邵洁琦 曾志江 杨敏 陆向然 钟秋生

[摘要] 目的 探究右歸丸联合隔姜灸治疗阳虚寒凝型膝骨性关节炎的临床效果。 方法 选取东莞市第三人民医院2013年6月～2017年6月诊治的110例阳虚寒凝型膝骨性关节炎患者，采取随机数字表法将其分为对照组与试验组，各55例。对照组给予口服右归丸治疗，试验组给予右归丸联合隔姜灸治疗。比较两组患者治疗前后血清炎症活动指标、血清免疫学指标、Lequesne指数积分及阳虚证候评分。 结果 两组患者治疗后红细胞沉降率（ESR）、C反应蛋白（CRP）、人体28个关节功能评估（DAS28）等血清炎症活动指标，白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）等血清免疫学指标以及Lequesne指数积分和阳虚证候评分均较治疗前明显降低（P < 0.05），且试验组治疗后各项血清炎症活动指标、血清免疫学指标、Lequesne指数积分及阳虚证候评分均明显低于同期对照组，差异有统计学意义（P < 0.05）。 结论 右归丸联合隔姜灸治疗阳虚寒凝型膝骨性关节炎效果显著，能够有效改善炎症症状，提高患者免疫力，缓解疼痛，安全性较高。

[关键词] 右归丸；隔姜灸；阳虚寒凝型；膝骨性关节炎

[中图分类号] R684.3 [文献标识码] A [文章编号] 1673-7210（2018）04（a）-0106-04

[Abstract] Objective To explore the clinical curative effect of Yougui Pills combined with ginger moxibustion in the treatment of knee osteoarthritis with syndrome of yang deficiency and coagulated cold. Methods One hundred and ten cases of knee osteoarthritis patients with syndrome of yang deficiency and coagulated cold treated in the Third People's Hospital of Dongguan City form June 2013 to June 2017 were selected and randomly divided into control group and experimental group by random number table method， with 55 cases in each group. The control group was given oral Yougui Pills， the experimental group was given Yougui Pills combined with ginger moxibustion. The serum inflammatory activity indicators， serum immunological indices， and the scores of Lequesne index and yang deficiency syndrome of the two groups before and after treatment were compared. Results After treatment， the serum inflammatory activity indicators of erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP） and 28 human body joint function assessment （DAS28）， the serum immunological indices of interleukin 1 （IL-1）， interleukin 6 （IL-6）， tumor necrosis factor alpha （TNF-α） and the scores of Lequesne index and yang deficiency syndrome in the two groups were significantly lower than those before treatment （P < 0.05）， and the serum inflammatory activity indicators， serum immunological indices， the scores of Lequesne index and yang deficiency syndrome in the experimental group after treatment were all significantly lower than those of control group at the same period， the differences were all statistically significant （P < 0.05）. Conclusion Yougui Pills combined with ginger moxibustion in the treatment of knee osteoarthritis with syndrome of yang deficiency and coagulated cold has remarkable curative effects， which can significantly improve the inflammatory symptoms and immunity， relieve pain， with high safety.

[Key words] Yougui Pills； Ginger moxibustion； Syndrome of yang deficiency and coagulated cold； Knee osteoarthritis

膝骨性关节炎是一类常见于中老年人群的慢性关节性疾病，多见于膝关节，其中阳虚寒凝型膝骨性关节炎是临床中最为常见的中医分型之一[1]。该病病机为本虚标实，常规治疗为口服非甾体抗炎药，但长期服药可加重患者的胃肠道负担，阻碍软骨基质的合成，导致软骨成分的不足，进一步加重患者骨组织损伤[2]。传统的中医右归丸经过临床验证，对阳虚寒凝型膝骨性关节炎具有良好的疗效。广东省东莞市第三人民医院（以下简称“我院”）在隔姜灸治疗膝骨性关节炎的临床探究中取得一定疗效，现针对阳虚寒凝型膝骨性关节炎患者分……