文献类型：期刊文献

中文题名：膝骨性关节炎中医药治疗与髌下脂肪垫CT改变的相关性研究

英文题名：Treating Knee Osteoarthritis by Chinese Medicine and Its Correlation Study with CT Changes of Infrapatellar Fat Pad

作者：王琳[1];戴恩来[2];刘太运[1];王钢[3];施乐年[1]

第一作者：王琳

机构：[1]甘肃中医学院附属医院放射科,兰州730020;[2]甘肃中医学院中西医结合系,兰州730000;[3]甘肃中医学院附属医院风湿病科,兰州730020

第一机构：甘肃中医药大学第二附属医院

年份：2013

卷号：33

期号：11

起止页码：1494

中文期刊名：中国中西医结合杂志

外文期刊名：Chinese Journal of Integrated Traditional and Western Medicine

收录：MEDLINE(收录号：24483110);CSTPCD;;Scopus(收录号：2-s2.0-84922393668);北大核心:【北大核心2011】；CSCD:【CSCD2013_2014】；PubMed;

基金：甘肃省教育厅科研基金项目(No.1106B-11);甘肃中医学院附属医院中青年科研基金项目(No.gsfy-09-16)

语种：中文

中文关键词：膝关节骨性关节炎;健步通络熏蒸液;髌下脂肪垫;计算机断层扫描

外文关键词：knee osteoarthritis; Jianbu Tongluo Xunzheng Liquid; infrapatellar fat pad; computer laminography

摘要：目的观察健步通络熏蒸液治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的疗效,探讨髌下脂肪垫CT扫描在治疗前后的变化及其与疗效的相关性。方法将105例KOA门诊患者随机分为3组,治疗组35例给予健步通络熏蒸液熏洗,30 min/次,每日1次,10次为1个疗程,共连续治疗3个疗程。对照组35例给予玻璃酸钠关节内注射,每次3 mL,1次/6日,共5次。联合组35例给予健步通络熏蒸液熏洗配合玻璃酸钠关节内注射,治疗方法同前两组。3组皆治疗30天。观察临床疗效及治疗前后髌下脂肪垫CT扫描变化,分析其相关性。结果治疗后联合组总有效率(88.57%,31/35)优于对照组(74.29%,26/35)和治疗组(80.00%,28/35),差异有统计学意义(P<0.05);且联合组美国特种外科医院(hospital for special surgery,HSS)膝关节功能评分优于对照组与治疗组(P<0.05)。治疗组与联合组治疗前后髌下脂肪垫的前后径、内外径、上下径均有缩小,密度均有降低(P<0.05);且联合组和治疗组优于对照组(P<0.05)。结论 CT扫描髌下脂肪垫治疗前后的变化主要存在于有中医药治疗的组内,说明CT扫描变化只与能改变髌下脂肪垫理化性质的疗效有关;而中医药治疗是全面、均衡地调节各组织功能与结构,因此,CT可作为中医药治疗各疾病临床疗效观察的较好检查手段。
Objective To observe the efficacy of Jianbu Tongluo Xunzheng Liquid （JTXL） in trea- ting knee osteoarthritis （KOA）, and to explore the correlation between changes of infrapatellar fat pad scanned by CT and the efficacy. Methods Totally 105 KOA outpatients were randomly assigned to three groups, i.e., the treatment group, the control group, and the combination group, 35 in each group. Pa- tients in the treatment group were fumigated by JTXL, 30 min each time, once daily, 10 times as a course of treatment, 3 courses in total. Those in the control group received intra-articular injection of So- dium Hyaluronate Injection （SHI）, 3 mL each time, once per 6 days, 5 times in total. Those in the combi- nation group were treated by fumigation of JTXL ＋ intra-articular injection of SHI in the same way as the foresaid two groups. All patients were treated for 30 days. Their clinical efficacy and changes of infrapatel- lar fat pad scanned by CT were observed, and their correlation was analyzed. Results The total effec- tive rate was 88.57% in the combination group, better than that of the control group （74.29%） and the treatment group （80.00% ~ bothP 〈0.05）. Besides, the score for knee joint functions at Hospital for Spe- cial Surgery （HSS） was better in the combination group than the other two groups （P 〈0.05）.The antero-posterior diameter, exterior-interior diameter, the superior-inferior diameter were shortened, and the density decreased in the treatment group and the combination group （P 〈0.05）. Besides, they were su- perior to those of the control group （P 〈0.05）. Conclusions Changes of infrapatellar fat pad scanned by CT only existed in the combination group and the treatment group, indicating changes of CT scanning was only correlated with effect on changing physicochemical properties of infrapatellar fat pad. Treatment by Chinese medicine could omnipotently and balancedly regulate functions and structures of every tissue. Therefore, CT could be taken as a better method for clinical efficacy observation by Chinese medicine.