独活寄生汤合身痛逐瘀汤治疗膝骨性关节炎-（肝肾不足、筋脉瘀滞证）的临床观察-中医骨伤科学专业论文.docxVIP

中文摘要 目的：本研究通过分析独活寄生汤合身痛逐瘀汤在改善膝关节骨痹患者 的疼痛、僵硬、关节活动障碍及中医证候方面的临床疗效与安全性，考察该方是 否切中膝痹的病因病机（“虚”、“邪”、“痰”、“瘀”），以供临床推广使用。 方法:收集 60 例膝骨性关节炎患者（均符合一定纳入标准）随机分为治 疗组和对照组，每组各 30 例。治疗组予以独活寄生汤合身痛逐瘀汤,对照组予以 塞来昔布胶囊（西乐葆）口服。4 周为 1 疗程，治疗观察 1 个疗程。 以 WOMAC 评分表、数字评价量表(NRS)和《中药新药临床研究指导原则》的 中医证候为评价标准，观察治疗前后患者在疼痛、僵硬、关节活动、中医证候方 面改善情况及安全性。数据整理后，采用 SPSS17. 0 统计软件包进行统计。 结果:治疗 4 周后，两组患者在 NRS 评分、WOMAC 评分(包括疼痛、僵硬、 关节功能、总积分)、中医证候评分（疼痛、功能受限、腰膝酸软、总积分）等 方面明显降低，治疗前后差异有统计学意义(P0.05)。治疗组的总有效率为 93.33%，对照组为 86.21%，经秩和检验，两者的差别有统计学意义(P0.05)， 表明治疗组优于对照组。两组的疗效优良率相比，治疗组为 70%，对照组为 41.38%，经卡方检验后，两者的差别有统计学意义(P0.05)，说明治疗组优于对 照组。 结论: 1、采用独活寄生汤合身痛逐瘀汤和西乐葆治疗 KOA，均能明显改 善其疼痛、僵硬、肿胀、关节活动障碍等不适； 2、治疗组的整体效果优于对照组。 关键词 KOA；“虚、邪、痰、瘀”；疗效观察 1 Abtract Objective:This clinical observation is to verify the fitness between modified duhuojishengtangjoined with shentongzhuyutang decoction and the etiology and pathogenesis of knee arthralgia syndrome which KOA is called and consists of deficiency, pathogenic factors, phlegm and stagnation in TCM, and to explore the assessments of clinical efficacy and safety in the improvement of pain, stiffness, joint movement disorder and TCM syndrome for clinical promotion. Method:We recruited 60 patients, all of whom were eligible of inclusion criteria and were randomly divided into one treatment group and one control group with 30 cases respectively. Patients in the treatment group were received oral modified duhuojishengtang joined with shentongzhuyutang decoction, while those in the control group oral Celecoxib Capsules. Fore weeks were set as a treatment courseas well as the interval of this clinical observation. In accordance with assessment criteria including WOMAC score table, NRS and the guiding principles of clinical research of new Chinese medicine drugs, we observed the improvement of pain, stiffness, joint movement and TCM syndromes together with safety. Data was processed by the statistic software of SPSS 17.0. Results：After fore weeks of treatment, the scores of the two groups including NRS, W