摘要
目的探讨消瘀通膝汤熏蒸联合关节腔内富血小板血浆(PRP)注射对膝骨关节炎(KOA)患者疗效及血清硫酸软骨素846(CS846)、基质金属蛋白酶-13(MMP-13)水平的影响。方法选取2019年10月至2022年10月河南省直属机关第二门诊部KOA患者92例,通过随机数字表法分为PRP组和中西医组,均46例。PRP组接受关节腔内PRP注射治疗,中西医组接受消瘀通膝汤熏蒸联合关节腔内PRP注射治疗,评估两组治疗3周后的临床效果,对比两组治疗前及治疗3周后的中医症状积分、膝关节功能障碍[西大略湖和麦克马斯特大学骨关节炎指数量表(WOMAC)]以及血清CS846、MMP-13水平变化。结果中西医组的临床总有效率高于PRP组(91.30%比73.91%,P<0.05);两组治疗3周后的关于关节刺痛不移、关节硬结积分、关节僵硬变形、皮肤瘀斑及屈伸活动不利共5项积分和总积分均低于治疗前(P<0.05),两组WOMAC量表关于疼痛维度、僵硬维度、日常活动度维度共3项评分及总分均相比治疗前降低(P<0.05),两组血清CS-846水平较治疗前降低(P<0.05),血清MMP-13水平较治疗前提升(P<0.05),其中中西医组变化幅度大于PRP组(P<0.05)。结论消瘀通膝汤熏蒸联合关节腔内PRP注射治疗KOA效果显著,能明显减轻中医症状,改善患者的膝关节功能,并对血清CS846、MMP-13水平起到抑制,以抑制膝关节软骨降解。
Objective To explore the efficacy of Xiaoyu Tongxi decoction fumigation combined with intraarticular platelet-rich plasma(PRP)injection on patients with knee osteoarthritis(KOA)and influence on levels of serum chondroitin sulfate 846(CS846)and matrix metalloproteinase-13(MMP-13).Methods A total of 92 patients with KOA in the Second Outpatient Department of Henan Province were selected from October 2019 to October 2022,and were divided into PRP group and Chinese-western medicine group by random number table method,46 cases in each group.The PRP group was treated with intraarticular PRP injection,and the Chinese-western medicine group was given Xiaoyu Tongxi decoction fumigation combined with intraarticular PRP injection.The clinical efficacy in the two groups was evaluated after 3 weeks of treatment.Traditional Chinese medicine symptoms scores,knee dysfunction[Western Ontario and McMaster University osteoarthritis index scale(WOMAC)]and serum CS846 and MMP-13 levels were compared between the two groups before treatment and after 3 weeks of treatment.Results The total clinical effective rate in Chinese-western medicine group was higher than that in PRP group(91.30%vs 73.91%,P<0.05).After 3 weeks of treatment,the scores of five items of joint tingling,joint induration,joint stiffness and deformation,skin ecchymosis and unfavorable flexion and extension and total score in the two groups were lower than those before treatment(P<0.05),and the scores of three items of pain dimension,stiffness dimension and daily activity dimension and total score of WOMAC scale in both groups were declined than those before treatment(P<0.05),and serum level of CS-846 in both groups was decreased compared with that before treatment(P<0.05),while serum level of MMP-13 was increased compared with that before treatment(P<0.05),and the changes in Chinese-western medicine group were greater than those in PRP group(P<0.05).Conclusion Xiaoyu Tongxi decoction fumigation combined with intraarticular PRP injection has a significant efficacy in the treatment of KOA,and it can significantly relieve the Traditional Chinese medicine symptoms,improve the knee function and inhibit the levels of serum CS846 and MMP-13 so as to inhibit the degradation of knee cartilage.
作者
陈卫华
庄卫生
黄韶辉
CHEN Weihua;ZHUANG Weisheng;HUANG Shaohui(The Second Ward of Rehabilitation Department,the Second Outpatient Department of Henan Province,Zhengzhou 450003,China)
出处
《河南医学研究》
CAS
2024年第15期2830-2835,共6页
Henan Medical Research
关键词
膝骨关节炎
消瘀通膝汤熏蒸
关节腔内富血小板血浆注射
knee osteoarthritis
Xiaoyu Tongxi decoction fumigation
intraarticular platelet rich plasma injection
