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目的:观察中西医综合疗法治疗寒湿阻络型膝骨关节炎(KOA)的疗效及对血清和关节液中间质细胞衍生因子-1(SDF-l)及鸢尾素的影响。方法:收集符合纳入标准病例共114例,根据就诊先后顺序随机按数字表法分为对照组56例和治疗组58例;对照组给予盐酸氨基葡萄糖片,2片/次,3次/d;对患者进行自我管理培训,1次/周,2 h/次。治疗组在对照组治的基础上采用白芥子散加味穴位贴敷,每次留置3~5 h,1次/周。手法治疗,30 min/次,1次/d。两组疗程均为6周。比较两组西安大略麦马斯特大学骨性关节炎指数(WOMAC)和生活质量评分及临床疗效,检测两组血清和膝关节液SDF-l和鸢尾素水平。结果:治疗组治疗后患者WOMAC量表各项评分及总积分均明显低于对照组(P<0.01);健康调查简表(SF-36)量表各项评分均显著高于对照组(P<0.01);经Ridit分析,观察组临床疗效优于对照组(P<0.05);治疗后治疗组血清和关节液中SDF-l明显低于对照组,鸢尾素明显高于对照组(P<0.01)。结论:中西医综合疗法治疗寒湿阻络型KOA的疗效确切,抑制血清和关节液中SDF-l水平及上调鸢尾素水平可能参与上述治疗作用。
OBJECTIVE: To observe the curative effect of integrated traditional Chinese and western medicine on cold-water resistance knee joint osteoarthritis (KOA) and its effect on serum and synovial fluid stromal cell-derived factor-1 (SDF-1) and irisin. Methods: A total of 114 patients were enrolled in this study. According to the order of treatment, they were randomly divided into control group (56 cases) and treatment group (58 cases). The control group was given glucosamine hydrochloride tablets (2 tablets / time, Patients self-management training, 1 / week, 2 h / time. The treatment group in the control group based on the use of mustard seed paste plus points, each stay 3 ~ 5 h, 1 / week. Manual treatment, 30 min / time, 1 time / d. The two courses of treatment were 6 weeks. The two groups were compared with the scores of WOMAC, the quality of life score and the clinical curative effect of the two groups, and the levels of SDF-1 and irisin in the two groups were detected. Results: The WOMAC scores and total scores in the treatment group were significantly lower than those in the control group after treatment (P <0.01). SF-36 scores in the treatment group were significantly higher than those in the control group (P <0.01). The Ridit analysis showed that the clinical efficacy of the observation group was better than that of the control group (P <0.05). After treatment, SDF-1 in serum and synovial fluid of the treatment group was significantly lower than that of the control group, and irisin was significantly higher than that of the control group (P < 0.01). Conclusion: The combination therapy of traditional Chinese and western medicine is effective in treating KOA with cold and dampness obstruction type. It may be involved in the above therapeutic effect by inhibiting SDF-1 in serum and synovial fluid and up-regulating irisin level.