吴亚烽　　王勇　　李冬春

[摘要] 目的 观察除痹健膝汤治疗肝肾亏虚型膝骨关节炎（KOA）的臨床疗效。 方法 选取2018年6月至2020年6月在湖南中医药大学第二附属医院确诊的80例肝肾亏虚型膝骨关节炎患者，并将其随机分为两组。其中治疗组40例患者服用除痹健膝汤进行治疗，对照组40例患者服用藤黄健骨片进行治疗，两组患者均进行1个月的治疗周期。对治疗前后的患者进行VAS评分，Lysholm量表评价和疗效评价，并予以比较。 结果 治疗后总有效率治疗组为92.5%，对照组为72.5%，两组比较，治疗组有效率明显高于对照组，差异有统计学意义（P<0.05）;两组VAS评分，Lysholm量表及疗效评价治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P<0.05）。 结论 通过服用除痹健膝汤治疗肝肾亏虚型膝骨关节炎，能够促进KOA患者疼痛缓解，活动功能改善，具有显著的临床疗效，且优于服用藤黄健骨片治疗KOA。

[关键词] 除痹健膝汤;膝骨关节炎;藤黄健骨片;肝肾亏虚

[中图分类号] R274.9          [文献标识码] B          [文章编号] 1673-9701（2021）12-0146-04

Clinical effect of Chubi jianxi decoction on 40 cases of knee osteoarthritis of liver and kidney deficiency type

WU Yafeng1， 2   WANG Yong2   LI Dongchun2

1.Graduate School， Hunan University of Chinese Medicine， Changsha   410005， China; 2.The Third Department of Bone Injury（Bone and Joint）， the Second Affiliated Hospital of Hu′nan University of Chinese Medicine， Changsha   410005， China

[Abstract] Objective To observe the clinical effect of chubi jianxi decoction on knee osteoarthritis （KOA） with deficiency of liver and kidney. Methods A total of 80 patients with KOA of liver and kidney deficiency type diagnosed in the Second Affiliated Hospital of Hunan University of Chinese Medicine from June 2018 to June 2020 were selected and randomly divided into two groups. Among them， 40 patients in the treatment group were treated with chubi jianxi decoction， while 40 patients in the control group were treated with tenghuang jiangu tablets. Both groups were treated for one month. VAS score， Lysholm scale and curative effect were evaluated before and after treatment. Results The total effective rate after treatment was 92.5% in the treatment group and 72.5% in the control group. Compared the two groups， the effective rate was significantly higher in the treatment group than that in the control group， and the difference was statistically significant（P<0.05）. There were significant differences in VAS score， Lysholm scale and curative effect before and after treatment in each group and between the two groups after treatment， all with statistically significant differences （P<0.05）. Conclusion Chubi Jianxi decoction can promote pain relief and improvement of activity function in KOA patients with liver and kidney deficiency， with significant clinical effect， which is better than tenghuang jiangu tablet in treating KOA.

[Key words] Chubi jianxi decoction; Knee osteoarthritis; Tenghuang jiangu tablets; Deficiency of liver and kidney

膝骨关节炎（Knee osteoarthritis，KOA）又稱膝关节退行性变，是一种常见的慢性膝关节疾病，以老年人多见，并且随着患者年龄的增加而进行性加重，同时会影响患者的正常生活质量，严重时甚至丧失生活自理能力，给家庭及社会带来沉重的负担[1]。其主要临床症状表现为膝关节疼痛、活动功能障碍[2]。而膝关节也是人体重要的负重及行走关节，由于当今社会环境的发展及生活方式的改变，KOA的危险因素也随之增多，如长期屈膝体力劳作，不恰当的负重体育锻炼，过度肥胖等，均提高了KOA的发病率，延缓KOA的进展和改善KOA患者的症状成为了目前研究的重点。KOA在中医学属于“膝痹病”范畴，临床常根据患者症状不同进行辨证分型[3]，而有研究表明，肝肾亏虚型为最常见的证型[4]，其以肝肾亏耗，生化之源不足为本，血瘀痹阻脉络，骨赘生长为标。……