| 引用本文: |
陈玉洁, 卢敏, 邱礼国, 许晓彤, 王林华, 李纳平, 叶贵生, 刘鑫.卢氏骨痹通外洗方联合硫酸氨基葡萄糖治疗寒湿痹阻型膝骨关节炎的临床研究[J].湖南中医药大学学报,2025,45(2):370-375[点击复制] |
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| 卢氏骨痹通外洗方联合硫酸氨基葡萄糖治疗寒湿痹阻型膝骨关节炎的临床研究 |
| 陈玉洁,卢敏,邱礼国,许晓彤,王林华,李纳平,叶贵生,刘鑫 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南中医药大学研究生院, 湖南 长沙 410208) |
| 摘要: |
| 目的 探讨卢氏骨痹通外洗方联合硫酸氨基葡萄糖治疗寒湿痹阻型膝骨关节炎（KOA）的临床疗效及安全性。方法 选取2024年1月至2024年8月湖南中医药大学第一附属医院骨伤科寒湿痹阻型KOA患者60例，采用随机数字表法分为观察组（n=30）和对照组（n=30）。对照组予口服硫酸氨基葡萄糖片，观察组在对照组的基础上予卢氏骨痹通外洗方熏洗膝关节，两组连续治疗12周。比较两组患者疼痛视觉模拟法（VAS）评分、西大略和麦克马斯特大学（WOMAC）评分、日本膝骨性关节炎功能评估量表（JOA）评分、临床疗效、关节液中白细胞介素（IL）-6、肿瘤坏死因子α（TNF-α）、前列腺素E2（PGE2）的含量及安全性。结果 与治疗前比较，治疗后两组疼痛VAS评分、WOMAC评分、JOA评分均降低（P<0.05），且观察组低于对照组（P<0.05）。观察组临床有效率（90.0%）高于对照组（83.3%），但差异无统计学意义（P＞0.05）。与治疗前比较，治疗后两组关节液中IL-6、TNF-α、PGE2水平均降低（P<0.05），且观察组低于对照组（P<0.05）。治疗过程中，两组患者局部及全身均无明显不良反应，治疗前后血常规、尿常规以及肝、肾功能检查结果未出现异常。结论 卢氏骨痹通外洗方对寒湿痹阻型KOA患者的临床疗效明确并且具有良好的安全性，其作用机制可能为通过降低关节液中IL-6、TNF-α及PGE2的含量，抑制KOA患者的炎症反应，从而减轻KOA患者疼痛症状。 |
| 关键词: 膝骨关节炎 卢氏骨痹通外洗方 中医外治法 寒湿痹阻 炎症因子 |
| DOI：10.3969/j.issn.1674-070X.2025.02.027 |
| 投稿时间：2024-11-01 |
| 基金项目:湖南省自然科学基金青年项目（2024JJ6360）；湖南省中医药管理局计划项目（B2023098，B2024250）；湖南省中医药管理局计划项目；湖南中医药大学校院联合重点项目（2023XYLH009）；湖南中医药大学校院联合基金项目（2023XYLH026）。 |
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| Clinical research on the treatment of knee osteoarthritis of cold-dampness obstruction pattern using LU's Gubi Tong external washing formula combined with glucosamine sulfate |
| CHEN Yujie, LU Min, QIU Liguo, XU Xiaotong, WANG Linhua, LI Naping, YE Guisheng, LIU Xin |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Graduate School of Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To explore the clinical efficacy of LU's Gubi Tong external washing formula combined with glucosamine sulfate in treating knee osteoarthritis (KOA) of cold-dampness obstruction pattern. Methods Sixty patients with cold-dampness obstruction type KOA in the Department of Orthopedics of the First Hospital of Hunan University of Chinese Medicine from January 2024 to August 2024 were selected and randomly divided into observation group (n=30) and control group (n=30) by random number table method. The control group was given oral glucosamine sulfate, while the observation group was treated with LU's Gubi Tong external washing formula for knee joint fumigation and washing on the basis of oral glucosamine sulfate for 12 consecutive weeks. The visual analogue scale (VAS) pain score, Western Ontario and McMaster Universities (WOMAC) score, Japanese Knee Osteoarthritis Association (JOA) score, clinical efficacy, the levels of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), and prostaglandin E2 (PGE2) in synovial fluid, as well as safety, were compared between the two groups. Results Compared with pre-treatment levels, post-treatment VAS, WOMAC, and JOA scores decreased in both groups (P<0.05), with the observation group showing lower scores than the control group (P<0.05). The clinical efficacy rate of the observation group (90%) was higher than that of the control group (83.3%), though the difference was not statistically significant (P>0.05). Compared with pre-treatment levels, post-treatment IL-6, TNF-α, and PGE2 levels in synovial fluid were significantly reduced in both groups (P<0.05), with the observation group showing lower levels than the control group (P<0.05). During the treatment, no obvious local or systemic adverse reactions occurred in either group, and no abnormalities were found in hematology, urinalysis, or liver and kidney function tests before and after treatment. Conclusion LU's Gubi Tong external washing formula has a definite clinical efficacy and good safety in patients with KOA of cold-dampness obstruction pattern. Its mechanism of action may involve reducing the levels of IL-6, TNF-α, and PGE2 in synovial fluid, thereby inhibiting the inflammatory response and alleviating knee joint pain in affected patients. |
| Key words: knee osteoarthritis LU's Gubi Tong external washing formula Chinese medicine external therapy cold-dampness obstruction inflammatory factors |
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