滑膜炎汤治疗湿热阻络证膝关节滑膜炎的临床研究

许兴辉

[摘要] 目的 观察滑膜炎汤治疗湿热阻络证膝关节滑膜炎的临床效果。 方法 选取2012年3月～2015年7月宝鸡市中医医院收治的96例诊断为膝关节滑膜炎且符合湿热阻络证的患者作为研究对象。采用随机数字表法将所有对象随机分成观察组（48例）和对照组（48例）。对照组采用微波理疗，每次30 min，每日1次。观察组患者给予滑膜炎汤，每日1剂，同时给予中药外敷。两组均以7 d为一个疗程，治疗4个疗程。观察两组患者治疗后关节肿胀程度的改善情况和中医证候疗效，比较两组患者治疗前后的膝关节疼痛程度和关节功能。 结果 经过4周的治疗后，观察组关节肿胀程度明显轻于对照组（P < 0.05），观察组中医证候疗效显著优于对照组（P < 0.05）。两组患者治疗后WOMAC量表疼痛、关节功能评分均较治疗前显著下降，且观察组治疗后WOMAC量表疼痛、关节功能评分较对照组治疗后下降更明显，差异有统计学意义（P < 0.05）。 结论 滑膜炎汤能显著促进膝关节滑膜炎患者关节积液的吸收，减轻关节肿胀和疼痛，改善關节功能，值得临床推广应用。

[关键词] 滑膜炎汤；湿热阻络证；膝关节滑膜炎

[中图分类号] R274 [文献标识码] A [文章编号] 1673-7210（2017）07（a）-0106-04

[Abstract] Objective To observe the clinical effect of Huamoyan Decoction in the treatment of gonarthromeningitis with syndrome of dampness-heat blocking collaterals. Methods 96 cases diagnosed as gonarthromeningitis met with the syndrome of dampness-heat blocking collaterals admitted to Baoji hospital of traditional Chinese medicine from March 2012 to July 2015 were selected as research objects. All the patients were randomly divided into observation group （48 cases） and control group （48 cases） by random number table. The control group was taken microwave physical therapy， 30 min each time， once a day. The observation group was taken Huamoyan Decoction， one dose each day， external application of Chinese medicine was given at the same time. Both groups were taken 7 days as a course， treating for 4 courses. The improvement of joint swelling degree and TCM syndrome effect of the two groups after treatment were observed. The pain degree of knee-joint and joint function of the two groups before and after treatment were compared. Results After treatment for 4 weeks， the joint swelling degree of observation group was obviously milder than that of control group （P < 0.05）， the TCM syndrome effect of observation group was obviously better than that of control group（P < 0.05）. The scores of pain and joint function of WOMAC scale after treatment in the two groups were lower than those before treatment， and scores of pain and joint function of WOMAC scale after treatment in the observation group were decreased more significantly compared with those of control group， with statistically significant difference （P < 0.05）. Conclusion Huamoyan Decoction can obviously promote the absorption of hydrops articuli in patients with gonarthromeningitis， reduce the swelling and pain of joint， improve the joint function， which is worthy of clinical promotion and application.

[Key words] Huamoyan Decoction； Syndrome of dampness-heat blocking collaterals； Gonarthromeningitis

膝关节滑膜炎是一种常见性、多发性疾病，是由于滑膜受到不同程度的内外刺激引起的损伤，导致关节腔内出现积液/积血的一种非感染性炎性反应[1-2]。病情较轻者表现为局部疼痛、关节活动受限，病情严重者容易造成患者暂时或长期部分丧失劳动力，无论对患者还是对社会的危害都较大[3]。临床上西医多采用对症治疗，以缓解症状，减轻痛苦，但往往不能彻底根治，且随着病情的进展，滑膜逐渐增厚、粘连，从而引发关节退行性病变，不利于患者的预后[4-5]。中医学讲究辨证论治，在治疗膝关节滑膜炎上有其独特的优势，为探讨中医药在治疗膝关节滑膜炎中的疗效，本研究采用滑膜炎汤治疗膝关节滑膜炎，并将结果报道如下：