CAJ | 학술논문

目的：探讨伤柏膏治疗气滞血瘀型膝关节骨性关节炎(KOA)的临床效果及其潜在的疗效机制。方法选择2012年1月~2015年1月就诊于广州市天河区中医院的气滞血瘀型KOA患者120例，将其随机分为伤柏膏组(伤柏膏外敷+口服塞来昔布)、冷感好及施组(伤柏膏外敷+口服塞来昔布)以及塞来昔布组(口服塞来昔布)，治疗3个疗程。治疗前后进行西安大略麦马斯特大学骨性关节炎指数可视化量表(WOMAC)疼痛评分和视觉模拟量表(VAS)疼痛评分，在疗程结束时抽取静脉血用于检测外周血清肿瘤坏死因子α(TNF-α)和白介素1(IL-1)的表达。结果与治疗前比较，三组患者治疗后WOMAC疼痛评分和VAS疼痛评分均明显降低(P<0.05)；治疗后，三组患者WOMAC疼痛评分和VAS疼痛评分比较差异有统计学意义(P<0.05)，其中，与冷感好及施组以及塞来昔布组比较，伤柏膏组WOMAC疼痛评分和VAS疼痛评分较低(P<0.05)；治疗后，三组患者血清TNF-α和IL-1表达差异有统计学意义(P<0.05)，其中，与冷感好及施组以及塞来昔布组比较，伤柏膏组TNF-α和IL-1表达水平较低(P<0.05)。结论伤柏膏能够有效改善气滞血瘀型KOA患者临床症状，其作用机制与抑制炎症关系密切。
목적：탐토상백고치료기체혈어형슬관절골성관절염(KOA)적림상효과급기잠재적료효궤제。방법선택2012년1월~2015년1월취진우엄주시천하구중의원적기체혈어형KOA환자120례，장기수궤분위상백고조(상백고외부+구복새래석포)、랭감호급시조(상백고외부+구복새래석포)이급새래석포조(구복새래석포)，치료3개료정。치료전후진행서안대략맥마사특대학골성관절염지수가시화량표(WOMAC)동통평분화시각모의량표(VAS)동통평분，재료정결속시추취정맥혈용우검측외주혈청종류배사인자α(TNF-α)화백개소1(IL-1)적표체。결과여치료전비교，삼조환자치료후WOMAC동통평분화VAS동통평분균명현강저(P<0.05)；치료후，삼조환자WOMAC동통평분화VAS동통평분비교차이유통계학의의(P<0.05)，기중，여랭감호급시조이급새래석포조비교，상백고조WOMAC동통평분화VAS동통평분교저(P<0.05)；치료후，삼조환자혈청TNF-α화IL-1표체차이유통계학의의(P<0.05)，기중，여랭감호급시조이급새래석포조비교，상백고조TNF-α화IL-1표체수평교저(P<0.05)。결론상백고능구유효개선기체혈어형KOA환자림상증상，기작용궤제여억제염증관계밀절。
Objective To investigate the effect and mechanism of Shangbo Ointment on qi stagnation and blood stasis type of patients with knee osteoarthritis (KOA). Methods 120 patients with qi and blood stasis type of KOA admitted to Traditional Chinese Medical Hospital of Tianhe District in Guangzhou City from January 2012 to January 2015 were enrolled. All patients were randomized into three groups: Shangbo Ointment group (external application of Shangbo Ointment +oral application of Celecoxib), Lengganhaojishi group (external application of Lengganhaojishi + oral appli-cation of Celecoxib) and Celecoxib group (oral application of Celecoxib), all patients were treated for 3 sessions. The West-ern Ontario and McMaster Universities (WOMAC) pain scores and visual analogue scale (VAS) pain scores were used to evaluate the severity of KOA. The vein blood was extracted and the peripheral blood of tumor necrosis factorα(TNF-α) and interleukin 1 (IL-1) expression at the end of the course was detected. Results The WOMAC pain scores and VAS pain scores after treatment in all three groups were lower than before treatment (P<0.05). The WOMAC pain scores and VAS pain scores after treatment among the three groups were statistically significant different (P< 0.05). Thereinto, the WOMAC pain scores and VAS pain scores in Shangbo Ointment group were significantly lower than those in Lenggan-haojishi group and Celecoxib group (P<0.05). The levels of TNF-α and IL-1 after treatment among the three groups were statistically significant different (P<0.05). Thereinto, The levels of TNF-αand IL-1 in Shangbo Ointment group were significantly lower than those in Lengganhaojishi group and Celecoxib group (P < 0.05). Conclusion Shangbo Ointment can improve qi stagnation and blood stasis type of patients with KOA. Its mechanism is related to inhibition of inflammation.