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皮冬财, 张霞, 雷静, 贾琼.探讨毛冬青汤对膝骨关节炎患者滑膜血流及炎症因子的影响[J].湖南中医药大学学报,2026,46(6):1239-1245[点击复制] |
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| 探讨毛冬青汤对膝骨关节炎患者滑膜血流及炎症因子的影响 |
| 皮冬财,张霞,雷静,贾琼 |
| (湖南中医药高等专科学校附属第一医院/湖南省直中医医院骨关节科, 湖南 株洲 412000;湖南中医药高等专科学校附属第一医院/湖南省直中医医院骨科医学中心, 湖南 株洲 412000) |
| 摘要: |
| 目的 探讨毛冬青汤对膝骨关节炎（KOA）滑膜血流及炎症因子的影响。方法 本研究以2022年7月至2024年12月期间于湖南中医药高等专科学校附属第一医院接受治疗的70例KOA患者为研究对象，采用随机数字表法将其分为对照组（35例，予以塞来昔布胶囊口服，0.2 g/次，1次/d，疗程8周）和观察组（35例，在对照组基础上加服毛冬青汤，疗程8周）。对比两组患者临床疗效、中医证候积分、膝关节功能[西安大略和麦克马斯特大学骨关节炎指数（WOMAC）量表评分]、滑膜血流参数[阻力指数（RI）、搏动指数（PI）和收缩期峰值流速（PSV）]、关节液炎症因子水平[白细胞介素（IL）-1β、肿瘤坏死因子-α（TNF-α）、IL-6]及凝血功能指标[凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）及纤维蛋白原（FIB）水平]，并记录两组患者不良反应发生情况。结果 治疗后，观察组总有效率（97.14%）高于对照组（77.14%）（P<0.05）。治疗后，两组患者中医证候积分、WOMAC量表中疼痛、僵硬、躯体功能等维度评分及总分、滑膜血流参数RI、PI及关节液IL-1β、TNF-α、IL-6水平均较治疗前降低（P<0.05），滑膜血流参数PSV较治疗前升高（P<0.05）；且观察组患者中医证候积分、WOMAC量表中疼痛、僵硬、躯体功能等维度评分及总分、滑膜血流参数RI、PI及关节液IL-1β、TNF-α、IL-6水平均低于对照组（P<0.05），滑膜血流参数PSV高于对照组（P<0.05）。两组患者不良反应发生率比较，差异无统计学意义（P<0.05）。结论 毛冬青汤应用于KOA患者可有效提高其临床疗效，改善临床症状及滑膜血流参数，并降低关节液中炎症因子水平，且安全性较高。 |
| 关键词: 血水同调 毛冬青汤 膝骨关节炎 炎症因子 滑膜血流参数 凝血功能 |
| DOI：10.3969/j.issn.1674-070X.2026.06.021 |
| 投稿时间：2026-01-28 |
| 基金项目:湖南省中医药管理局2024年度中医药科研课题（A2024043）。 |
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| Effects of Maodongqing Decoction on synovial blood flow and inflammatory factors in patients with knee osteoarthritis |
| PI Dongcai, ZHANG Xia, LEI Jing, JIA Qiong |
| (Department of Osteoarthropathy, the First Affiliated Hospital of Hunan Traditional Chinese Medical College/Hunan Provincial Traditional Chinese Medicine Hospital, Zhuzhou, Hunan 412000, China;Orthopedic Medical Center, the First Affiliated Hospital of Hunan Traditional Chinese Medical College/Hunan Provincial Traditional Chinese Medicine Hospital, Zhuzhou, Hunan 412000, China) |
| Abstract: |
| Objective To investigate the effects of Maodongqing Decoction (MDQD) on synovial blood flow and inflammatory factors in patients with knee osteoarthritis (KOA). Methods A total of 70 patients with KOA treated at the First Affiliated Hospital of Hunan Traditional Chinese Medicine College/Hunan Provincial Traditional Chinese Medicine Hospital between July 2022 and December 2024 were enrolled in this study. Using a random number table method, patients were randomly assigned to control group (n=35) which received oral celecoxib capsules (0.2 g once daily) for 8 weeks, and observation group (n=35), which received MDQD in addition to the treatment administered to the control group for 8 weeks. Clinical efficacy, Chinese medicine pattern scores, knee joint function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), synovial blood flow parameters including resistance index (RI), pulsatility index (PI), and peak systolic velocity (PSV), levels of inflammatory factors in synovial fluid including interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and IL-6, and coagulation function indicators including thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen (FIB), were compared between the two groups. The occurrence of adverse reactions of the two groups was also recorded. Results After treatment, the total effective rate in the observation group (97.14%) was significantly higher than that in the control group (77.14%) (P<0.05). After treatment, TCM pattern scores, WOMAC pain, stiffness and physical function scores, total WOMAC scores, synovial blood flow parameters RI and PI values, and the levels of IL-1β, TNF-α, and IL-6 in synovial fluid were significantly decreased in both groups compared with those before treatment (P<0.05), whereas PSV value was significantly increased (P<0.05). Furthermore, TCM pattern scores, WOMAC pain, stiffness and physical function scores, total WOMAC scores, RI and PI values, and the levels of IL-1β, TNF-α, and IL-6 in synovial fluid were significantly lower in the observation group than in the control group (P<0.05), whereas PSV value was significantly higher (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion MDQD can effectively improve clinical efficacy, alleviate clinical symptoms, improve synovial blood flow parameters, and reduce the levels of inflammatory factors in synovial fluid in patients with KOA, while demonstrating a favorable safety profile. |
| Key words: blood-water co-regulation Maodongqing Decoction knee osteoarthritis inflammatory factors synovial blood flow parameters coagulation function |
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