壮骨除痹丸联合等速肌力训练治疗早中期寒湿痹阻型膝骨关节炎疗效观察

doi:10.3760/cma.j.cn441417-20250312-13027

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (13): 2247-2252.DOI: 10.3760/cma.j.cn441417-20250312-13027

壮骨除痹丸联合等速肌力训练治疗早中期寒湿痹阻型膝骨关节炎疗效观察

殷向辉¹ 陈荣² 范冰洋¹ 李雄¹

¹延安市中医医院运动医学科，延安 716000；²延安市中医医院呼吸科，延安 716000

收稿日期:2025-03-12 出版日期:2025-07-01 发布日期:2025-08-04
通讯作者: 李雄，Email：355219859@qq.com
基金资助:
2024年度市级中医医院中医药科研能力提升项目（SZY-NLTL-2024-032）

Observation on the efficacy of Zhuanggu Chubi pill combined with isokinetic muscle strength training in the treatment of early and mid-stage knee osteoarthritis (cold and dampness obstructive type)

Yin Xianghui¹, Chen Rong², Fan Bingyang¹, Li Xiong¹

¹Department of Sports Medicine, Yan'an Traditional Chinese Medicine Hospital, Yan'an, Shaanxi 716000,China; ²Department of Respiratory, Yan'an Traditional Chinese Medicine Hospital, Yan'an, Shaanxi 716000, China

Received:2025-03-12 Online:2025-07-01 Published:2025-08-04
Contact: Li Xiong, Email: 355219859@qq.com
Supported by:
The project of improving the scientific research ability of traditional Chinese medicine in municipal traditional Chinese medicine hospitals in 2024 (SZY-NLTL-2024-032)

摘要/Abstract

摘要：

目的　观察壮骨除痹丸联合等速肌力训练治疗早中期寒湿痹阻型膝骨关节炎的疗效。方法　选取2024年1—10月延安市中医院运动医学科收治的早中期寒湿痹阻型膝骨关节炎门诊患者120例，采用随机数表法分为对照组、试验A组、试验B组、试验C组，各30例。对照组男15例、女15例，年龄（55.81±4.96）岁；试验A组男12例、女18例，年龄（56.28±5.25）岁；试验B组男13例、女17例，年龄（55.70±5.03）岁；试验C组男10例、女20例，年龄（56.15±5.37）岁。对照组给予塞来昔布+功能锻炼治疗，试验A组给予塞来昔布+功能锻炼+壮骨除痹丸治疗，试验B组给予塞来昔布+功能锻炼+等速肌力训练，试验C组给予塞来昔布+功能锻炼+壮骨除痹丸+等速肌力训练。4组均连续治疗4周，均随访12周。比较4组临床疗效、中医症状分级量化积分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、股四头肌伸屈肌角速度60°/s时峰值力矩（PT）和总功（TW）及安全性评价。统计学方法采用χ²检验、秩和检验、方差分析。结果　试验C组治疗总有效率高于对照组［93.33%（28/30）比70.00%（21/30）］，差异有统计学意义（χ²=5.455，P=0.038）；治疗4周、随访12周后，4组中医症状分级量化积分均降低，试验A组［（13.63±3.17）分、（10.13±2.73）分］、B组［（12.57±2.77）分、（10.27±2.63）分］、C组［（10.33±2.80）分、（8.37±2.20）分］均低于对照组［（15.40±3.07）分、（12.07±2.57）分］，且试验C组最低（均P<0.05）；4组WOMAC评分均降低，试验A组［（22.47±7.67）分、（20.17±5.67）分］、B组［（23.53±7.97）分、（20.37±5.77）分］、C组［（16.53±5.47）分、（13.30±4.27）分］均低于对照组［（29.17±9.73）分、（26.13±7.37）分］，且试验C组最低（均P<0.05）；4组PT和TW均升高，试验C组［（72.56±13.77）N·m、（74.86±12.93）N·m和（79.78±8.63）J、（80.83±8.42）J］均高于对照组［（65.46±12.95）N·m、（66.71±13.06）N·m和（74.48±10.61）J、（75.01±9.54）J］（均P<0.05）。治疗期间，4组患者出现轻微可自行缓解的不良反应，随访期间各项指标均无明显异常。结论　壮骨除痹丸联合等速肌力训练治疗早中期寒湿痹阻型膝骨关节炎患者疗效较高，能在保证安全的前提下提高患者膝功能，改善临床症状，降低疼痛程度，提升肌力，且在随访期间能持续保持优势。

关键词: 膝骨关节炎, 寒湿痹阻型, 壮骨除痹丸, 等速肌力训练

Abstract:

Objective　To observe the efficacy of Zhuanggu Chubi pill combined with isokinetic strength training for early-mid knee osteoarthritis (cold-dampness obstructive type). Methods　A total of 120 outpatients with early and mid-stage knee osteoarthritis (cold and dampness obstructive type) were selected from Department of Sports Medicine of Yan'an Traditional Chinese Medicine Hospital from January 2024 to October 2024. Patients were randomly divided into four groups: control group, experimental group A, experimental group B, and experimental group C, with 30 patients in each group. The control group included 15 males and 15 females, aged (55.81±4.96) years; group A included 12 males and 18 females, aged (56.28±5.25) years; group B included 13 males and 17 females, aged (55.70±5.03) years; and group C included 10 males and 20 females, aged (56.15±5.37) years. The control group received celecoxib and functional exercise; group A received celecoxib, functional exercise, and Zhuanggu Chubi pills; group B received celecoxib, functional exercise, and isokinetic strength training; and group C received celecoxib, functional exercise, Zhuanggu Chubi pills, and isokinetic strength training. All groups were treated continuously for 4 weeks and followed up for 12 weeks. Clinical efficacy, traditional Chinese medicine (TCM) symptom grading scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, peak torque (PT) and total work (TW) at a quadriceps flexion/extension speed of 60°/s, and safety evaluations were compared among the four groups. Statistical methods included χ² test, rank-sum test, and analysis of variance. Results　The total effective rate in experimental group C was higher than that in the control group [93.33% (28/30) vs. 70.00% (21/30)], with a statistically significant difference (χ²=5.455, P=0.038). After 4 weeks of treatment and 12 weeks of follow-up, the traditional Chinese medicine symptom grading scores decreased in all four groups. The scores for experimental group A [(13.63±3.17) points, (10.13±2.73) points], group B [(12.57±2.77) points, (10.27±2.63) points], and group C [(10.33±2.80) points, (8.37±2.20) points] were all lower than those in the control group [(15.40±3.07) points, (12.07±2.57) points], with group C having the lowest scores (all P<0.05). WOMAC scores also decreased in all groups, with experimental group A [(22.47±7.67) points, (20.17±5.67) points], group B [(23.53±7.97) points, (20.37±5.77) points], and group C [(16.53±5.47) points, (13.30±4.27) points] being lower than the control group [(29.17±9.73) points, (26.13±7.37) points], and group C having the lowest scores (all P<0.05). Peak torque (PT) and total work (TW) increased in all groups, with experimental group C [(72.56±13.77) N·m, (74.86±12.93) N·m and (79.78±8.63) J, (80.83±8.42) J] being higher than the control group [(65.46±12.95) N·m, (66.71±13.06) N·m and (74.48±10.61) J, (75.01±9.54) J] (all P<0.05). During treatment, all four groups experienced mild adverse reactions that were self-limiting, and no significant abnormalities were observed in any indicators during follow-up. Conclusion　Zhuanggu Chubi Pills combined with isokinetic strength training is effective for early-mid knee osteoarthritis (cold-dampness obstructive type), improving knee function, reducing symptoms and pain, enhancing muscle strength, and maintaining advantages during follow-up.

Key words: Knee osteoarthritis, , cold and dampness obstructive type, , Zhuanggu Chubi , pills, , Isokinetic muscle strength training

殷向辉陈荣范冰洋李雄.

壮骨除痹丸联合等速肌力训练治疗早中期寒湿痹阻型膝骨关节炎疗效观察 [J]. 国际医药卫生导报, 2025, 31(13): 2247-2252.

Yin Xianghui, Chen Rong, Fan Bingyang, Li Xiong.

Observation on the efficacy of Zhuanggu Chubi pill combined with isokinetic muscle strength training in the treatment of early and mid-stage knee osteoarthritis (cold and dampness obstructive type) [J]. International Medicine and Health Guidance News, 2025, 31(13): 2247-2252.

参考文献

[1]Hunter DJ, Bierma-Zeinstra S. Osteoarthritis[J]. Lancet, 2019, 393(10182):1745-1759. DOI: 10.1016/S0140-6736(19)30417-9.

[2]Safiri S, Kolahi AA, Smith E, et al. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017[J]. Ann Rheum Dis, 2020, 79(6): 819-828. DOI: 10.1136/annrheumdis-2019-216515.

[3]曾国威,钟浩博,黎旭,等.膝关节渗液性滑膜炎与膝骨关节炎相关性的研究进展[J].中华骨与关节外科杂志,2023,16(3):282-288. DOI:10.3969/j.issn.2095-9958.2023.03.15.

[4]Arden NK, Perry TA, Bannuru RR, et al. Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines[J]. Nat Rev Rheumatol, 2021, 17(1): 59-66. DOI: 10.1038/s41584-020-00523-9.

[5]Meiyappan KP, Cote MP, Bozic KJ, et al. Adherence to the American academy of orthopaedic surgeons clinical practice guidelines for nonoperative management of knee osteoarthritis[J]. J Arthroplasty, 2020, 35(2): 347-352. DOI: 10.1016/j.arth.2019.08.051.

[6]潘希安,张远金,张国富,等. AI可视化技术在复杂全髋关节置换术患者术前规划中的临床应用[J].国际医药卫生导报,2024,30(22):3769-3774. DOI:10.3760/cma.j.issn.1007-1245.2024.22.016.

[7]端木宪雨,徐宁,李仙,等.电针联合等速肌力训练治疗膝骨关节炎临床观察[J].山东中医杂志,2023,42(8):831-835. DOI:10.16295/j.cnki.0257-358x.2023.08.010.

[8]张春雷,李冀.膝骨关节炎的中医药治疗进展[J].中医药学报,2022,50(1):106-110. DOI:10.19664/j.cnki.1002-2392.220023.

[9]中华医学会骨科学分会关节外科学组,中国医师协会骨科医师分会骨关节炎学组,国家老年疾病临床医学研究中心(湘雅医院),等.中国骨关节炎诊疗指南(2021年版)[J].中华骨科杂志,2021,41(18):1291-1314. DOI:10.3760/cma.j.cn121113-20210624-00424.

[10]中华中医药学会.膝骨关节炎中西医结合诊疗指南(2023年版)[J].中医正骨,2023,35(6):1-10. DOI:10.3969/j.issn.1001-6015.2023.06.001.

[11]潘华山,王艳.运动医学[M].北京:中国中医药出版社,2023.

[12]da Silva Júnior JEF, Dibai-Filho AV, Santos IS, et al. Measurement properties of the short version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for individuals with knee osteoarthritis[J]. BMC Musculoskelet Disord, 2023, 24(1):574. DOI: 10.1186/s12891-023-06696-0.

[13]常宝生,刘治桓,赵程锦.自体富血小板血浆对骨关节炎患者LXA4和p65-RelA的影响[J].国际医药卫生导报,2024,30(22):3764-3769. DOI:10.3760/cma.j.issn.1007-1245.2024.22.015.

[14]Zhang H, Si W, Pi H. Incidence and risk factors related to fear of falling during the first mobilisation after total knee arthroplasty among older patients with knee osteoarthritis: a cross-sectional study[J]. J Clin Nurs, 2021, 30(17-18): 2665-2672. DOI: 10.1111/jocn.15731.

[15]de Almeida AC, Aily JB, Pedroso MG, et al. Reductions of cardiovascular and metabolic risk factors after a 14-week periodized training model in patients with knee osteoarthritis: a randomized controlled trial[J]. Clin Rheumatol, 2021, 40(1): 303-314. DOI: 10.1007/s10067-020-05213-1.

[16]杨赛成,夏修远,陈家豪.非甾体抗炎药在外科术后的使用及安全性分析[J].中国药物应用与监测,2021,18(5):333-335. DOI:10.3969/j.issn.1672-8157.2021.05.014.

[17]张浩天,次仁卓玛,翟德宇.等速肌力训练对膝骨关节炎康复疗效影响的Meta分析[J].西藏医药,2024,45(2):44-46.

[18]李学飞,崔龙慷,陈文华,等.骨痹饮联合针刀治疗肾虚血瘀型膝骨关节炎的临床疗效观察[J].中华中医药杂志,2022,37(2):1205-1208.

[19]胡芷萱.壮骨通痹丸治疗糖尿病性骨质疏松症肝肾亏虚证的临床观察[D].湖南中医药大学,2023.DOI:10.27138/d.cnki.ghuzc.2023.000299.

[20]董熠,刘丽佳,韩潞雯,等.香豆素类化学成分的药理作用及毒性机制研究进展[J].中草药,2023,54(16):5462-5472. DOI:10.7501/j.issn.0253-2670.2023.16.035.

[21]谢文鹏,马腾,梁延琛,等.苍膝通痹胶囊调控circRNA_0008365/miR-1271/p38 MAPK通路轴促进膝骨关节炎软骨细胞自噬的机制研究[J].中国中药杂志,2023,48(18):4843-4851. DOI:10.19540/j.cnki.cjcmm.20230510.708.

[22]王玥竹,田峻,贾绍辉,等.肌肉失衡参与膝骨关节炎发生的研究进展[J].中华物理医学与康复杂志,2024,46(5):468-474. DOI:10.3760/cma.j.issn.0254-1424.2024.05.018.

[23]尹润宇,杨东元,王世坤,等.补肾活血类中成药治疗膝骨性关节炎的有效性和安全性网状Meta分析[J].中草药,2023,54(13):4266-4277. DOI:10.7501/j.issn.0253-2670.2023.13.019.

[24]梁颖杰,李飞雄,许彪彪.壮骨关节丸联合依托考昔治疗早期膝骨关节炎的临床研究[J].现代药物与临床,2024,39(4):994-998. DOI:10.7501/j.issn.1674-5515.2024.04.031.

[25]李赛超,陈秀天,陈雷雷,等.基于步态分析探讨等速肌力训练治疗膝骨关节炎疗效观察[J].现代中西医结合杂志,2024,33(16):2201-2206. DOI:10.3969/j.issn.1008-8849.2024.16.002.

壮骨除痹丸联合等速肌力训练治疗早中期寒湿痹阻型膝骨关节炎疗效观察

Observation on the efficacy of Zhuanggu Chubi pill combined with isokinetic muscle strength training in the treatment of early and mid-stage knee osteoarthritis (cold and dampness obstructive type)

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