知柏强骨汤治疗肝肾亏虚型膝关节骨性关节炎的临床疗效观察

Clinical observation on the efficacy of Zhibai Qianggu Decoction in treating knee osteoarthritis with liver-kidney deficiency

摘要:

目的 探讨知柏强骨汤治疗肝肾亏虚型膝关节骨性关节炎（KOA）的临床疗效。方法 选取2021年1月—2024年3月在徐州市中心医院确诊为肝肾亏虚型KOA的80例患者，按照随机数字表法分为对照组与治疗组，每组40例。对照组给予常规治疗，治疗组在常规治疗基础上加用知柏强骨汤。比较两组临床疗效、膝关节活动度、中医证候评分、骨代谢指标及炎症因子水平。结果 治疗组的总有效率高于对照组（P <0.05）。治疗组治疗前后膝关节伸直度、屈曲度和屈伸弧度的差值均高于对照组（P <0.05）。治疗组治疗前后中医证候评分的差值均高于对照组（P <0.05）。治疗组治疗前后抗酒石酸酸性磷酸酶、Ⅰ型胶原羧基端肽、骨钙素、骨保护素水平的差值均高于对照组（P <0.05）。治疗组治疗前后白细胞介素-1、白细胞介素-6、肿瘤坏死因子-α、血沉水平的差值均高于对照组（P <0.05）。结论 知柏强骨汤联合常规治疗对肝肾亏虚型KOA具有显著的临床疗效。

Abstract:

Objective To evaluate the therapeutic effect of Zhibai Qianggu Tang (ZBQGT) on knee osteoarthritis (KOA) with liver and kidney deficiency syndrome (LKDS).Method Eighty KOA patients with LKDS diagnosed between January 2021 and March 2024 were randomized into a control group (n = 40, conventional treatment) and a treatment group (n = 40, conventional treatment + ZBQGT). Clinical efficacy, knee joint mobility, Traditional Chinese Medicine (TCM) syndrome scores, bone metabolism markers (TRACP, CTX-I, BGP, OPG), and inflammation markers (IL-1, IL-6, TNF-α, ESR) were compared.Results The total effective rate was significantly higher in the treatment group (P < 0.05). Improvements in knee extension, flexion, range of motion, and TCM syndrome scores were significantly greater in the treatment group (P < 0.05). Changes in TRACP, CTX-I, BGP, and OPG levels were more favorable in the treatment group (P < 0.05). Decreases in IL-1, IL-6, TNF-α, and ESR were significantly greater in the treatment group (P < 0.05).Conclusion Zhibai Qianggu Decoction combined with conventional treatment demonstrates significant clinical efficacy in KOA patients with liver-kidney deficiency, improving joint function, bone metabolism, and reducing inflammation.