【作者】 胡德洪；

【导师】 钟广玲；

【作者基本信息】 广州中医药大学 ， 中医骨伤科学， 2009， 硕士

【摘要】 目的:观察活血通络汤在治疗膝骨关节炎中的疗效,探讨补肾活血法在膝骨关节炎中的作用。方法:选择2008年7月至2008年12月间在我院诊断并治疗的60例原发性膝骨关节炎患者,随机分为治疗组(活血通络汤加基础治疗组)及对照组(西乐葆加基础治疗组),每组30例,疗程4周。治疗后参照改良的膝关节骨关节炎病情评分标准及疗效判定标准,从症状体征(膝部疼痛、膝部功能)及中医证候两方面进行疗效观察。疗程结束后作治疗前后的组内对比及组间对比,比较两组疗效。结果:(1)治疗组与对照组治疗前后的所有项目积分均较自身治疗前减少,具有显著性差异P(<0.01);(2)治疗后两组患者的组间总积分比较与功能积分比较P>0.05,无显著性差异;治疗后两组患者的组间疼痛积分比较与中医证候积分比较P<0.01,具有显著性差异;(3)活血通络汤方在治疗膝骨关节炎疾病疗效上和西乐葆效果相当,而活血通络汤方在改善膝骨关节炎中医证候疗效上优于西乐葆。结论:临床上应用补肾活血法治疗膝骨关节炎能获得良好的疗效,其主要是针对膝骨关节炎病机——肝肾不足,气血不足为本,气滞血瘀,脉络痹阻为标而辨证用药,达到标本兼治的功效。更多还原

【Abstract】 Objective:To observe the clinical effect of activating blood and dredging collateral prescription on osteoarthritis of knee(KOA),and study the mechanism of prescriptions for KOA with nourishing kidney and activating blood.Methods:Sixty patients who were diagnosed as osteoarthritis of knee in Foshan Hospital of TCM from July to December 2008 were randomly divided into two groups on an average:the therapeutic group was using activating blood and dredging collateral prescription and basic treatment,the control group was using celecoxib and basic treatment.Four weeks later,according to the revision classified standard of American rheumatism association’ s osteoarthritis and the II issue of clinical test plan for knee osteoarthritis,the changes of main symptoms and signs(ache of the knee,function of the knee)and curative effects according to the theory of TCM were observed,using the improvement grades standard the contrasts were performed between the same group and the different groups.Result:(1) Accumulative point of symptoms and signs decrease with remarkable difference(P<0.01) after treatment in two groups.But there is no remarkable difference among 2 groups(P>0.05).(2) The integral change of patient’ s symptoms and signs and the function integral change between two groups have no remarkable difference(P>0.05),however,the ache integral change and the symptom integral change according to the theory of TCM had significant difference (P<0.05).(3)There is no remarkable difference between two groups to relieve the clinical symptoms and signs,but,the therapeutic group had certain superiority to alleviate the symptom according to the theory of TCM than that of control group.Conclusion:In clinic,the result for treatment that using nourishing kidney and activating blood provide patients good therapeutic efficacy.The mechanism is that aim at pathogenesis of osteoarthritis of knee that asthenia of the kidney and liver,vital energy and blood deficiency is the essence,vital energy, blood,channels and collaterals blocked are the appearance.Diagnosis and treatment based on the overall analysis of symptoms and signs solve the essence and the appearance.更多还原