摘要
目的研究健骨蠲痹方治疗膝关节骨关节炎(KOA)合并骨质疏松症的临床疗效。方法选取在本院骨科就诊的KOA合并骨质疏松症患者80例,随机分为观察组和对照组,每组40例。观察组采用唑来膦酸注射液联合健骨蠲痹方治疗,对照组仅采用唑来膦酸注射液治疗,2组疗程均为8周。比较2组治疗前后关节液中炎性因子(HA、TNF-α、IL-1β)、骨代谢(t-PⅠNP、N-MID-OC、β-CTx、25-OH-VD)及血生化指标(Ca、P、ALP)水平;进行Lequesne指数、关节肿胀和压痛评分;测定骨密度(BMD);比较2组的临床疗效。结果治疗后,2组关节液中HA水平明显升高,TNF-α和IL-1β水平明显下降,骨代谢t-PⅠNP、N-MID-OC、β-CTx水平明显下降,25-OH-VD明显升高,钙和磷水平均明显升高,ALP水平明显下降,Lequesne指数、关节肿胀和压痛评分明显下降,BMD明显升高,观察组各项指标改善程度均显著优于对照组(均P<0.05)。结论应用唑来膦酸联合健骨蠲痹方治疗KOA合并骨质疏松症,在降低患者关节液中炎性因子表达、改善骨代谢、膝关节功能和骨密度等方面具有较好的临床疗效。
Objective To study the clinical effect of Jiangu Juanbi decoction in the treatment of knee osteoarthritis combined with osteoporosis.Methods A total of 80 patients with knee osteoarthritis and osteoporosis in the orthopedics department of our hospital were enrolled and divided into observation group（using zoledronic acid injection combined with Jiangu Juanbi decoction）and control group（using zoledronic acid injection）,with 40 cases in each group.After treatment of 8 weeks,the levels of inflammatory cytokines（HA,TNF-αand IL-1β）in the joint fluid,bone metabolism（t-PⅠNP,N-MID-OC,β-CTx,25-OH-VD）,blood biochemical indicators（Ca,P,ALP）,Lequesne index score,joint swelling and tenderness score,bone mineral density（BMD）and clinical efficacy were measured in both groups.Results After treatment,the level of HA in the synovial fluid of knee osteoarthritis patients was significantly increased,the levels of TNF-αand IL-1βwere significantly decreased,and the levels of t-PⅠNP,N-MID-OC andβ-CTx were significantly decreased,25-OH-VD was significantly increased,serum calcium and phosphorus levels were significantly increased,ALP level was decreased obviously,Lequesne index score was decreased significantly,knee swelling and tenderness were significantly decreased,BMD test results were significantly higher than those before treatment in both groups,with obvious better improvement in the observation group than the control group（all P〈0.05）.Conclusion The application of Jiangu Juanbi decoction combined with zoledronic acid reduce the expression of inflammatory cytokines,improve bone metabolism,relieve clinical symptoms and improve knee joint function and bone mineral density,which has good clinical effects in the treatment of knee osteoarthritis with osteoporosis.
作者
张东洋
秦合伟
刘正阁
ZHANG Dongyang;QIN Hewei;LIU Zhengge(The Sixteenth People＇s Hospital of Zhengzhou,Zhengzhou 452470,China;Henan Province Hospital of TCM,Zhengzhou 450002,China)
出处
《中西医结合研究》
2017年第6期281-284,共4页
Research of Integrated Traditional Chinese and Western Medicine
基金
河南省中医药科学研究专项课题(No.2016ZY2097)
关键词
唑来膦酸
健骨蠲痹方
骨关节炎
骨质疏松症
zoledronic acid
Jiangu Juanbi decoction
osteoarthritis
osteoporosis
