| 摘要: |
| 目的：观察清热拔毒膏外敷治疗膝骨关节炎（KOA） 湿热内蕴型的临床疗效。方法：将符合纳入标准的KOA 患者随机分为4 组：手法按摩组（A 组） 23 例，清热拔毒膏加手法按摩组（B 组） 25 例，清热拔毒膏组（C 组） 27 例，扶他林软膏对照组（D 组） 24 例，最终共99 例患者完成本课题研究，观察治疗前后西安大略和麦马斯特大学骨关节炎指数（WOMAC）、疼痛视觉模拟评分法（VAS） 评分，酶联免疫吸附试验（ELISA） 检测关节液肿瘤坏死因子-α （TNF-α）、白细胞介素-1β（IL-1β）、基质金属蛋白酶-1（MMP-1） 指标。结果：B 组和C 组WOMAC、VAS 评分优于A 组及D 组，差异均有统计学意义（P＜0.05），TNF-α、IL-1β、MMP-1 因子检测显示B 组、C 组和D 组优于A 组，差异均有统计学意义（P＜0.05）；临床疗效总有效率B 组88.00%和C 组85.19%均高于A 组73.91%和D 组79.17%，差异均有统计学意义（P＜0.05）。在治疗过程中，4 组患者均未见推拿手法和药物的不良反应。结论：以汉防己为君药的清热拔毒膏外敷治疗KOA 湿热内蕴型患者临床疗效确切，改善患者临床不适症状，降低膝关节液炎症反应，患者安全性高。 |
| 关键词: 膝骨关节炎 湿热内蕴型 清热拔毒膏 肿瘤坏死因子-α 白细胞介素-1β 基质金属蛋白酶-1 |
| DOI： |
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| 基金项目:广西中医药大学自然科学基金面上项目（2019MS010） |
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| Clinical Study on External Application with Qingre Badu Plaster for Knee Osteoarthritisof Damp-Heat Accumulation Type |
| LIU Yuan,SUN Xuelian |
| (单篇PDF全文查阅请上中国知网下载阅读（中国知网电子版刊出时间：纸刊刊出日期一个月左右）) |
| Abstract: |
| Abstract： Objective： To observe the clinical effect of Qingre Badu plaster for knee osteoarthritis(KOA) of damp- heat
accumulation type. Methods： The KOA patients who met the inclusion criteria were randomly divided into four groups，
namely the manual massage group(Group A)，the Qingre Badu plaster and manual massage group(Group B)，the Qingre Badu
plaster group(Group C) and the control group with voltaren emulgel(Group D)， 23， 25， 27 and 24 cases in each group
respectively. Finally，a total of 99 patients completed the study. Before and after treatment，the scores of Western Ontario
and Mcmaster Universities Osteoarthritis Index(WOMAC) and Visual Analogue Scale(VAS) were observed； tumor necrosis
factor-α(TNF-α)，interleukin-1β(IL-1β) and matrix metalloproteinase-1(MMP-1) in synovial fluid were detected by Enzyme
Linked Immunosorbent Assay(ELISA). Results：The scores of WOMAC and VAS in Group B and Group C were better than
those in Group A and Group D，differences being significant(P＜0.05). The detection of TNF-α，IL-1β and MMP-1 showed
that the levels in Group B， C and D were better than those in Group A， differences being significant(P＜0.05). The total
effective rate was 88.00% in Group B and 85.19% in Group C，higher than those of 73.91% in Group A and 79.17% in Group
D，differences being significant(P＜0.05). During treatment，there was no response to massage manipulation and no adverse
reaction to drugs in the four groups. Conclusion： The external application of Qingre Badu plaster， with Radix Stephaniae
Tetrandrae as the chief medicinal， has definite clinical effect for KOA patients of damp- heat accumulation type， and can
improve clinical uncomfortable symptoms，reduce inflammatory responses in knee joint fluid with high safety. |
| Key words: Keywords ： Knee osteoarthritis Damp-heat accumulation type Qingre Badu plaster Tumor necrosis factor-α Intenleukin-1β Matrix metalloproteinase-1 |
