来源：风湿病与关节炎,2018,7（6）:10-14.

三联序贯通痹法治疗早期膝骨关节炎30例临床观察

（临床研究）

兰维娅¹，唐　芳²，马武开²，周　静²，卢向阳¹，陈琳英¹，李　宇¹，蒋　总¹

　　【摘　要】目的：观察运用三联序贯通痹法治疗早期膝骨关节炎风寒湿痹型的临床疗效。方法：将60例早期膝骨关节炎患者随机分为治疗组和对照组，每组30例。治疗组采用三联序贯通痹法外用，对照组口服双氯芬酸钠缓释胶囊。2组1个疗程均为4周。观察2组临床疗效，以及治疗前后视觉模拟评分法（VAS）评分、膝骨关节炎严重性指数（ISOA）评分，检测外周血白细胞介素-6、肿瘤坏死因子-α水平，并记录安全性指标。结果：治疗组临床控制8例，显效12例，有效8例，无效2例，总有效率为93.33%；对照组临床控制6例，显效15例，有效4例，无效5例，总有效率为83.33%。2组比较，差异无统计学意义（P > 0.05）。治疗后，2组VAS评分、ISOA各项评分、白细胞介素-6、肿瘤坏死因子-α较治疗前均有改善（P < 0.05或P < 0.01），且治疗组优于对照组（P < 0.01）。2组患者均未见明显不良反应。结论：采用三联序贯通痹法综合治疗早期膝骨关节炎风寒湿痹型患者，能够有效控制炎症反应，减轻症状，且无明显不良反应。

　　【关键词】　骨关节炎，膝；早期；风寒湿痹型；三联序贯通痹法；炎症反应；临床疗效

Clinical Observation on 30 Cases of Early Knee Osteoarthritis with Three-step Sequential Therapy

LAN Wei-ya,TANG Fang,MA Wu-kai,ZHOU Jing,LU Xiang-yang,CHEN Lin-ying,LI Yu,JIANG Zong

　　【ABSTRACT】Objective:To observe the clinical efficacy of three-step sequential therapy in the treatment of early knee osteoarthritis of wind-cold-dampness type.Methods:Sixty patients with early knee osteoarthritis were randomly divided into a treatment group and a control group,30 cases in each group.The treatment group was treated with three-step sequential therapy,while the control group was treated with Diclofenac Sodium Sustained Release Capsules.The two groups were treated for four weeks.The clinical effects of both groups were observed,as well as the changes of VAS and ISOA.The levels of interleukin-6 and TNF-α in peripheral blood were detected,and the safety indexes were recorded.Results:In the treatment group,8 cases were clinically controlled,12 cases were markedly effective,8 cases were effective and 2 cases were ineffective,with a total effective rate of 93.33%;while in the control group,6 cases were clinically controlled,15 cases were markedly effective,4 cases were effective and 5 cases were ineffective,and the total effective rate was 83.33%.There was no significant difference between the two groups（P > 0.05）.After treatment,VAS scores,ISOA scores,interleukin -6 and TNF-α of the two groups were better than before treatment（P < 0.05 or P < 0.01）,and the treatment group was better than the control group（P < 0.01）.No obvious adverse reaction was found in the two groups after treatment.Conclusion:Treating early knee osteoarthritis of wind-cold-dampness type with three-step sequential therapy can effectively control the inflammatory reaction and alleviate the symptoms,having no obvious adverse reactions.

　　【Keywords】 osteoarthritis,knee;early stage;wind-cold-dampness type;three-step sequential therapy;inflammatory eaction;clinical efficacy