province were divided into the treatment group and the control group randomly. After statistics processing, two groups of patient ages, the sex, the condition distribute the non-significance difference, has the commensurability. The treatment group was treated with traditional Chinese medicine composite treatment (The traditional Chinese medicine decoction oral administration, the traditional Chinese medicine smoke wash) Every day medicinal preparation The control group was treated with western medicine-Loxoprofen Sodium Tablets and Capsaicin Ointment. (60mg/time, daily three times). Two groups of patients coordinate the function exercise: Encourages the patient to make quadriceps femoris exercise. Each time contracts for 3 seconds, then the relaxation, each time exercises 20 minutes, daily 3 times The course of two groups were 3 weeks. The period of follow-up was between 3 months and 6 months. Recorded and compared the improvement of the treatment function. The statistical analysis was performed by SPSS 10.0.
Result:
Every index was improved obviously in the treatment group and the control group in both groups after the treatment with a significant difference (P<0.01) . And in the treatment group 33 example patients, controls obviously leads is 57.58%, the total effective rate is 93.94%; In the control group 33 example patients, controls obviously leads is 24.24%, the total effective rate is 72.72%. After statistics processing, two groups of Effectiveness distribute the significance differences. After the treatment group cures, before the symptom integral reduces, processes P<0.01 after statistics, has the significance difference; After the control group cures, before the symptom, are few, processes P<0.05 after statistics, has the significance difference; Treats the latter two group of symptom integral differential value comparison to process P<0.01 after statistics, has the significance difference, may think that the treatment group surpasses the control group obviously. So the traditional Chinese medicine composite treatment is more effective in treating OA than the treatment of western medicine-Loxoprofen Sodium Tablets and Capsaicin Ointment. And the rest ache ,Joint aestus, rubor, stands the help, to walk most greatly is away from, does not take the level road, after two groups treat, compares not obvious difference (P>0.05), But the early morning stiff and ladders as well as under squats symptom symptoms and so on difficulty, two groups of comparisons have the significance difference (P <0.05), Walking ache, the arthrocele and the high and low steps have the extremely significance difference (P<0.01)berween the two groups. And the two cases of drug safety after treatment compared to the difference was not statistically significant
Conclusion:
The traditional Chinese medicine composite treatment to treats the knee joint osseous arthritis disease curative effect to be accurate, compares the curative effect with the oral administration western medicine happy pine to be more obvious, is worth the clinical practice. However, the number of cases in this group slightly less, to reflect the results of the accuracy and comprehensiveness, there are certain limitations, need to explore further study
引文
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