应建伟　刘其顺　裘伟国

[摘要] 目的 观察超声经皮透入舒筋活血汤联合西乐葆治疗膝关节骨性关节炎的临床疗效。 方法 90例均为2014年11月～2015年6月在我院骨科门诊及病房收治的膝关节骨性关节炎患者，随机分为三组（超声中药透入组、西乐葆组、超声中药透入联合西乐葆组），采用临床常用的VAS疼痛评分以及膝关节功能评分（Lequesne指数）评定疗效。 结果 三组患者治疗后2周、4周在膝关节疼痛缓解及关节功能活动方面有明显改善（P<0.05），且在治疗后同一时间三组比较，超声中药透入联合西乐葆组效果最佳，差异具有统计学意义（P<0.05）。而西乐葆组与超声中药透入组比较，差异无统计学意义（P>0.05）。 結论 超声经皮透入舒筋活血汤联合西乐葆对于膝关节骨性关节炎患者，既能明显缓解疼痛，又能够良好的改善关节功能，从而取得满意的疗效，在临床中值得推广运用。

[关键词] 超声经皮透入；舒筋活血汤；西乐葆；膝关节骨性关节炎

[中图分类号] R684.3 [文献标识码] B [文章编号] 1673-9701（2018）20-0112-04

Clinical observation of ultrasound percutaneous penetration of shujin huoxue decoction combined with celecoxib in the treatment of knee osteoarthritis

YING Jianwei1 LIU Qishun2 GONG Weiguo3 TIAN Xiaojun1 YE Chengfeng1

1.Department of Orthopedics，Tonglu County Hospital of TCM in Zhejiang Province，Hangzhou 311500，China；2.Department of Orthopedics，Zhejiang Medical Health Group Hangzhou Hospital， Hangzhou 310022，China；3.The Third Clinical Medical College of Zhejiang Chinese Medical University，Hangzhou 310053，China

[Abstract] Objective To observe the clinical effect of ultrasound percutaneous penetration of shujin huoxue decoction combined with celecoxib in the treatment of knee osteoarthritis. Methods 90 cases were patients with knee osteoarthritis who were admitted to the outpatient department and ward of orthopedics from November 2014 to June 2015 and were randomly divided into 3 groups（ultrasound Chinese medicine penetration group， Celecoxib group， and ultrasound Chinese medicine penetration combined with Celecoxib group）. Clinically commonly used VAS pain score and knee function score（Lequesne index）were used to assess the efficacy. Results In the three groups of patients， there were significant improvement in pain relief and joint function of knee joint after 2 and 4 weeks of treatment（P<0.05）. At the same time after treatment in the three groups， the efficacy was the best in the ultrasound Chinese medicine penetration combined with celecoxib group. The difference was statistically significant（P<0.05）. However， there was no statistically significant difference between the celecoxib group and ultrasound Chinese medicine group（P>0.05）. Conclusion Ultrasound percutaneous penetration shujin huoxue decoction combined with celecoxib for the patients with knee osteoarthritis can both significantly relieve pain and well improve joint function， in order to achieve satisfactory results， which is worthy of clinical promotion and application.

[Key words] Ultrasound percutaneous penetration； Shujin huoxue decoction； Celecoxib； Knee osteoarthritis

膝关节骨性关节炎是一种以膝关节软骨的退行性病变和继发性骨质增生为主的慢性关节疾病，临床主要表现为膝关节慢性疼痛及屈伸功能活动受限，是骨科常见病、多发病，其患病率随着年龄增大而增加。据国内相关文献报道，75岁以上的人群中膝关节骨性关节炎的发病率为80%，给患者及家庭带来较大痛苦和负担，严重影响患者的生活质量[1-4]。随着年龄的增长，膝关节骨性关节炎不可避免发生，但对其病因、病机尚不完全清楚[5]。

目前骨性关节炎的临床诊断存在着局限性，尚无有效的骨性关节炎早期诊断手段，往往患者就诊时已发展为中、晚期，严重影响其正常工作及生活。……