CAJ | 학술논문

目的：基于关节超声评价独活寄生汤治疗肝肾亏虚型膝关节骨性关节炎(KOA)的近期临床疗效。方法将120例肝肾亏虚型KOA患者随机分为2组,每组60例。对照组予盐酸氨基葡萄糖胶囊口服,治疗组在对照组治疗基础上加用独活寄生汤,均治疗8周。观察2组KOA患者治疗前后红细胞沉降率(ESR)、C反应蛋白(CRP)、WOMAC评分、关节肿胀积分、中医证候评分变化,采用高频关节超声监测2组患者治疗前后膝关节髌上囊积液、滑膜厚度、软骨及骨质破坏、滑膜血流信号声像图的变化特征。结果治疗组在改善WOMAC评分、关节肿胀积分、中医证候评分等方面较对照组有明显优势,差异有统计学意义(P＜0.05,P＜0.01)；治疗后患者关节腔积液减少,膝关节滑膜厚度变薄,关节滑膜血流信号减少(P＜0.05,P＜0.01)。结论独活寄生汤治疗肝肾亏虚型KOA临床效果显著。超声可以清晰地观察KOA患者关节腔积液、滑膜厚度、滑膜血流信号等改变,为临床药物治疗KOA提供较好的影像学评价依据。
목적：기우관절초성평개독활기생탕치료간신우허형슬관절골성관절염(KOA)적근기림상료효。방법장120례간신우허형KOA환자수궤분위2조,매조60례。대조조여염산안기포도당효낭구복,치료조재대조조치료기출상가용독활기생탕,균치료8주。관찰2조KOA환자치료전후홍세포침강솔(ESR)、C반응단백(CRP)、WOMAC평분、관절종창적분、중의증후평분변화,채용고빈관절초성감측2조환자치료전후슬관절빈상낭적액、활막후도、연골급골질파배、활막혈류신호성상도적변화특정。결과치료조재개선WOMAC평분、관절종창적분、중의증후평분등방면교대조조유명현우세,차이유통계학의의(P＜0.05,P＜0.01)；치료후환자관절강적액감소,슬관절활막후도변박,관절활막혈류신호감소(P＜0.05,P＜0.01)。결론독활기생탕치료간신우허형KOA림상효과현저。초성가이청석지관찰KOA환자관절강적액、활막후도、활막혈류신호등개변,위림상약물치료KOA제공교호적영상학평개의거。
Objective To evaluate the clinical efficacy ofDuhuo Jisheng Decoction in treating liver and kidney deficiency syndrome of knee osteoarthritis (KOA) by ultrasound.Methods A total of 120 cases of KOA patients with liver and kidney deficiency syndrome were randomly divided into two groups (each contains 60 cases). Control group took hydrochloric acid glucosamine capsules, while treatment group tookDuhuo Jisheng Decoction additionally for 8 weeks. ESR, CRP, WOMAC, joint swelling scores, and TCM syndrome scores of the two groups were determined, and the sonographic characteristics of knee-joint effusion in patellar fabricius, synovial membrane, cartilage and bone erosions were compared before and after treatment.Results There were significant differences in ESR, CRP, WOMAC, joint swelling scores, and TCM syndrome scores between before and after treatment in both groups (P<0.05,P<0.01). The knee-joint synovial membrane got thinner after therapy in osteoarthritis patients, and the effusion in knee-joint also decreased. The vessel flow signals in knee-joint synovial membrane of osteoarthritis decreased after drug therapy (P<0.05,P<0.01).ConclusionDuhuo Jisheng Decoction can improve clinical efficacy of KOA with liver and kidney deficiency syndrome. Ultrasound can clearly observe the changes of effusion in patellar fabricius, and synovial membrane, and can provide good imaging assessment for the drug therapy for KOA patients.