中药辨证外敷治疗膝骨性关节炎的临床观察

目的：探讨中药辨证外敷治疗膝骨性关节炎的临床疗效。方法：采用随机对照研究方式，将131例单膝骨性关节炎患者分为治疗组和对照组，其中以通痹散、消瘀散、解毒散辨证外敷治疗膝骨性关节炎75例（治疗组），与通痹散辨证治疗膝骨性关节炎56倒（对照组）进行临床疗效对比。结果：2组患者治疗后VAS评分、膝关节滑膜厚度、关节腔积液积分及w0MAc评分与治疗前比较均有下降，差异有统计学意义（P〈0．05）。治疗组能更有效的降低疼痛程度及滑膜厚度、减少关节积液、改善关节活动功能。但在改善软骨厚度方面比较差异无统计学意义（P〉0．05），且2组均不能有效改善软骨厚度。在疗效方面：治疗组总有效率为93．3％，对照组为82．1％。2组比较差异具有统计学意义（P〈0．05），治疗组疗效优于对照组。结论：中药辨证外敷治疗膝骨性关节炎疗效显著，值得临床推广应用。

Clinical Study of External Application by TCM Differentiation in Treating Knee Osteoarthritis

Objective:To observe the clinical effect of external application by TCM differentiation on knee osteoarthritis(KOA).Methods:One hundred and thirty-one patients with single KOA were randomly divided into treatment group(75 cases) and control group(56 cases).Patients in treatment group were treated with external application of Tongbi Power,Xiaoyu Power,and Jiedu Power by TCM differentiation,while patients in control group were treated with external application of Tongbi Powder.Results:After treatment,the VAS score,knee synovial thickness,arthroedema and the WOMAC score of the 2 groups were both decreased compared with before treatment.The difference in the 2 groups was significant(P<0.05).Better results were observed in treatment group in reducing pain,synovial thickness and arthroedema as well as improving joint motion.However,neither of the two groups improved cartilage thickness.As far as the efficacy concerned,the effective rate was 96.0% and 82.1% in treatment group and control group.There was significant difference between the 2 groups(P<0.05).Conclusion:The external application by TCM differentiation is effective in treating knee osteoarthritis.