世界中医药

目的：探讨正骨散联合功能锻炼治疗膝骨关节炎的临床疗效，并分析其对患者膝关节功能的影响。方法：选取2014年10月至2016年4月在北京市丰盛中医骨伤专科医院骨科门诊接受治疗的膝骨关节炎患者90例，依据就诊序号分为治疗组（n=45）和对照组（n=45）。治疗组给予正骨散外用结合功能锻炼治疗，对照组仅给予正骨散外用治疗，2组均连续治疗30 d。比较2组临床疗效，采用Lysholm膝关节评分表比较2组治疗前后膝关节功能，比较2组治疗前后等长肌力、肌容积、活动范围、JOA及VAS评分。结果：治疗后，2组Lysholm各项评分中除跛行外，其余各项评分均明显升高，差异有统计学意义（P<0.05或P<0.01），且治疗组各项评分均高于对照组，差异有统计学意义（P<0.05或P<0.01）；与对照组比较，治疗组膝关节功能正常比例明显升高，较差比例明显降低，差异有统计学意义（P<0.05）。与治疗前比较，治疗后2组患者屈肌肌力明显增大，活动范围明显增加，差异有统计学意义（P<0.05或P<0.01），且治疗组明显大于对照组，差异有统计学意义（P<0.05），治疗组伸肌肌力也明显增大，差异有统计学意义（P<0.05），但2组间差异无统计学意义（P>0.05）。治疗后2组主观症状、临床体征、日常活动受限度及JOA总分均明显增加，VAS评分明显降低，且2组间差异有统计学意义（P<0.05或P<0.01）。治疗后，治疗组总有效率93.33%，明显高于对照组的77.78%，差异有统计学意义（P<0.05）。结论：正骨散联合功能锻炼可以更明显改善膝骨关节炎患者活动受限等临床症状，降低关节疼痛，增加等长肌力，明显改善患者膝关节功能，提高整体治疗效果，临床疗效优于正骨散单用。

English Summary:

To explore the effect of Zhenggu powder combined with functional exercise in the treatment of knee osteoarthritis and its effect on knee joint function. Methods:All 90 cases of patients with knee osteoarthritis in our hospital from October 2014 to April 2016 were elected and divided into a treatment group （n=45） and a control group （n=45）. The treatment group was treated with Zhenggu powder combined with function exercise treatment, the control group Zhenggu powder, and both treated for 30 d. The clinical efficacy of 2 groups were compared. The knee function of 2 groups before and after treatment was compared using Lysholm knee score. The isometric muscle strength, muscle volume, range of motion, JOA and VAS score of 2 groups before and after treatment were compared.Results:Except the limp, the Lysholm scores of 2 groups increased significantly after treatment （P<0.05 or P<0.01）, and the treatment group was higher than the control group significantly （P<0.05 or P<0.01）; the proportion of normal knee function of the treatment group was significantly higher than that of the control group, the proportion of poor knee function lower （P<0.05）. Compared with those before treatment, flexor muscle strength, scope of activities of 2 groups after the treatment were increased significantly （P<0.05 or P<0.01）, and the treatment group was higher than the control group significantly （P<0.05）; the extensor muscle strength of the treatment group also increased significantly （P<0.05）, but there was no significant difference between 2 groups （P>0.05）. After treatment, subjective symptoms, clinical signs, limitation of daily activities and JOA score of 2 groups were significantly increased, VAS score significantly reduced, and there was significant difference between 2 groups （P<0.05 or P<0.01）. The total effective rate of treatment group was 93.33%, which was higher than 77.78% of control group significantly （P<0.05）.Conclusion:Zhenggu powder combined with functional exercise in treatment of patients with knee osteoarthritis can significantly improve clinical symptoms, reduce joint pain, increase isometric muscle strength and improve the knee joint function and therapeutic effect, and the clinical curative effect is better than applying Zhenggu powder alone.

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