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补肾活血法治疗肾虚型骨关节炎临床研
究
（作者： _________ 单位： ___________ 邮编： ___________ ）
【摘要】 目的 观察补肾活血方治疗肾虚型膝骨关节炎的 临
床疗效及对炎症因子的影响。方法
选取膝骨关节炎患者113例,
随机分为治疗组（56例）和对照组（57例）,分别采用补肾活血方和塞来 昔布、氨基葡萄糖联合用药治疗，观察2组临床疗效，应用平均Womac 关节炎指数评分和平均骨关节炎严重程度指数评定用药前后临床症 状改善情况，采用ELISA法检测血清炎症因子肿瘤坏死因子（TNF）- a、 白细胞介素（IL）-6。结果 治疗组总有效率为 89.3%,优于对照组 （P0.05） ; Womac关节炎指数评分较治疗前显著改善（P0.01）,与对照 组比较有显著差异（P0.05）;骨关节炎严重程度指数较治疗前显著改 善（P0.05）,与对照组无显著差异（P0.05）。治疗组血清TNF- a、IL-6水 平明显降低（P0.01,P0.05）。结论 补肾活血方治疗肾虚型膝骨关节炎 总体疗效优于塞来昔布、氨基葡萄糖联合用药；通过抑制炎症因子的 产生而减轻炎症反应是其重要机理之一。
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【关键词】 补肾活血法；肾虚；骨关节炎
Abstract : Objective To explore the clinical effiicacy and effect on cytok ines of inv igorati ng the kid ney and activat ing blood fomula on treating osteoarthritis patients in the pattern of kidney deficiency. Methods 113 patients with knee osteoarthritis were randomly divided into two groups in cludi ng 56 cases of treatme nt group and 57 cases of con trol group, which were treated by inv igorati ng the kidney and activating blood fomula and combinaton of Celecoxib and Glucosam ine respectively. The cli nical effiicacy of two groups were inv estigated by Womac osteoarthritis in dex and the average severity of OA in dex. The cha nges of serum in flammatory cytok ines TNF- a and IL-6 were detected by ELISA. Results The total efficiency of the treatment group was 89.3% and better than the control group (P0.05) after 16 weeks of treatment. Womac osteoarthritis in dex and OA severity in dex of treatme nt group were improved sig ni fica ntly compared with pre-treatme nt (P0.01, P0.05). There was significant differenee in Womac osteoarthritis index (P0.05) and no significant difference in OA severity index (P0.05) compared with control group. The serum TNF- a, IL-6 levels of treatme nt group sig ni fica ntly decreased after treatme nt in treatme nt group (P0.01, P0.05). Con clusi on The inv igorati ng the kid ney and activating blood fomula had better clinical effiicacy in treating knee osetoarthritis
tha n comb inaton therapy of Celecoxib and
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Glucosamine. Inhibition of cytokine production and reducing the in flammatory reacti on are one of the key mecha ni sms.
Key words : invigorating the kidney and activating blood
therapy ; kidney deficiency ; osteoarthitis
骨关节炎(Osteoarthritis,OA)多见于老年人，发病率高，该病
不仅可引起关节软骨损害，而且还累及软骨下骨、韧带、关节囊、滑 膜和关节周围肌肉，最终导致关节软骨退变、纤维化、断裂、溃疡及 整个关节面的损害。老年人年高体弱，肾元渐衰，气血亏虚，骨失所养, 而使骨骼发生退行性改变，复因感受风寒湿之邪或久行久立，强力负重 而致筋骨失养，血瘀气滞,故致关节疼痛，屈伸不利。针对肾虚型0A患 者血瘀阻络为标、肾虚为本的病理本质，以补肾活血为法拟方治疗肾 虚型膝关节0A,取得了良好的临床疗效，并通过检测外周血炎症因子， 初步探讨了其作用机制。现将结果报道如下。
1资料与方法 1.1 一般资料
2003 — 2005年共收治113例膝关节OA患者,均为临澧县中医院门 诊或住院患者。按就诊时间顺序随机分为治疗组与对照组。治疗组 56例，其中男性19例,女性37例，年龄(52.2 ±11.3)岁，单膝38例,双膝 18例，共74个膝关节，病程(4.1 ±2.6)年;对照组57例，其中男性21例, 女性36例,年龄(49.9 ±12.8)岁,单膝35例,双膝22例，共79个膝关节, 病程（3.8 i2.1）年。2组患者在性别、年龄、病情分级方面无显著差异
补肾活血法治疗肾虚型骨关节炎临床研究
