CAJ | 학술논문

目的：研究中医综合康复疗法在老年骨性关节炎诊治中的治疗效果及安全性。方法随机选取该科2013年2月至2014年1月诊治的80例老年骨性关节炎患者，根据治疗方案分为中医组与西医组，各40例。中医组患者均接受中医康复治疗，主要包括手法推拿、中药熏洗、中药内服（包括六味地黄丸及自制当归四逆汤），疗程3周。西医组患者采用西药治疗，给予关节内注射25 mg玻璃酸钠，每周1次；口服0.75 g盐酸氨基葡萄糖胶囊，每天2次，均连续治疗3周。通过对照分析两组治疗方案的临床疗效及视觉模拟评分表（JOA）、视觉模拟评分表（VAS）评分。结果中医组显效率[62.5%（25/40）]、总有效率[92.5%（37/40）]明显高于西医组[25.0%（10/40）、65.0%（26/40）]，差异均有统计学意义（P<0.05）；治疗前，中医组JOA、VAS评分[（50.2±10.6）、（7.8±2.3）分]与西医组[（49.9±11.2）、（7.7±2.4）分]比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者JOA 评分[（91.5±16.3）、（84.1±13.3）分]较治疗前明显升高，VAS 评分[（2.4±1.2）、（3.6±1.8）分]较治疗前明显降低，且中医组JOA、VAS评分明显优于西医组，差异均有统计学意义（P<0.05）。结论中医康复疗法对老年骨性关节炎不仅具有良好的治疗效果，同时不良反应小、安全可靠，可在临床推广应用。
목적：연구중의종합강복요법재노년골성관절염진치중적치료효과급안전성。방법수궤선취해과2013년2월지2014년1월진치적80례노년골성관절염환자，근거치료방안분위중의조여서의조，각40례。중의조환자균접수중의강복치료，주요포괄수법추나、중약훈세、중약내복（포괄륙미지황환급자제당귀사역탕），료정3주。서의조환자채용서약치료，급여관절내주사25 mg파리산납，매주1차；구복0.75 g염산안기포도당효낭，매천2차，균련속치료3주。통과대조분석량조치료방안적림상료효급시각모의평분표（JOA）、시각모의평분표（VAS）평분。결과중의조현효솔[62.5%（25/40）]、총유효솔[92.5%（37/40）]명현고우서의조[25.0%（10/40）、65.0%（26/40）]，차이균유통계학의의（P<0.05）；치료전，중의조JOA、VAS평분[（50.2±10.6）、（7.8±2.3）분]여서의조[（49.9±11.2）、（7.7±2.4）분]비교，차이균무통계학의의（P＞0.05）；치료후，량조환자JOA 평분[（91.5±16.3）、（84.1±13.3）분]교치료전명현승고，VAS 평분[（2.4±1.2）、（3.6±1.8）분]교치료전명현강저，차중의조JOA、VAS평분명현우우서의조，차이균유통계학의의（P<0.05）。결론중의강복요법대노년골성관절염불부구유량호적치료효과，동시불량반응소、안전가고，가재림상추엄응용。
Objective To approach therapeutic effect and safety of TCM rehabilitation therapy in the treatment of senile osteoarthritis disease. Methods Totally 80 elderly patients with senile osteoarthritis were randomly selected from Feb. 2013 to Jan. 2014 in this department who were divided into the TCM group and the western medicine group , 40 of each group. The pa-tients in the TCM group were accepted TCM rehabilitation therapy,including TCM massage,TCM fumigation and internal TCM including Liuweidihuang pills and angelica sini decoction,while those in the western medicine group with western medicine,in-cluding intra-articular injection of 25 mg sodium hyaluronate,once in each week,taking 0.75 g glucosamine hydrochloride cap-sules orally for twice a day lasting 3 weeks continuously. Upon comparison and analysis,the clinic effects,JOA,VAS grading of the two groups were studied. Results The significant efficiency [62.5%(25/40)],the total efficiency[92.5%(37/40)] of the TCM group were significantly higher than those[25.0%(10/40)、65.0%(26/40)]of the western medicine group. The differences were sta-tistically significant(P<0.05). Compared the JOA and VAS scores before treatment, there were no differences in statistical signif-icance between the[(50.2±10.6),(7.8±2.3)] of TCM group and the[(49.9±11.2),(7.7±2.4)%] of the western medicine group(P>0.05);The JOA scores[(91.5±16.3)、(84.1±13.3)] were raised but the VAS scores [(2.4±1.2)、(3.6±1.8)]after the treatment of the two groups drop respectively. The JOA and VAS scores of the TCM group were distinctly superior than those of the western group , which had statistical significance(P<0.05). Conclusion Upon being confirmed by clinic research,the TCM rehabilitation therapy is not only better in effect in senile osteoarthritiscases but also less in adverse effect with safety and reliablity,being worthy to promotion.