独活寄生汤加减方治疗肝肾亏虚证膝骨关节炎的临床疗效观察

The clinical effect of modified Duhuo Jisheng Decoction in treating knee osteoarthritis with liver and kidney deficiency syndrome

关键词:  独活寄生汤  膝骨关节炎  膝关节表面软骨  中医治疗

Key words:  Duhuo Jisheng Decoction  knee osteoarthritis  surface cartilage of knee joint  traditional Chinese medicine therapy

摘要:

[目的] 观察独活寄生汤加减方治疗肝肾亏虚证膝骨关节炎的临床疗效。[方法] 通过随机数字表法将80例膝骨关节炎患者随机分为治疗组和对照组，每组各40例。治疗组给予独活寄生汤加减方口服，对照组给予盐酸氨基葡萄糖胶囊口服，连续服用12周。观察比较两组患者治疗前后中医证候积分、骨关节炎指数（WOMAC）评分、视觉模拟评分法（VAS）评分和超声下膝关节软骨损伤分级等指标以及临床疗效。[结果] 治疗组中，中医证候积分、WOMAC评分以及VAS评分均呈现出显著下降趋势，与对照组比较，差异有统计学意义（P<0.05）。治疗组总有效率为95.00%，对照组为75.00%，两组总有效率比较，差异有统计学意义（P<0.05）。治疗前后两组超声下软骨损伤分级未见明显改善，膝关节表面软骨厚度无明显变化，两组间比较，差异无统计学意义（P>0.05）。[结论] 独活寄生汤加减方能够缓解患者膝关节疼痛，延缓病情进展，提升患者膝关节功能状态，并提高临床整体疗效。

Abstract:

[Objective] To observe the clinical effect of modified Duhuo Jisheng Decoction in the treatment of knee osteoarthritis with liver and kidney deficiency syndrome. [Methods] We randomly assigned 80 patients with knee arthritis to a treatment group and a control group of 40 patients each using the random number table method. The treatment group was given modified Duhuo Jisheng Decoction orally，and the control group was given glucosamine hydrochloride capsules orally for 12 weeks. The traditional Chinese medicine syndrome score，Western Ontario and McMaster University Osteoarthritis survey scale（WOMAC） score，visual analog scale（VAS），grading of knee joint cartilage injury visualized by ultrasound and other indicators and clinical efficacy were compared between the two groups before and after treatment. [Results] In the treatment group of this study，the traditional Chinese medicine syndrome scores，WOMAC scores，and VAS scores all showed a significant downward trend. Compared with the control group，the differences were statistically significant（P<0.05）. Further analysis showed that the total effective rate of the treatment group was 95.00%，while that of the control group was 75.00%. The difference of effective rate between the two groups was also statistically significant（P<0.05）. Before and after treatment，there was no significant improvement in the cartilage injury grading under ultrasound in the two groups. There was no significant change in the thickness of the knee joint surface cartilage，and there was no statistically significant difference between the two groups（P>0.05）. [Conclusion] The modified Duhuo Jisheng Decoction can alleviate knee joint pain in patients，delay disease progression，enhance the functional status of the knee joint，and improve overall clinical efficacy.