Clinical Efficacy of Modified Zhenwutang Combined with Zhengji Technique on Cold-dampness Arthralgia Syndrome Caused by Knee Osteoarthritis at Episode

Ping LI; Qing SHI; He LI; Liu-xin QU; Song GAO; Guang-juan KE

doi:10.13422/j.cnki.syfjx.20192032

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Clinical Efficacy of Modified Zhenwutang Combined with Zhengji Technique on Cold-dampness Arthralgia Syndrome Caused by Knee Osteoarthritis at Episode

Clinic | 更新时间：2021-02-09

- Clinical Efficacy of Modified Zhenwutang Combined with Zhengji Technique on Cold-dampness Arthralgia Syndrome Caused by Knee Osteoarthritis at Episode
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 23, Pages: 98-103(2019)
- 作者机构：
  
  东南大学　附属中大医院，南京　 210009
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20192032
  CLC： R289; R274; R274.9; R684.3
- Received：06 June 2019，
  
  Published Online：28 June 2019，
  
  Published：05 December 2019
- 稿件说明：
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Ping LI, Qing SHI, He LI, et al. Clinical Efficacy of Modified Zhenwutang Combined with Zhengji Technique on Cold-dampness Arthralgia Syndrome Caused by Knee Osteoarthritis at Episode[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(23): 98-103.
DOI：

Ping LI, Qing SHI, He LI, et al. Clinical Efficacy of Modified Zhenwutang Combined with Zhengji Technique on Cold-dampness Arthralgia Syndrome Caused by Knee Osteoarthritis at Episode[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(23): 98-103. DOI： 10.13422/j.cnki.syfjx.20192032.

摘要

目的：

探讨真武汤加味联合整脊手法治疗膝骨关节炎(KOA)发作期寒湿痹阻证的疗效及对关节液炎症因子的影响。

方法：

将148例患者根据随机按数字表法分为对照组和观察组各74例。对照组口服塞来昔布胶囊，0.2 g/次，1次/d；整脊疗法，采用腰椎定位斜扳法和指压法进行治疗，手法隔日1次，每周3次，共12次。观察组采用真武汤加味内服，1剂/d，整脊疗法同对照组。两组疗程均为连续治疗4周。进行治疗前后西安大略和麦克马斯特大学骨关节炎指数可视化量表(WOMAC)，疼痛和肿胀程度，膝OA严重程度指数(ISOA)，膝关节局部体征和寒湿痹阻证评分，生活质量采用关节炎影响评估

表2

(AIMS2-SF)，均于治疗前后各评价1次。检测治疗前后关节液白细胞介素-1

(IL-1

)，IL-17，P物质(SP)，肿瘤坏死因子-

(TNF-

)和钙素基因相关肽(CGRP)水平。

注：

与本组治疗前比较

0.01；与对照组治疗后比较

0.01(表3～6同)。

组别

时间

例数

疼痛

僵硬

关节功能

WOMAC总分

对照

治疗前

14.47±3.81

2.51±0.73

42.57±6.35

59.64±8.79

治疗后

4.25±1.01

1.48±0.52

18.14±3.62

24.13±5.21

观察

治疗前

14.58±3.74

2.42±0.64

43.16±7.31

60.12±9.84

治疗后

2.64±0.85

1，2)

0.75±0.35

1，2)

12.52±2.99

1，2)

15.80±3.21

1，2)

结果：

观察组患者临床疗效优于对照组(

＝2.131，

0.05)；观察组患者WOMAC量表疼痛、僵硬和关节功能3个维度评分和WOMAC总分均低于对照组(

0.01)；疼痛(行走痛、静息痛、压痛)和肿胀程度评分均低于对照组(

0.01)；观察组ISOA，寒湿痹阻证和膝关节局部体征评分均低于对照组(

0.01)；观察组AIMS2-SF量表躯体、症状、影响、社会和工作因子评分和总分均高于对照组(

0.01)；观察组关节液IL-1

，IL-17，TNF-

，SP和CGRP水平均低于对照组(

0.01)。

结论：

真武汤加味内服结合整脊疗法治疗KOA急性期寒湿痹阻证患者，能明显减轻临床症状，改善关节功能，提高患者生活质量，并能降低关节液中促炎因子和神经肽类物质表达，从而抑制了炎症反应，控制了临床症状。

Abstract

Objective:

To study the clinical efficacy of modified Zhenwutang combined with Zhengji technique on cold-dampness arthralgia syndrome caused by knee osteoarthritis (KOA) at episode and the effect on inflammatory factors of joint fluid.

Method:

One hundred and forty-eight patients were randomly divided into control group and observation group by random number table. Patients in control group got celecoxib capsules

0.2 g/time

1 time/day

and Zhengji technique with lumbar positioning oblique pulling and finger pressing for 12 times

1 time for every two days

3 times/week. Patients in observation group got modified Zhenwutang

1 dose/day

and the same Zhengji technique. The course of treatment was 4 weeks. Before and after treatment

western Ontario and McMaster University Osteoarthritis index (WOMAC)

pain and swelling

index of severity of osteoarthritis (ISOA)

local signs of knee joint and cold-dampness obstruction syndrome were scored

and the score of quality of life were discussed by arthritis impact measurement scale 2 (AIMS2-SF). And levels of interleukin-1 beta (IL-1

)

IL-17

tumor necrosis factor-alpha (TNF-

)

substance P (SP) and calcitonin gene-related peptide (CGRP) were detected.

Result:

The clinical efficacy in observation group was better than that in control group (

=2.131

0.05). Scores of pain from WOMAC scale

stiff

joint function and the total score of WOMAC were lower than those in control group (

0.01)

and scores of pain (walking pain

resting pain

tenderness)

degree of swelling

ISOA

cold-dampness arthralgia syndrome and local signs of knee joint were lower than those in control group (

0.01). And physical

symptoms

impact

social and work factor scores

the total scores of AIMS2-SF scale

IL-1

IL-17

TNF-

SP and CGRP were higher than those in control group (

0.01).

Conclusion:

Modified Zhenwutang combined with Zhengji technique can relieve clinical symptoms of patients with cold-dampness arthralgia syndrome caused by knee osteoarthritis (KOA) at episode

ameliorate joint function to improve patients' quality of life

reduce the expression of proinflammatory factors and neuropeptides in synovial fluid

so as to inhibit the inflammatory response and controlling clinical symptoms.

关键词

Keywords

references

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