舒筋松腱剂治疗晚期膝骨关节炎的效果及对血清bFGF水平和膝关节功能恢复的影响

张里援; 陈湘宜; 吴惠明

doi:10.16766/j.cnki.issn.1674-4152.001772

舒筋松腱剂治疗晚期膝骨关节炎的效果及对血清bFGF水平和膝关节功能恢复的影响

doi: 10.16766/j.cnki.issn.1674-4152.001772

1.
温州市中医院骨伤科，浙江温州 325000
2.
温州市中医院中医妇科，浙江温州 325000

基金项目:

国家计划生育委员会医药卫生科技发展研究中心-创伤修复专项项目 ZX-01-C2016036

详细信息

通讯作者:
张里援，E-mail：yisheng3527@163.com

中图分类号: R244 R684.3
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出版历程
- 收稿日期: 2020-05-26
- 网络出版日期: 2022-02-19

Effects of Shujin Songjian topical liniment on the prevention and treatment of advanced knee osteoarthritis and its influence on serum bFGF level and knee joint function recovery

1.
Department of Orthopaedics and Orthopaedics, Wenzhou Traditional Chinese Medicine Hospital, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探究舒筋松腱剂在晚期膝骨关节炎(KOA)中的应用效果。方法采用随机数表法将2017年1月—2019年6月温州市中医院诊治的74例晚期KOA患者分为治疗组(37例)与对照组(37例)，对照组接受全膝关节置换术(TKA)治疗，术后常规处理，治疗组在对照组基础上于术后7 d开始行舒筋松腱剂外敷，用药28 d后评价疗效。治疗前后对2组西安大略和麦克马斯特大学骨关节炎调查量表(WOMAC)、Rasmussen分级评分进行统计，且经酶联免疫吸附法(ELISA)测定血清骨钙素(BGP)、血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平。结果治疗组总有效率为97.30%，比对照组高(78.38%，P＜0.05)；与组内治疗前对比，2组治疗后WOMAC各项评分、血清VEGF、bFGF水平均显著下降(均P＜0.05)，血清BGP水平及Rasmussen分级各项评分均显著上升(均P＜0.05)，且治疗组治疗后WOMAC各项评分、血清VEGF、bFGF水平均显著低于对照组，血清BGP水平及Rasmussen分级各项评分均显著高于对照组(均P＜0.05)。结论舒筋松腱剂外敷能有效提高晚期KOA患者TKA术后效果，减轻骨关节炎症状，降低bFGF水平，改善膝关节功能。
- 舒筋松腱剂 /
- 膝骨关节炎 /
- 症状 /
- 细胞生长因子 /
- 关节功能
Abstract: Objective To investigate the effects of Shujin Songjian topical liniment on the treatment of advanced knee osteoarthritis (KOA). Methods Seventy-four patients with advanced KOA who were diagnosed and treated between January 2017 and June 2019 were divided into a treatment group (n=37) and a control group (n=37) via the random number table method. The control group was treated with total knee arthroplasty (TKA) and given routine treatment after surgery. On the 7th day after surgery, the treatment group was externally applied with Shujin Songjian topical liniment. The curative effect of this agent was evaluated after 28 days of medication. Scores of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Rasmussen grading were calculated and statistically analysed before and after treatment. Levels of serum bone gla protein (BGP), vascular endothelial cell growth factor (VEGF) and basic fibroblast growth factor (bFGF) were determined via enzyme-linked immunosorbent assay. Results The total effective rate in the treatment group (97.30%) was significantly higher than that in the control group (78.38%, P < 0.05). The WOMAC scores, serum VEGF and bFGF levels in the two groups significantly decreased after treatment (all P < 0.05), whereas serum BGP levels and Rasmussen grading scores significantly increased (all P < 0.05). After treatment, WOMAC scores, serum VEGF and bFGF levels of the treatment group were significantly lower, whereas serum BGP levels and Rasmussen grading scores were significantly higher than those of the control group (all P < 0.05). Conclusion External application of Shujin Songjian topical liniment can effectively improve the effects of TKA on patients with advanced KOA, reduce the symptoms of osteoarthritis and the level of bFGF and improve knee joint functions.
- Shujin Songjian topical liniment /
- Knee osteoarthritis /
- Symptom /
- Cell growth factor /
- Joint function

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表 1 2组膝骨关节炎患者总有效率比较[例(%)]

组别	例数	临床治愈	有效	无效	总有效
治疗组	37	30(81.08)	6(16.22)	1(2.70)	36(97.30)
对照组	37	24(64.86)	5(13.52)	8(21.62)	29(78.38)
注：2组总有效率比较，χ²=4.554，P=0.033。

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表 2 2组膝骨关节炎患者治疗前后WOMAC评分比较(x ±s, 分)

组别	例数	僵硬		疼痛		关节功能
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	5.26±0.48	2.05±0.38^a	9.23±1.52	5.68±1.24^a	36.24±5.72	20.01±4.97^a
对照组	37	5.30±0.57	3.68±0.43^a	9.27±1.74	6.82±1.35^a	36.09±5.81	25.38±4.23^a
t值		0.327	17.278	0.105	3.783	0.112	5.005
P值		0.745	＜0.001	0.916	＜0.001	0.911	＜0.001
注：与组内治疗前比较，^aP＜0.05。

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表 3 2组膝骨关节炎患者治疗前后血清指标比较(x ±s)

组别	例数	BGP(μg/mL)		VEGF(ng/L)		bFGF(pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	3.10±0.72	6.21±1.35^a	166.35±20.96	108.37±15.06^a	4.08±0.69	1.42±0.53^a
对照组	37	3.08±0.80	5.13±1.20^a	167.02±21.16	130.48±18.65^a	4.05±0.70	2.06±0.58^a
t值		0.113	3.637	0.137	5.610	0.186	4.955
P值		0.910	0.001	0.892	＜0.001	0.853	＜0.001
注：与组内治疗前比较，^aP＜0.05。

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表 4 2组膝骨关节炎患者治疗前后Rasmussen分级评分比较(x ±s, 分)

组别	例数	疼痛		活动范围		肌力		功能部分		稳定性		屈曲畸形
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	2.25±0.86	28.25±1.75^a	3.21±0.78	17.15±0.68^a	2.40±0.76	9.10±0.86^a	1.64±0.50	20.00±1.42^a	2.41±1.67	9.02±0.75^a	2.54±0.52	9.11±0.72^a
对照组	37	2.30±0.79	17.46±3.58^a	3.24±0.80	13.08±1.32^a	2.42±0.79	7.61±1.36^a	1.68±0.49	15.24±1.78^a	2.40±1.63	7.70±2.48^a	2.61±0.73	7.68±2.16^a
t值		0.260	16.471	0.163	16.673	0.111	5.632	0.347	12.716	0.026	3.099	0.475	3.820
P值		0.795	＜0.001	0.871	＜0.001	0.912	＜0.001	0.729	＜0.001	0.979	0.003	0.636	＜0.001
注：与组内治疗前比较，^aP＜0.05。

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