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河南省中医院,郑州 450002
[第一作者] 左瑞庭,硕士,主治医师,从事中医风湿骨病研究,E-mail:zuoduanting333@163.com
*谷慧敏,硕士,主治医师,从事中医风湿骨病研究,Tel:0371-69915492,E-mail:guhuimin6666@163.com
收稿日期:2019-07-24,
网络出版日期:2019-11-18,
纸质出版日期:2020-04-05
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左瑞庭, 孟庆良, 马俊福, 等. 加味散膝汤联合塞来昔布治疗膝关节滑膜炎寒湿痹阻证的疗效观察[J]. 中国实验方剂学杂志, 2020,26(7):98-103.
Rui-ting ZUO, Qing-liang MENG, Jun-fu MA, et al. Clinical Efficacy of Flavored Sanxitang Combined with Celecoxib in Treatment of Gonarthromeningitis Cased by Dampness and Cold[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(7): 98-103.
左瑞庭, 孟庆良, 马俊福, 等. 加味散膝汤联合塞来昔布治疗膝关节滑膜炎寒湿痹阻证的疗效观察[J]. 中国实验方剂学杂志, 2020,26(7):98-103. DOI: 10.13422/j.cnki.syfjx.20200521.
Rui-ting ZUO, Qing-liang MENG, Jun-fu MA, et al. Clinical Efficacy of Flavored Sanxitang Combined with Celecoxib in Treatment of Gonarthromeningitis Cased by Dampness and Cold[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(7): 98-103. DOI: 10.13422/j.cnki.syfjx.20200521.
目的:
2
观察加味散膝汤联合塞来昔布对膝关节滑膜炎寒湿痹阻证患者的临床疗效。
方法:
2
120例患者随机分为对照组和治疗组,各60例。对照组口服塞来昔布胶囊,治疗组口服塞来昔布胶囊+加味散膝汤,疗程均为30 d。治疗前后分别观察两组患者的疼痛视觉模拟评分(VAS),美国膝关节协会膝关节功能(AKS),关节炎影响评定量表(AIMS)和骨性关节炎指数量表(WOMAC);测量膝关节周径,关节腔积液和滑膜增生厚度;检测血清肿瘤坏死因子-
α
(TNF-
α
),血清基质金属蛋白酶-3(MMP-3),血清白细胞介素-1(IL-1)和血沉(ESR)的含量;观察两组有效率和不良反应。
结果:
2
治疗组总有效率94.8%(55/58),高于对照组的80.7%(46/57)(
P
<
0.05);与本组治疗前比较,两组治疗后VAS,AIMS,WOMAC,膝关节周径,关节腔积液,滑膜增生厚度明显降低(
P
<
0.05),AKS评分明显升高(
P
<
0.05);治疗后与对照组比较,观察组VAS,AIMS,WOMAC,膝关节周径,关节腔积液,滑膜增生厚度明显降低(
P
<
0.05),AKS评分明显升高(
P
<
0.05)。与本组治疗前比较,两组TNF-
α
,MMP-3,IL-1和ESR含量明显降低(
P
<
0.05);治疗后与对照组比较,观察组TNF-
α
,MMP-3,IL-1和ESR含量明显降低(
P
<
0.05)。治疗组不良反应发生率5.89%(4/58),低于对照组的22.81%(13/57)(
P
<
0.05)。
结论:
2
散膝汤联合塞来昔布可有效改善膝关节滑膜炎寒湿痹阻证患者的临床症状,不良反应发生率低。
Objective:
2
To observe the clinical efficacy of flavored Sanxitang combined with celecoxib in treating gonarthromeningitis caused by dampness and cold.
Method:
2
Totally 120 case were randomly divided into the control group and the treatment group
with 60 cases in each group. The control group was given celecoxib
and the treatment group was treated with flavored sanxitang combined with celecoxib for 30 d. The visual analogue scale (VAS)
American knee association knee function scale (AKS)
arthritis impact scale (AIMS)
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were observed before and after treatment. The circumferential diameter
articular cavity effusion and synovial hyperplasia thickness were measured. The serum tumor necrosis factor-
α
(TNF-
α
)
matrix metalloproteinase (MMP)-3
serum interleukin-1 (IL-1) and erythrocyte sedimentation rate (ESR) were detected. The effective rate and adverse reactions were observed in two groups.
Result:
2
The total effective rate in treatment group was 94.8% (55/58)
which was higher than 80.7% (46/57) in control group (
P
<
0.05). Compared with before treatment
VAS
AIMS
WOMAC
knee circumference
articular cavity effusion and synovial hyperplasia thickness were significantly reduced in two groups (
P
<
0.05)
while the AKS score was significantly increased (
P
<
0.05). Compared with after treatment
VAS
AIMS
WOMAC
knee circumference
articular cavity effusion and synovial hyperplasia thickness were significantly reduced in observation group (
P
<
0.05)
whereas the AKS score was significantly increased (
P
<
0.05). TNF-
α
MMP-3
IL-1 and ESR in two groups were significantly lower than those group before treatment (
P
<
0.05). After treatment
TNF-
α
MMP-3
IL-1 and ESR levels in observation group were significantly reduced compared with those in control group (
P
<
0.05). The incidence rate of adverse reactions in treatment group was 5.89% (4/58)
which was lower than 22.81% (13/57) in control group (
P
<
0.05).
Conclusion:
2
Flavored Sanxitang combined with celecoxib could alleviate the clinical symptoms of gonarthromeningitis caused by dampness and cold
with a low incidence of adverse reactions.
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