摘要
目的:探讨中医辨证施护对膝关节急性创伤性滑膜炎患者临床疗效及红细胞沉降率(ESR)、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)、人基质金属蛋白酯3(MMP-3)的影响。方法:将78例患者随机分为观察组40例和对照组38例,2组均服用滑膜炎颗粒,开水冲服,1袋/次,3次/d,服用2周。对照组采用常规护理,观察组采用中医辨证护理。2周后,评定临床疗效,并记录2组治疗前、后VAS疼痛评分、WOMAC评分,检测ESR、IL-1β、TNF-α、MMP-3水平。结果:总有效率观察组为87.50%,对照组为76.32%,2组比较差异有统计学意义(P<0.05)。2组在治疗观察期间未发现与应用药物相关的不良反应。VAS评分、WOMAC各项评分干预前后2组组内比较,差异有统计学意义(P<0.05);干预后2组组间比较差异也有统计学意义(P<0.05)。IL-1β、TNF-α、MMP-3、ESR水平干预前后2组组内比较,差异有统计学意义(P<0.05);干预后2组组间比较差异也有统计学意义(P<0.05)。结论:对于膝关节急性创伤性滑膜炎,在采用滑膜炎颗粒治疗的基础上给予中医辨证护理,有助于提高临床疗效,其作用机制可能与降低炎症反应状态,降低IL-1β、TNF-α、MMP-3炎性介质水平,减少基质金属蛋白酶分泌等有关。
Objective: To explore clinical effects of TCM syndrome differentiation and nursing in the treatment for acute traumatic synovitis of knee joint and its influence on ESR, IL-1β, TNF-α and MMP-3. Methods:Altogether 78 patients were randomized into the observation group(40 cases) and the control group(38 cases), both groups took synovitis granules orally, mixed with hot water, one pack each time, three times each day, for two weeks. The control group adopted routine nursing, and the observation group TCM syndrome differentiation and nursing. After intervened for two weeks, to assess clinical effects, and record VAS scores and WOMAC scores before and after treating, and detect ESR, the levels of IL-1β, TNF-α and MMP-3. Results: Total effective rate of the observation group was 87.50%, higher than 76.32% of the control group, and the difference showed statistical meaning(P<0.05). No side effects related to the medicines happened during therapeutic observation period. The difference had statistical meaning in VAS scoers and WOMAC scores within two groups before and after the intervention(P<0.05);the difference was statistically significant between both groups after the intervention(P<0.05). The difference was statistically significant in the levels of ESR, IL-1β, TNF-α and MMP-3 within two groups before and after the intervention(P <0.05);there was a significant difference between both groups after the intervention(P <0.05).Conclusion: For acute traumatic synovitis of knee joint, TCM syndrome differentiation and nursing based on synovitis granules is helpful to raise clinical effects, and its mechanism might be related to decreasing inflammatory response, lowering the levels of IL-1β, TNF-α and MMP-3 and reducing the secretion of MMP-3.
作者
王海丽
李室莲
郎毅
倪良桃
王丽霞
WANG Haili;LI Shilian;LANG Yi;NI Liangtao;WANG Lixia(The First Teaching Hospital of Xinjiang Medical University, Urumqi 830001, China;Xinjiang Uygur Autonomous Region TCM Hospital)
出处
《西部中医药》
2019年第8期122-125,共4页
Western Journal of Traditional Chinese Medicine
基金
新疆维吾尔自治区自然科学基金(编号2017D01C163)
