摘要
目的:观察金乌骨通胶囊对肾虚血瘀型退行性膝骨性关节炎(KOA)的疗效及对血清软骨寡聚基质蛋白(COMP),Ⅱ型胶原C-端肽(CTX-Ⅱ),Ⅰ型胶原C-末端肽(CTX-Ⅰ)和基质金属蛋白酶-3(MMP-3)水平的影响。方法:将160例肾虚血瘀型KOA患者,采用分层、分区组随机分为对照组和观察组各80例。对照组口服盐酸氨基葡萄糖片,480 mg/次,3次/d,并口服塞来昔布胶囊,0.2 g·d^(-1)。观察组在对照组治疗的基础上加服金乌骨通胶囊,3粒/次,3次/d。两组疗程均为8周。进行治疗前后骨关节炎指数(WOMAC),肾虚血瘀证,世界卫生组织(WHO)生存质量测定量表简表(WHOQOL-BREF)评分;检测治疗前后血清COMP,CTX-Ⅱ,CTX-Ⅰ和MMP-3的水平。结果:经Ridit分析,观察组临床疗效优于对照组(P<0.01);治疗后观察组WOMAC量表指数中疼痛、僵硬、关节功能评分及总分均低于对照组(P<0.01);治疗后观察组肾虚血瘀证评分低于对照组(P<0.01);治疗后观察组WHOQOL-BREF量表中生存质量主观感觉、健康状况主观感觉、生理、心理4个领域评分均高于对照组(P<0.01);治疗后观察组血清COMP,CTX-Ⅱ,CTX-Ⅰ和MMP-3均低于对照组(P<0.01),两组患者治疗后血清COMP,CTX-Ⅱ,CTX-Ⅰ和MMP-3均高于健康对照组。结论:在常规西医治疗的基础上,加服金乌骨通胶囊能调节肾虚血瘀型膝骨性关节炎的骨代谢指标,降低WOMAC指数评分,提高患者的生活质量,临床疗效优于单纯的西医治疗。
Objective： To observe the efficacy of Jinwu Gutong capsules on degenerative knee osteoarthritis（ KOA） with deficiency of kidney and blood stasis,and its effect on cartilage oligomeric matrix protein（ COMP）, collagen type Ⅱ C-peptide（ CTX-Ⅱ）, collagen type I C-peptide（ CTX-I） and matrix metalloproteinase-3（ MMP-3）. Method： One hundred and sixty patients were randomly divided into control group（ 80 cases） and observation group（ 80 cases） by random number table. The patients in control group received glucosamine hydrochloride tablets,480 mg/time,3 times/day,and celebrex,0. 2 g·d^-1. In addition to the therapy of control group,the patients in observation group received Jinwu Gutong capsules,3 grains/day,3 times/day. The courses of treatment were 8 weeks. Before and after the treatment,osteoarthritis index（ WOMAC）,kidney deficiency and blood stasis syndrome,World Health Organization（ WHO） quality of life measurement table（ WHOQOL-BREF） score,and levels of COMP,CTX-Ⅱ,CTX-Ⅰ and MMP-3 were detected. Result： The clinical efficacy in observation group was superior to that in control group according to Ridit analysis（ P〈0. 01）.After the treatment,scores of pain,stiffness,joint function score,total scores,and kidney deficiency and blood stasis syndrome score in observation group were lower than those in control group（ P〈0. 01）. And scores of subjective feelings of quality of life and health status,physiology and mental health in observation group were higher than those in control group（ P〈0. 01）. Levels of COMP,CTX-Ⅱ,CTX-Ⅰand MMP-3 in observation group were lower than those in control group（ P〈0. 01）. Levels of COMP,CTX-Ⅱ,CTX-Ⅰand MMP-3 in both groups were higher than those in healthy group. Conclusion： In addition to the therapy of conventional western medicine,Jinwu Gutong capsules can ameliorate bone metabolism indexes of patients with degenerative knee osteoarthritis（ KOA）with deficiency of kidney and blood stasis type,reduce scores of WOMAC index,and improve patients＇ quality of life,with a better clinical effect than pure treatment with western medicine.
作者
韩广敬
衣玉胜
周凯
闫金明
刘小龙
吴新华
HAN Guang-jing YI Yu-sheng ZHOU Kai YAN Jin-ming LIU Xiao-long WU Xin-hua(Dongying District People＇s Hospital, Dongying 257000, China The Affiliated Hospital of Medical College of Qingdao University, Qingdao 266000, China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2016年第20期168-172,共5页
Chinese Journal of Experimental Traditional Medical Formulae
基金
东营市科技局医学基金项目(20142031A)
