四妙散加味对膝关节滑膜炎湿热阻络证患者关节液炎性因子和神经肽物质的影响

胡华; 李连泰; 刘艳伟; 王书君; 谢双喜; 孙建君

doi:10.13422/j.cnki.syfjx.20192333

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四妙散加味对膝关节滑膜炎湿热阻络证患者关节液炎性因子和神经肽物质的影响

临床 | 更新时间：2021-02-09

- 四妙散加味对膝关节滑膜炎湿热阻络证患者关节液炎性因子和神经肽物质的影响
- Effect of Modified Simiaosan on Inflammatory Factors and Neuropeptide Substances of Patients with Synovitis of Knee Joint and Damp-heat Obstruction Collateral Syndrome
- 中国实验方剂学杂志 2020年26卷第6期页码：97-102
- 作者机构：
  
  承德医学院　附属医院，河北承德　 067000
- 作者简介：
  
  [第一作者]　胡华，硕士，住院医师，从事骨伤科临床研究工作，E-mail：gskhuhua@163.com
  *李连泰，硕士，主任医师，从事骨伤科临床研究工作，E-mail：liliantai369@163.com
- 基金信息：
  
  河北省中医药管理局科研计划项目(2016066)
- DOI：10.13422/j.cnki.syfjx.20192333
  中图分类号： R24; R274; R274.9; R289
- 收稿日期：2019-08-07，
  
  网络出版日期：2019-09-25，
  
  纸质出版日期：2020-03-20
- 稿件说明：
移动端阅览
胡华, 李连泰, 刘艳伟, 等. 四妙散加味对膝关节滑膜炎湿热阻络证患者关节液炎性因子和神经肽物质的影响[J]. 中国实验方剂学杂志, 2020,26(6):97-102.

Hua HU, Lian-tai LI, Yan-wei LIU, et al. Effect of Modified Simiaosan on Inflammatory Factors and Neuropeptide Substances of Patients with Synovitis of Knee Joint and Damp-heat Obstruction Collateral Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(6): 97-102.
胡华, 李连泰, 刘艳伟, 等. 四妙散加味对膝关节滑膜炎湿热阻络证患者关节液炎性因子和神经肽物质的影响[J]. 中国实验方剂学杂志, 2020,26(6):97-102. DOI： 10.13422/j.cnki.syfjx.20192333.

Hua HU, Lian-tai LI, Yan-wei LIU, et al. Effect of Modified Simiaosan on Inflammatory Factors and Neuropeptide Substances of Patients with Synovitis of Knee Joint and Damp-heat Obstruction Collateral Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(6): 97-102. DOI： 10.13422/j.cnki.syfjx.20192333.

摘要

目的：

观察四妙散加味对膝关节滑膜炎(KS)湿热阻络证的临床疗效及对关节液炎性因子和神经肽物质的影响。

方法：

将135例患者分为对照组67例和观察组68例。对照组抽净关节内积液后，以曲安奈德注射液关节内注射，1周1次，共2次，并口服醋氯芬酸缓释片，0.2 g/次，1次/d。观察组西医治疗措施同对照组，并内服四妙散加味，1剂/d，两组疗程均为连续治疗4周。进行治疗前后膝关节疼痛和肿胀程度评分，膝关节功能采用美国西安大略和麦克马斯特大学骨关节炎评分(WOMAC)，进行治疗前后湿热阻络证和膝关节局部体征评价；检测治疗前后关节液白细胞介素-1

(IL-1

)，IL-6，肿瘤坏死因子-

(TNF-

)，超敏C反应蛋白(hs-CRP)，P物质(SP)，钙素基因相关肽(CGRP)，神经肽Y(NPY)和血管活性肠肽(VIP)水平。

结果：

治疗后观察组膝关节疼痛程度和肿胀程度均低于对照组(

0.01)；观察组WOMAC量表各因子评分和总分均低于对照组(

0.01)；观察组湿热阻络证积分、膝关节屈伸范围评分和浮髌试验评分均低于对照组(

0.01)；观察组关节液IL-1

，IL-6，TNF-

和hs-CRP水平均低于对照组(

0.01)；观察组关节液SP，CGRP，NPY和VIP水平均低于对照组(

0.01)；经秩和检验，观察组临床疗效优于对照组(

＝2.089，

0.05)。

结论：

四妙散加味治疗KS湿热阻络证患者，能明显减轻疼痛、肿胀症状，促进膝关节活动功能恢复，并能抑制关节液中促炎因子和神经肽类物质表达，提高了临床治疗效果。

Abstract

Objective:

To observe the clinical efficacy of modified Simiaosan on synovitis of knee joint with damp-heat obstruction collateral syndrome and the effect on inflammatory factors and neuropeptide substances in synovial fluid.

Method:

One hundred and thirty-five patients were randomly divided into control group(67 cases) and observation group(68 cases) by random number table. Patients' intra-articular effusion was drawn out. Triamcinolone acetonide was injected into arthrosis for 2 times

1 time/week

and aceclofenac sustained-release tablets were given for 4 weeks

0.2 g/time

1 time/day. In addition to the therapy of control group

patients in observation group were also given modified Simiaosan for 4 weeks

1 dose/day. Before and after treatment

pain

swelling of knee joint and were scored

Western Ontario and McMaster University (WOMAC) were adopted for scoring knee score

and damp-heat obstruction syndrome and local signs of knee joint were also assessed. And levels of interleukin-1 beta (IL-1 beta)

IL-6

tumor necrosis factor-alpha (TNF-alpha)

hypersensitive C-reactive protein (hs-CRP)

substance P (SP)

calcitonin gene-related peptide (CGRP)

neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) were detected.

Result:

After treatment

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

0.01). Scores of WOMAC

the total score

integral of damp-heat obstruction collateral syndrome

knee flexion-extension range score and floating patella test were all lower than those in control group (

0.01). And levels of IL-1

IL-6

TNF-

hs-CRP

CGRP

NPY and VIP were all lower than those in control group (

0.01). Analyzed by rank sum test

the clinical efficacy in observation group was better than those in control group (

=2.089

0.05).

Conclusion:

Modified Simiaosan can significantly alleviate pain and swelling symptoms

promote the recovery of knee joint function

and inhibit the expressions of proinflammatory factors and neuropeptides in synovial fluid

with a better clinical efficacy.

关键词

Keywords

references

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