中药外治联合双醋瑞因治疗膝骨关节炎临床观察(1)
【摘 要】目的：观察中药外治联合双醋瑞因治疗膝骨关节炎的临床疗效。方法：将64例膝骨关节炎患者随机分为对照组和治疗组，每组32例，对照组给予双醋瑞因治疗，治疗组在对照组治疗基础上加用中药外治。2组均以4周为1个疗程。观察2组临床疗效及治疗前后Lequesne评分。结果：治疗组痊愈17例，显效12例，有效3例，无效0例，显效率为90.06%；对照组痊愈14例，显效10例，有效6例，无效2例，显效率为75.00%。2组比较，差异有统计学意义(P < 0.05)。治疗后，2组Lequesne评分各项指标均较治疗前改善(P < 0.05)，且治疗组优于对照组(P < 0.05)。2组不良反应发生率比较，差异无统计学意义(P > 0.05)。结论：运用中药外治联合双醋瑞因治疗膝骨关节炎疗效满意，安全性好，值得进一步推广。
【关键词】 骨关节炎，膝；双醋瑞因；中药外治；临床疗效
Clinical Observation on the Treatment of Knee Osteoarthritis by External Application of Chinese Medicine Combined with Diacerein
QIAO Deng-chao，WANG Shao-hua，LIU Huai-sheng，FAN Xiao-long，BAI Yu，DENG Ya-dian
【ABSTRACT】Objective：To observe the clinical effect of external application of Chinese medicine combined with diacerein in the treatment of knee osteoarthritis.Methods：Sixty-four cases of knee osteoarthritis were randomly divided into a control group and a treatment group，32 cases in each group.The control group was treated with diacerein，while the treatment group，based on the treatment of the control group，was treated with Chinese medicine externally.The two groups were treated for four weeks as a course.The clinical efficacy and Lequesne score of the two groups before and after treatment were observed.Results：In the treatment group，17 cases were cured，12 cases were markedly effective，3 cases were effective，and no case was ineffective，the effective rate being 90.06%.In the control group，14 cases were cured，10 cases were markedly effective，6 cases were effective，2 cases were ineffective，and the effective rate was 75%.The difference between the two groups was statistically significant(P < 0.05).After treatment，the Lequesne scores of the two groups were better than those before treatment(P < 0.05)，and the treatment group was better than the control group(P < 0.05).There was no significant difference of the incidence of adverse reactions between the two groups(P > 0.05).Conclusion：External application of Chinese medicine combined with diacerein is effective in the treatment of knee osteoarthritis，safe and worthy of further promotion.
【Keywords】 osteoarthritis，knee；diacerein；external application of Chinese medicine；clinical curative effect
膝骨關节炎(knee osteoarthritis，KOA)又称膝关节退行性骨关节病，主要病理变化是损坏膝关节软骨、关节滑膜、软骨下骨等组织及关节周围骨质增生[1]。本病是临床骨科常见的难治性膝关节退行性疾病，发病率随着年龄增长而上升[2]，也是人类常见的致残原因之一。主要临床症状为膝关节疼痛、压痛、局部肿胀，活动后加重，上下楼梯明显，休息后症状缓解等[3]。目前，治疗KOA常用方法有口服氨基葡萄糖、非甾体抗炎药、中药，关节腔内药物注射，针灸理疗等。最近研究发现，非甾体抗炎药能控制局部症状和改善关节活动度，但不能控制KOA病情的继续发展，还可能加重骨关节炎(osteoarthritis，OA)的病理损伤[4]，且发生胃肠道疾病的危险性较高。全膝关节置换手术是病情发展至终末期患者的主要治疗方法，但是早中期患者保守治疗对本病演变非常关键[5]。为了寻找更好的治疗早中期KOA的方法，本研究选用郑州市骨科医院自制中药洗剂联合双醋瑞因对64例患者进行治疗观察，现总结报告 (乔登朝 王少华 刘怀省 范晓龙 白玉 邓亚典)
【关键词】 骨关节炎，膝；双醋瑞因；中药外治；临床疗效
Clinical Observation on the Treatment of Knee Osteoarthritis by External Application of Chinese Medicine Combined with Diacerein
QIAO Deng-chao，WANG Shao-hua，LIU Huai-sheng，FAN Xiao-long，BAI Yu，DENG Ya-dian
【ABSTRACT】Objective：To observe the clinical effect of external application of Chinese medicine combined with diacerein in the treatment of knee osteoarthritis.Methods：Sixty-four cases of knee osteoarthritis were randomly divided into a control group and a treatment group，32 cases in each group.The control group was treated with diacerein，while the treatment group，based on the treatment of the control group，was treated with Chinese medicine externally.The two groups were treated for four weeks as a course.The clinical efficacy and Lequesne score of the two groups before and after treatment were observed.Results：In the treatment group，17 cases were cured，12 cases were markedly effective，3 cases were effective，and no case was ineffective，the effective rate being 90.06%.In the control group，14 cases were cured，10 cases were markedly effective，6 cases were effective，2 cases were ineffective，and the effective rate was 75%.The difference between the two groups was statistically significant(P < 0.05).After treatment，the Lequesne scores of the two groups were better than those before treatment(P < 0.05)，and the treatment group was better than the control group(P < 0.05).There was no significant difference of the incidence of adverse reactions between the two groups(P > 0.05).Conclusion：External application of Chinese medicine combined with diacerein is effective in the treatment of knee osteoarthritis，safe and worthy of further promotion.
【Keywords】 osteoarthritis，knee；diacerein；external application of Chinese medicine；clinical curative effect
膝骨關节炎(knee osteoarthritis，KOA)又称膝关节退行性骨关节病，主要病理变化是损坏膝关节软骨、关节滑膜、软骨下骨等组织及关节周围骨质增生[1]。本病是临床骨科常见的难治性膝关节退行性疾病，发病率随着年龄增长而上升[2]，也是人类常见的致残原因之一。主要临床症状为膝关节疼痛、压痛、局部肿胀，活动后加重，上下楼梯明显，休息后症状缓解等[3]。目前，治疗KOA常用方法有口服氨基葡萄糖、非甾体抗炎药、中药，关节腔内药物注射，针灸理疗等。最近研究发现，非甾体抗炎药能控制局部症状和改善关节活动度，但不能控制KOA病情的继续发展，还可能加重骨关节炎(osteoarthritis，OA)的病理损伤[4]，且发生胃肠道疾病的危险性较高。全膝关节置换手术是病情发展至终末期患者的主要治疗方法，但是早中期患者保守治疗对本病演变非常关键[5]。为了寻找更好的治疗早中期KOA的方法，本研究选用郑州市骨科医院自制中药洗剂联合双醋瑞因对64例患者进行治疗观察，现总结报告 (乔登朝 王少华 刘怀省 范晓龙 白玉 邓亚典)