【作者】 张雪飞；

【导师】 王昭佩；

【作者基本信息】 广州中医药大学 ， 中医骨伤科学， 2006， 硕士

【摘要】 研究目的 膝关节骨关节炎是骨科常见病、疑难病之一,近年来发病率呈上升趋势,严重影响着人们的身体健康和生活质量。目前本病临床尚缺乏特效的药物治疗。本研究旨在分析自拟方剂四子散局部热敷配合补肾活血汤内服的方法治疗膝关节骨关节炎的临床疗效,初步探讨其改善膝关节骨关节炎患者症状和体征的机理,从而为膝关节骨关节炎的治疗开辟一条新途径。 研究方法 采用随机对照临床试验设计,将80例符合病例选择标准的膝关节骨关节炎患者随机分为治疗组、对照组Ⅰ和对照组Ⅱ三组。治疗组予以四子散热敷加补肾活血汤内服,对照组Ⅰ予以温感型好及施外贴加补肾活血汤内服,对照组Ⅱ则单纯内服补肾活血汤。参照Lequesne的OA严重性和活动性指数评估法,制定临床病例观察表,如实记录患者情况,2个疗程共8周后作疗效评定,进行治疗前后比较以及组间比较,做统计学处理,对纳入本研究的膝关节骨关节炎患者进行直观模拟量表(VAS)、膝关节功能评分、综合疗效、不良反应等方面的评估。 研究结果 三组患者的VAS计分和膝关节功能评分,治疗前后采用自身比较t检验,差异均有极其显著性(P<0.01)。临床疗效评定中,治疗组总有效率为91.18%,对照组Ⅰ总有效率为90.63%,对照组Ⅱ总有效率为80.65%,经采用Ridit分析,治疗组与对照组Ⅰ比较没有显著性差异(P>0.05),治疗组与对照组Ⅱ比较有显著性差异(P<0.05),治疗组疗效优于对照组Ⅱ。三组患者治疗期间均未发现与药物有关的全身和局部毒副作用出现。 结论 补肾活血汤内服治疗膝关节骨关节炎疗效明显,如同时配合四子散局部热敷则效果更佳。四子散局部热敷治疗膝关节骨关节炎与温感型好及施外贴具有相似的疗效。且疗效与患者年龄、病程、病情有关,患者年龄愈高、病程愈长、病情愈重,疗效越差。四子散热敷配合补肾活血汤内服是一个安全有效的治疗膝关节骨关节炎的方案。更多还原

【Abstract】 ObjeciveKnee osteoarthritis is a common and stubborn disease of orthopedics. The morbility rise up in the recent years. It has been a severe influence on human health and quality of life. Now the disease still lack specific medicine in the clinic. The objective of this study is to analyze the clinical effects of Sizi powder fomentation combined with Bushenhuoxue decoction oral administration in the treatment of knee osteoarthritis, and to investigate initially the mechanism of improving patients’ symptoms and sings. Thereby to develop a new treatment way for knee osteoarthritis. MethodsA random control design of clinical trials was adopted. The 80 patients whose consistent with inclusion criteria were divided into three groups randomly. The treament group was treated by Sizi powder fomentation and Bushenhuoxue decoction oral administration. The control group I was treated by compound capsicum patches and Bushenhuoxue decoction oral administration. The control group II was treated by Bushenhuoxue decoction oral administration only. Then referred to the Lequesne evaluation about 0A severity and reactiveness and made observation table to record patients’ information. After two courses of treatment made effect evaluation. The available data were done statistical treatment. The comparison was done in front and back of a group respectively and among three groups. To evaluate the VAS scores, scores of knee joint function, synthetic effects and adverse reaction of these patients. ResultsThe VAS scores and the knee joint function scores of three groups’ comparison in front and back adopt the oneself comparison t examination. The statistical significant is all to show obviouly difference (P<0. 01). The total effective rate of treament group is 91.18%, the control group I is 90.63 %, the control group II is 80.65%. After been examined by Ridit analysis, the statistical significant between treament group and control group I has no difference(P>0. 05). The statistical significant between treament group and control group II has obvious difference(P<0. 05). The treament group has an advantage over the control group II. During the treatment period, three groups all didn’ t discover any poisonous side effect of the whole body or part body that something do with medicines. Cone Iust i onBushenhuoxue decotion oral administration is an effective method to cure the knee osteoarthritis. If combined with Sizi powder fomentation, the result is better. It has the similar effect between Sizi powder fomentation and compound capsicum patches in the treatment of knee osteoarthritis. The curative effect have something to do with patients’ age, course of illness and pathogenetic condition. Patients’ age is more high, the course of illness is more long, the condition is more heavy, the curative effect is more bad. Sizi powder fomentation combined with Bushenhuoxue decotion oral administration is a safe and valid treatment prescription for knee osteoarthritis.更多还原