【摘要】 目的 观察加味补中益气汤对膝关节周围骨挫伤患者疼痛水平及膝关节功能的影响。方法 选取2022年4月至2025年4月收治的膝关节周围骨挫伤患者98例，采用随机数字表法分为常规组和试验组，每组49例。研究无失访脱落病例，均完成研究。常规组采用常规疗法治疗，试验组在常规疗法基础上采用加味补中益气汤辅助治疗，连续治疗2周。比较两组总有效率、骨髓水肿评分、疼痛视觉模拟评分(VAS)、Lysholm评分、中医证候评分、不良反应发生率以及基质金属蛋白酶2(MMP-2)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶9(MMP-9)差异。结果 试验组总有效率(93.88%)高于常规组(79.59%),差异有统计学意义(P<0.05)。两组治疗前VAS评分、骨髓水肿评分、Lysholm评分、中医证候评分比较，差异无统计学意义(P>0.05)。两组治疗2周、8周VAS评分、中医证候评分、骨髓水肿评分降低，且试验组治疗2周、8周低于常规组(P<0.05)。两组治疗2周、8周Lysholm评分升高，且试验组治疗2周、8周高于常规组(P<0.05)。两组治疗前TNF-α、MMP-2、MMP-9比较，差异无统计学意义(P>0.05)。两组治疗2周、8周TNF-α、MMP-2、MMP-9降低，且试验组治疗2周、8周低于常规组(P<0.05)。试验组总不良反应发生率(10.20%)与常规组(4.08%)比较，差异无统计学意义(P>0.05)。结论 加味补中益气汤治疗膝关节周围骨挫伤可减轻疼痛和骨髓水肿，改善膝关节功能。更多还原

【Abstract】 Objective To observe the effect of Modified Buzhong Yiqi Decoction on pain level and knee joint function in patients with periarticular bone contusion of the knee.Methods A total of 98 patients with periarticular bone contusion admitted from April 2022 to April 2025 were selected and divided into the conventional group(n=49) and the experimental group(n=49) by random number table method.There were no cases of loss to follow-up or dropping out during the process, and all completed the study.The conventional group was treated with conventional therapy, while the experimental group was supplemented with Modified Buzhong Yiqi Decoction on the basis of conventional therapy for two consecutive weeks.The total effective rate, bone marrow edema score, Visual Analogue Scale(VAS) for pain, Lysholm score, Traditional Chinese Medicine(TCM) symptom score, incidence of adverse reactions, and matrix metalloproteinase 2(MMP-2),tumor necrosis factor-α(TNF-α),and matrix metalloproteinase 9(MMP-9) between the two groups were compared.Results The total effective rate of the experimental group(93.88%) was higher than that of the conventional group(79.59%)(P<0.05).There was no statistically significant difference in the VAS score, bone marrow edema score, Lysholm score and TCM symptom score before treatment between the two groups(P>0.05).Compared with before treatment, the VAS scores, TCM symptom scores, and bone marrow edema scores of both groups decreased at 2 weeks and 8 weeks of treatment, and the scores of the experimental group at 2 weeks and 8 weeks of treatment were lower than those of the conventional group(P<0.05).Compared with before treatment, the Lysholm scores of both groups increased at 2 weeks and 8 weeks of treatment, and the scores of the experimental group were higher than those of the conventional group at 2 weeks and 8 weeks of treatment(P<0.05).There was no statistically significant difference in TNF-α,MMP-2 and MMP-9 between the two groups before treatment(P>0.05).Compared with before treatment, TNF-α,MMP-2 and MMP-9 in both groups decreased at 2 weeks and 8 weeks of treatment, and those in the experimental group were lower than those in the conventional group at 2 weeks and 8 weeks of treatment(P<0.05).The total incidence of adverse reactions in the experimental group(10.20%) was not statistically different from that in the conventional group(4.08%)(P>0.05).Conclusion Modified Buzhong Yiqi Decoction can alleviate pain and bone marrow edema and improve knee joint function in patients with periarticular bone contusion of the knee.更多还原