中医辨证施治对早期膝骨关节炎疗效及关节软骨MRI影响的临床对照试验
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作者Author单位AddressE-Mail
张洪美 ZHANG Hong-mei 中国中医科学院望京医院骨关节一科,北京 100102 The 1st Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Science,Beijing 100102,China wangjingzhm@sina.com 
张志强 ZHANG Zhi-qiang 中国中医科学院望京医院骨关节一科,北京 100102 The 1st Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Science,Beijing 100102,China  
闵重函 MIN Zhong-han 中国中医科学院望京医院骨关节一科,北京 100102 The 1st Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Science,Beijing 100102,China  
李辉 LI Hui 中国中医科学院望京医院骨关节一科,北京 100102 The 1st Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Science,Beijing 100102,China  
荆琳 JING Lin 中国中医科学院望京医院骨关节一科,北京 100102 The 1st Department of Bone and Joint,Wangjing Hospital of China Academy of Chinese Medicine Science,Beijing 100102,China  
期刊信息:《中国骨伤》2008年,第21卷,第9期,第651-653页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:首都医学科技发展基金支持项目(编号:05SF2-15)
中文摘要:

目的:探讨中医辨证施治对早期膝骨关节炎的疗效,观察关节软骨MRI在治疗前后的变化及意义。

方法:早期膝骨关节炎患者60例,按Doll法分为2组。试验组32例40个关节,男6例,女26例;年龄43~65岁,平均为52.2岁。对照组28例33个关节,男5例,女23例;年龄42~65岁,平均54.4岁。试验组予中医辨证中药口服,对照组予塞来昔布及盐酸氨基葡萄糖口服,疗程为3个月,分别于治疗前及随访时予MR检查及膝骨关节炎严重性指数(ISOA)评分,观察关节承重区软骨的变化及评价治疗效果。

结果:60例全部随访13~17个月,平均15.3个月。试验组膝关节MRI显示显效15个关节,有效17个关节,总有效率为80.0%;对照组显效8个关节,有效11个关节,总有效率为57.6%.试验组ISOA评分治疗后平均为(0.35±0.16)分,对照组ISOA评分治疗后平均为(3.68±0.18)分,经统计学分析,t=6.94,P<0.05,故两组治疗后疗效差异有统计学意义。

结论:中医辨证施治可以显着减缓或抑制早期膝骨关节炎的关节软骨退变,减轻膝骨关节炎的严重程度,具有显着的临床疗效。
【关键词】骨关节炎,膝  中药疗法  软骨  磁共振成像  临床对照试验
 
Controlled clinical trials on the effects of Chinese traditional medicine for the treatment of osteoarthritis of knee joint at early stage and its MRI changes
ABSTRACT  

Objective: To investigate the effects of Chinese traditional medicine for the treatment of osteoarthritis of knee joint at early stage,as well as to observe the changes of articular cartilage in MRI before and after the treatment.

Methods: Sixty patients were divided into two groups according to Doll's law,32 patients in the treatment group(6 male and 26 female,with an average age of 52.2 years, ranging from 43 to 65 years,40 joints),28 patients in the control group(5 male and 23 female,with an average age of 54.4 years, ranging from 42 to 65 years,33 joints). The patients in the test group were given Chinese traditional medicine orally,and patients in the control group were given celecoxib and the glucosamine hydrochloride orally for three months. MR scan and ISOA score were given respectively before and after treatment. After the treatment,the articular cartilage changes of the weight bearing area were observed to evaluate the therapeutic effects.

Results: All the patients were followed up ranging from 13 to 17 months,with an average of 15.3 months. According to MRI evaluation,15 joints got an excellent result, and 17 joints got a good result in the treatment group,the total excellent and good rate was 80.0%;and in the control group, above data were 8,11 and 57.6% respectively. The average ISOA score of the treatment group after treatment was 0.35±0.16,and in the control group was 3.68±0.18. There was significant differences between the two groups of ISOA score(t=6.94,P<0.05).

Conclusion: Chinese traditional medicine can significantly alleviate or inhibit the cartilage degeneration of knee osteoarthritis at early stage and improve joint function. It had significant clinical effects.
KEY WORDS  Osteoarthritis,knee  Treatment with Chinese herbs  Cartilage  Magnetic resonance imaging  Controlled clinical trials
 
引用本文,请按以下格式著录参考文献:
中文格式:张洪美,张志强,闵重函,李辉,荆琳.中医辨证施治对早期膝骨关节炎疗效及关节软骨MRI影响的临床对照试验[J].中国骨伤,2008,21(9):651~653
英文格式:ZHANG Hong-mei,ZHANG Zhi-qiang,MIN Zhong-han,LI Hui,JING Lin.Controlled clinical trials on the effects of Chinese traditional medicine for the treatment of osteoarthritis of knee joint at early stage and its MRI changes[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(9):651~653
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