苗战杰

【摘 要】目的：观察逐瘀通痹汤加减联合常规西药治疗膝骨关节炎的临床疗效。方法：将96例膝骨关节炎患者按照随机数字表法分为治疗组和对照组，每组48例。对照组采用常规西药治疗，治疗组在对照组基础上加用逐瘀通痹汤加减治疗。2组均以12周为1个疗程。观察2组临床疗效，以及治疗前后中医证候积分、西安大略和麦克马斯特大学骨关节炎指数量表（WOMAC评分）、血清炎性因子[白细胞介素（IL）-6、IL-1、肿瘤坏死因子-α（TNF-α）]水平。结果：治疗组显效26例，有效20例，无效2例，总有效率为95.83%;对照组显效23例，有效16例，无效9例，总有效率为81.25%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组中医证候积分、WOMAC评分、IL-6、IL-1、TNF-α较治疗前均降低（P < 0.05），且治疗组低于对照组（P < 0.05）。结论：逐瘀通痹汤加减联合常规西药治疗膝骨关节炎疗效显著，能降低中医证候积分，减轻病情程度及炎症反应。

【关键词】 膝骨关节炎;逐瘀通痹汤;临床疗效

Clinical Observation on 48 Cases of Knee Osteoarthritis Treated by Modified Zhuyu Tongbi Tang

（逐瘀通痹汤）Combined with Conventional Western Medicine

MIAO Zhan-jie

【ABSTRACT】Objective：To observe the clinical efficacy of modified Zhuyu Tongbi Tang（逐瘀通痹汤）

combined with conventional western medicine in the treatment of knee osteoarthritis.Methods：Ninety-six patients with knee osteoarthritis were randomly divided into a treatment group and a control group，48 cases in each group.The control group was treated with conventional western medicine，and the treatment group was treated with Zhuyu Tongbi Tang based on the treatment for the control group.Both groups were treated for 12 weeks as a course of treatment.The clinical efficacy，TCM syndrome score，WOMAC score，IL-6，IL-1，and TNF-α were observed before and after treatment.Results：In the treatment group，26 cases were markedly effective，20 cases were effective and 2 cases were ineffective，and the total effective rate was 95.83%.In the control group，23 cases were markedly effective，16 cases were effective and 9 cases were ineffective，and the total effective rate was 81.25%.The difference between the two groups was statistically significant（P < 0.05）.After treatment，TCM syndrome score，WOMAC score，IL-6，IL-1 and TNF-α in the two groups were lower than before treatment

（P < 0.05），and they were lower in the treatment group than in the control group（P < 0.05）.Conclusion：

Modified Zhuyu Tongbi Tang Combined with conventional western medicine has a significant effect in the treatment of knee osteoarthritis，which can lower the TCM syndrome score and reduce the degree of illness and inflam-matory reaction.

【Keywords】 knee osteoarthritis;Zhu-yu Tongbi Tang（逐瘀通痹湯）;clinical efficacy

膝骨关节炎（knee osteoarthritis，KOA）是临床骨科常见的退行性病变，病情迁延难愈，多伴有膝关节疼痛、肿胀，治疗不及时会引发膝关节持续性疼痛，甚至引起畸形，严重影响患者日常生活[1]。临床西医常采用软骨保护剂、抗炎药物治疗，具有一定疗效，但病情易反复，效果有待提升[2]。中医学认为，KOA属“骨痹”范畴，主要由于风寒湿邪侵入，气滞血瘀，痹阻经络所致，治疗应采取逐瘀通痹、舒筋活络、祛风止痛等方法[3]。本研究采用逐瘀通痹汤加减治疗KOA患者48例，现总结报道如下。

1 临床资料

1.1 一般资料 选取2019年2月至2020年2月在漯河市召陵区人民医院就诊的KOA患者96例，按照随机数字表法分为治疗组和对照组，每组48例。治疗组男25例，女23例;年龄41～78岁，平均（54.34±5.61）岁;病程1～8年，平均（3.92±1.30）年;病变部位左膝15例，右膝15例，双膝18例。……