【摘要】 目的:观察透明质酸钠联合膝痹通汤治疗老年膝关节骨性关节炎患者的临床疗效。方法:将80例膝关节骨性关节炎患者按照随机数字表法分为2组各40例。对照组予透明质酸钠膝关节腔内注射;观察组采用透明质酸钠膝关节腔内注射联合膝痹通汤治疗。治疗5周后评价疗效。观察治疗前后各项指标:Lequesne指数、视觉模拟评分(VAS)、外周静脉血肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、基质金属蛋白酶-3(MMP-3)、C-反应蛋白(CRP)水平、关节肿胀评分、关节压痛评分,并进行临床疗效评定。结果:治疗后,2组Lequesne指数、VAS评分、膝关节肿胀及压痛评分较治疗前均降低,差异均有统计学意义(P<0.05),且观察组Lequesne指数、VAS评分、膝关节肿胀及压痛评分降低程度优于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组外周血TNF-α、IL-1、MMP-3和CRP水平明显降低,差异均有统计学意义(P<0.05);且观察组外周血TNF-α、IL-1、MMP-3和CRP水平降低程度优于对照组,差异均有统计学意义(P<0.05)。临床疗效总有效率观察组95.0%,对照组80.0%,2组比较,差异有统计学意义(P<0.05)。结论:透明质酸钠联合膝痹通汤治疗老年膝关节骨性关节炎能够改善患者膝关节功能和肿胀、压痛、疼痛、僵硬等症状,降低TNF-α、IL-1、MMP-3和CRP水平。更多还原

【Abstract】 Objective: To observe the clinical effect of sodium hyaluronate combined with Xibitong tang for knee osteoarthritis in senile patients. Methods: According to random number table, divided 80 cases of patients with knee osteoarthritis into two groups randomly, 40 cases in each group. Both groups received sodium hyaluronate by intra- articular injection for treatment,while the observation group additionally received Xibitong tang. The curative effect was evaluated after 5 weeks of treatment. Observed all indexes before and after treatment such as Lequesne index, visual analogue score (VAS),levels of tumor necrosis factor - α(TNF- α), interleukin- 1 (IL- 1), matrix metalloproteinase- 3 (MMP- 3), and C- reactive protein (CRP) in peripheral venous blood,as well as score of joint swelling and tenderness. The clinical effect was evaluated as well. Results:After treatment,Lequesne indexes,VAS, and scores of joint swelling and tenderness in both groups were lower than those before reatment,differences being significant (P < 0.05). The decreased degrees of Lequesne indexes ,VAS, and scores of joint swelling and tenderness in the observation group were superior to those in the control group,differences being significant (P < 0.05). After treatment,levels of TNF- α,IL- 1,MMP- 3,and CRP in peripheral venous blood in the observation group were significantly decreased,differences being significant (P < 0.05); the decreased degrees of levels of TNF- α,IL- 1,MMP- 3,and CRP in peripheral venous blood in the observation group were superior to those in the control group,differences being significant (P < 0.05). The total effective rate was 95.0% in the observation group and 80.0% in the control group,the difference being significant (P < 0.05). Conclusion:The therapy of sodium hyaluronate combined with Xibitong tang for knee steoarthritis in senile patients can improve knee function and symptoms such as swelling,tenderness, pain,and rigidity,and decrease levels of TNF- α,IL- 1,MMP- 3,and CRP.更多还原