摘要
目的:探讨通络止痛散中药离子导入联合玻璃酸钠膝关节腔注射治疗早中期膝骨性关节炎(KOA)的临床疗效及作用机制。方法:将98例KOA患者随机按数字法分为观察组和对照组各49例。对照组采用玻璃酸钠20 mg,关节腔内注射,1次/1周,共5周。观察组在对照组治疗的基础上加用通络止痛散中药离子导入,2次/d,连续5周。采用"西安大略和麦克马斯特大学骨关节炎指数"(WOMAC评分)观察患者症状、体征,检测治疗前后关节液膝关节滑液透明质酸(HA)、肿瘤坏死因子-α(TNF-α)及白细胞介素-1β(IL-1β)水平。结果:观察组总有效率97.96%,优于对照组的81.63%(P<0.01);观察组WOMAC疼痛、僵硬和日常生活受限各维度评分及总分均低于对照组(P<0.01);观察组膝关节肿胀和压痛评分低于对照组(P<0.01);观察组关节液中HA水平高于对照组,TNF-α和IL-1β水平低于对照组(P<0.01)。结论:采用通络止痛散中药离子导入联合玻璃酸钠膝关节腔注射治疗KOA临床疗效显著,其作用机制可能增加关节液中HA浓度,降低关节滑液中TNF-α和IL-1β水平有关。
Objective： To observe the clinical effect and mechanism of iontophoresis of Tongluo Zhitong powder articular cavity injection of sodium hyaluronate on the early and medial stages of the knee osteoarthritis. Method： Ninty-eight patients were randomly divided into observation group（ n=49） and control group （n=49）. Control group were treated with articular cavity injection of sodium hyaluronate, 20 mg each time, 1 time each week, for 5 weeks. Observation group were treated with iontophoresis of Tongluo Zhitong powder on the basis of control group, 2 times each day, for 5 weeks. The symptoms and signs of patients were tested by the Western Ontario and McMaster Universities （WOMAC） scores. The level of hyaluronic aci （HA）, tumor necrosis factor-α （TNF-α） and interleukin-1β（IL-1β） of knee joint synovia in pretherapy and post-treatment were detected. Result： The total effective rate of observation group （97.96%） was superior to control group （81.63%）（P〈0.01）. The scores of WOMAC which including pain, stiffness, swell and tenderness of observation group were lower than control group （P〈0.01）. The level of HA in observation group was higher than control group and the level of TNF-α and IL-1β in observation group was lower than control group （P〈0.01）. Conclusion： The clinical curative effect of iontophoresis of Tongluo Zhitong powder combining with articular cavity injection of sodium hyaluronate on KOA is significant. The mechanism of action may be related with increasing the concentration of HA and decreasing the level of TNF-α and IL-1β.
出处
《中国实验方剂学杂志》
CAS
北大核心
2014年第2期188-191,共4页
Chinese Journal of Experimental Traditional Medical Formulae
基金
北京中医药大学科研基金项目(20111023)
