Effect of Addition and Subtraction Therapy of Xuanbitang on Acute Inflammation Caused by Knee Osteoarthritis of Rheumatic Fever Arthralgia Type at Attack Stage

Li-tao LIU; Hua-liang ZHU; Zong-bo ZHOU; Zi-yu HUANG

doi:10.13422/j.cnki.syfjx.20200731

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Effect of Addition and Subtraction Therapy of Xuanbitang on Acute Inflammation Caused by Knee Osteoarthritis of Rheumatic Fever Arthralgia Type at Attack Stage

Clinic | 更新时间：2020-09-09

- Effect of Addition and Subtraction Therapy of Xuanbitang on Acute Inflammation Caused by Knee Osteoarthritis of Rheumatic Fever Arthralgia Type at Attack Stage
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 18, Pages: 105-110(2020)
- 作者机构：
  
  海口市中医医院，海口 570216
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20200731
  CLC： R289;R68;R684;R684.3
- Received：10 March 2020，
  
  Published Online：10 April 2020，
  
  Published：20 September 2020
- 稿件说明：
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刘利涛,朱华亮,周宗波等.宣痹汤加减对风湿热痹型膝骨性关节炎发作期急性炎症的影响[J].中国实验方剂学杂志,2020,26(18):105-110.

LIU Li-tao,ZHU Hua-liang,ZHOU Zong-bo,et al.Effect of Addition and Subtraction Therapy of Xuanbitang on Acute Inflammation Caused by Knee Osteoarthritis of Rheumatic Fever Arthralgia Type at Attack Stage[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(18):105-110.
刘利涛,朱华亮,周宗波等.宣痹汤加减对风湿热痹型膝骨性关节炎发作期急性炎症的影响[J].中国实验方剂学杂志,2020,26(18):105-110. DOI： 10.13422/j.cnki.syfjx.20200731.

LIU Li-tao,ZHU Hua-liang,ZHOU Zong-bo,et al.Effect of Addition and Subtraction Therapy of Xuanbitang on Acute Inflammation Caused by Knee Osteoarthritis of Rheumatic Fever Arthralgia Type at Attack Stage[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(18):105-110. DOI： 10.13422/j.cnki.syfjx.20200731.

摘要

目的

观察宣痹汤加减对风湿热痹型膝骨性关节炎（KOA）发作期的控制效果及对急性炎症因子的影响。

方法

将128例患者以SAS软件生成的随机数字表，按1∶1分为对照组和观察组各64例。两组患者基础治疗，口服塞来昔布胶囊，0.2 g/次，1次/d；口服盐酸氨基葡萄糖胶囊，1粒/次，2次/d。对照组口服四妙丸，6 g/次，2次/d；观察组内服宣痹汤加减，1剂/d。两组疗程均为治疗2周。膝关节疼痛程度采用疼痛视觉模拟（VAS）评分法，患者每日记录活动时和静息时的VAS评分，并记录疼痛缓解时间和疼痛消失时间；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）评分、肿胀程度评分和风湿热痹证评分；检测治疗前后超敏C反应蛋白（hs-CRP），白细胞介素-1

(IL-1

)，IL-6，肿瘤坏死因子-

(TNF-

)，血清基质金属蛋白酶-3（MMP-3）水平；并进行安全性评价。

结果

观察组综合疗效总有效率为95.00%（57/60），高于对照组的83.05%（49/59）（

0.05）；观察组患者在治疗后3，7，10，14 d时点，膝关节疼痛程度评分均低于对照组（

0.01）；观察组患者的疼痛缓解时间和疼痛消失时间均短于对照组（

0.01）；观察组WOMAC，肿胀程度和风湿热痹证评分均低于对照组（

0.01）；观察组血清hs-CRP，IL-1

，IL-6，TNF-

和MMP-3水平均低于对照组（

0.01）；未发现患者服用宣痹汤相关不良反应。

结论

宣痹汤加减内服治疗风湿热痹型KOA发作期患者可减轻疼痛、肿胀等症状，改善膝关节功能，缩短了病程，并可控制急性炎症反应，临床疗效显著，且安全。

Abstract

Objective

To observe the controlling effect of addition and subtraction therapy of Xuanbi tang on knee osteoarthritis of rheumatic fever arthralgia type (KOA) at attack stage and to investigate the influence to acute inflammation factors.

Method

One hundred and twenty-eight patients were randomly divided into control group and observation group (1∶1) by random number table with SAS software. The patients in both groups got celecoxib capsules

0.2 g/time

1 time/day

glucosamine hydrochloride capsule

1 grain/time

2 times/day. Patients in control group addiiontally got Simiaowan

6 g/time

2 times/day. Patients in observation group got addition and subtraction therapy of Xuanbitang

1 dose/day

with a treatment course of 2 weeks in both groups. Visual analogue scale of pain (VAS) was used to discuss pain degree of knee joint

and the VAS scores during activity and resting state were recorded every day

and the time to pain relief and time to pain disappearance were also recorded. Before and after treatment

the scores of osteoarthritis index visual scale of Western Ontario and McMaster University (WOMAC)

scores of swelling degree and scores of rheumatism heat arthralgia syndrome were graded. The levels of high sensitive C-reactive protein (hs CRP)

interleukin-1

(IL-1

)

interleukin-6 (IL-6)

tumor necrosis factor-

(TNF-

) and serum matrix metalloproteinase-3 (MMP-3) were detected before and after treatment. In addition

safety was evaluated and discussed.

Result

The comprehensive total effective rate in observation group was 95.00% (57/60)

higher than 83.05% (49/59) in control group (

0.05). At the third

seventh

tenth

fourteenth day after treatment

scores of knee joint pain degree in observation group were lower than those in control group (

0.01). Time to pain relief and time to pain disappearance were shorter than those in control group (

0.01). Scores of WOMAC

swelling degree and rheumatism heat arthralgia syndrome were all lower than those in control group (

0.01). Levels of hs-CRP

IL-1

IL-6

TNF-

and MMP-3 were lower than those in control group (

0.01). In addition

there was no adverse reaction related to Xuanbitang.

Conclusion

Addition and subtraction therapy of Xuanbitang can relieve pain

swelling and other symptoms

improve knee joint function

shorten the course of disease

and control the acute inflammatory reaction

with significant clinical efficacy and safety.

关键词

Keywords

references

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