世界中医药

作者	单位
林智军，李玉茂，谢晓勇，李平生，张玉九，刘航涛，林奇益	南京军区福州总院附属第一医院骨科，莆田，351100

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中文摘要:

目的：观察补肾消痛方在治疗骨性关节炎方面的临床疗效，并借此探讨该方在SDF-1/CXCR4信号转导通路对骨关节炎的作用机制。方法：选取2015年8月至2016年1月收住我科的膝骨关节炎（Knee Osteoarthritis，KOA）患者90例，随机分成对照组和观察组，各45例。对照组服用双氯芬酸钠缓释片，2片/d，1次/片，治疗10 d，观察组采用内服和外敷补肾消痛方，治疗10 d后观察2组治疗的临床疗效、各临床功能评分、药物不良反应、血浆IL-6及MMP-9水平的变化等情况。结果：1）治疗后观察组有效率8667％，对照组有效率6889％，2组有效率比较差异具有统计学意义（P<005）；2）2组患者治疗前症各评分及屈曲度比较差异无统计学意义(P>005)，治疗10 d后，HHS、Feller、屈曲度均升高，但对照组升高更明显，WOMAC、VAS均降低，对照组降低更明显，差异有统计学意义(P<005)；3）不良反应中，对照组出现14例(3300％)，观察组4例(110％)，观察组不良反应明显低于对照组(P<005)；4）2组患者治疗前血浆IL-6及MMP-9水平比较差异无统计学意义(P>005)。治疗10 d后，2组的IL-6及MMP-9水平均较治疗前下降，但观察组下降更明显（P<005）。结论：补肾消痛方在治疗膝骨关节炎方面有显著的临床效果，且不良反应明显降低，值得推广，同时，该方可能通过目前热门的SDF-1/CXCR4信号转导通路，通过降低炎性反应水平，对OA起作用。

English Summary:

To observe the effect of the Reliving-pain Tonifying-kidney Formula in the treatment of osteoarthritis, and to discuss the party SDF-1 / CXCR4 signal transduction mechanisms of osteoarthritis. Methods: A total of 90 osteoarthritis patients who were admitted to our department during August 2015 to January 2016, were randomly divided into control group and observation group, 45 cases in each group. The control group were given diclofenac sodium sustained-release tablets, 2 / day,1 / piece, for 10 days, the observation group given oral and winnowing Reliving-pain Tonifying-kidney Formula, the clinical efficacy of the treatment was observed 10 days after treatment, all clinical scores, adverse reactions, IL-6 and other changes in plasma levels of MMP-9 and the case. Results:1）After treatment, observation group effective rate was 86.67%, the control group was 68.89%, the differences were statistically significant (P<005）；2）There were no significantly different on disease scores and flexion of patients in both two groups before treatment (P>005), but 10 days after treatment, HHS, Feller, flexion were increased in the two groups, but the control group increased more significantly, WOMAC, VAS decreased more significantly in control group, the difference was statistically significant (P<005）;3）There were 14 cases (33.00%) of adverse reactions in the control group and 4 cases (11.0%) in the observation group, significantly lower than the control group group (P<005）; 4）There were no significant difference of plasma IL-6 and MMP-9 level before the treatment (P>005). But 10 days after treatment, IL-6 and MMP-9 levels decreased in both groups, but the observation group decreased more significantly (P<005）. Conclusion: Reliving-pain Tonifying-kidney Formula can achieve significant clinical efficacy, with less adverse reactions, which is worthy to be promoted in the clinical practice. Meanwhile, the drug may work on OA through the currently popular SDF-1 / CXCR4 signaling pathway to reduce inflammation levels.

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