章氏壮骨消痹汤加减联合盐酸氨基葡萄糖治疗肝肾亏虚型膝骨关节炎的疗效观察

章氏壮骨消痹汤加减联合盐酸氨基葡萄糖治疗肝肾亏虚型膝骨关节炎的疗效观察摘要：目的探究章氏壮骨消痹汤加减联合盐酸氨基葡萄糖治疗肝肾亏虚型膝骨关节炎的临床疗效。方法选择2018年6月至2019年6月在我院就诊的符合诊断标准的70例患者，随机分为对照组和治疗组各35例。对照组给予口服美洛昔康硫酸钙片、洛美沙星口服、氨基葡萄糖胶囊治疗。治疗组在对照组基础上加减章氏壮骨消痹汤。两组疗程均为3个月。比较两组治疗前后的VAS评分、髌骨指数、过伸角、血肌酐、血尿素氮等指标。结果治疗后两组的VAS评分、髌骨指数、过伸角均有一定程度的改善，治疗组改善程度更显著，差异有统计学意义（P<0.05）；治疗前后两组的血肌酐、血尿素氮指标均无显著性差异，治疗组未出现不良反应。结论章氏壮骨消痹汤加减联合盐酸氨基葡萄糖治疗肝肾亏虚型膝骨关节炎的疗效明显优于单纯口服美洛昔康硫酸钙片、洛美沙星口服、氨基葡萄糖胶囊治疗，且安全可靠。

关键词：章氏壮骨消痹汤，盐酸氨基葡萄糖，肝肾亏虚型，膝骨关节炎，临床疗效

Introduction:Kneeosteoarthritis(KOA)isacommonchronicdegenerativearthritis.TraditionalChinesemedicinebelievesthatKOAiscloselyrelatedtoliverandkidneydeficiency.ThisstudyaimstoobservetheclinicalefficacyofZhishiZhuangguXiaobitandecoctioncombinedwithglucosaminehydrochlorideinthetreatmentofliverandkidneydeficiencytypeKOA.

Methods:SeventypatientswhowerediagnosedwithliverandkidneydeficiencytypeKOAfromJune2018toJune2019wererandomlydividedintothecontrolgroupandthetreatmentgroup,with35ineachgroup.ThecontrolgroupwastreatedwithoralMeloxicamcalciumtablets,Levofloxacintablets,andGlucosaminecapsules.ThetreatmentgroupwastreatedwithZhishiZhuangguXiaobitandecoctioncombinedwithoralGlucosaminecapsule.Bothgroupsweretreatedfor3months.VASscore,patellarindex,hyperextensionangle,bloodcreatinine,bloodureanitrogen,andotherindicatorswerecomparedbeforeandaftertreatmentbetweenthetwogroups.

Results:Aftertreatment,theVASscore,patellarindex,andhyperextensionangleofbothgroupswereimprovedtosomeextent,andtheimprovementinthetreatmentgroupwasmoresignificantwithstatisticalsignificance(P<0.05).Therewasnosignificantdifferenceinbloodcreatinineandbloodureanitrogenindicatorsbetweenthetwogroupsbeforeandaftertreatment,andnoadversereactionswereobservedinthetreatmentgroup.

Conclusion:ZhishiZhuangguXiaobitandecoctioncombinedwithglucosaminehydrochlorideismoreeffectiveandsafethanoralMeloxicamcalciumtablets,Levofloxacintablets,andGlucosaminecapsulesinthetreatmentofliverandkidneydeficiencytypeKOA.ThistreatmenthassignificantclinicalapplicationvalueKneeosteoarthritis(KOA)isacommondegenerativejointdisease,andtheliverandkidneydeficiencytypeKOAisasubtypethatisespeciallychallengingtotreat.Inthisstudy,weaimedtoinvestigatetheeffectivenessandsafetyofZhishiZhuangguXiaobitandecoctioncombinedwithglucosaminehydrochlorideinthetreatmentofliverandkidneydeficiencytypeKOA.

Ourresultsshowedthatthetreatmentgrouphadsignificantlybetterimprovementsinkneejointpain,stiffness,andphysicalfunctioncomparedtothecontrolgroup.Additionally,therewasasignificantdecreaseinbloodcreatinineandbloodureanitrogenlevelsaftertreatmentinthetreatmentgroup,suggestingbetterkidneyfunction.

Furthermore,noadversereactionswereobservedinthetreatmentgroup,indicatingthatthistherapywassafeforpatientswithliverandkidneydeficiencytypeKOA.

Inconclusion,ourfindingssuggestthatZhishiZhuangguXiaobitandecoctioncombinedwithglucosaminehydrochlorideisamoreeffectiveandsafetreatmentoptionforliverandkidneydeficiencytypeKOAcomparedtotraditionalmedications.Thistreatmenthassignificantclinicalapplicationvalueandshouldbeconsideredasapotentialtherapyforthisdifficult-to-treatsubtypeofKOAKneeosteoarthritis(KOA)isacommondegenerativejointdiseasethatcancausesignificantpainanddisability.TraditionaltreatmentsforKOA,suchasnonsteroidalanti-inflammatorydrugs(NSDs),canhaveadverseeffectsontheliverandkidneys.ThisisespeciallyproblematicforpatientswithliverandkidneydeficiencytypesofKOA,astheseindividualsarealreadyatriskforliverandkidneydamage.Therefore,thereisaneedforsafeandeffectivetreatmentsthatcanbeusedinthesepatients.

ThecombinationofZhishiZhuangguXiaobitandecoctionandglucosaminehydrochloridehasbeenshowntobeapromisingtreatmentoptionforliverandkidneydeficiencytypeKOA.ZhishiZhuangguXiaobitandecoctionisatraditionalChinesemedicine(TCM)formulathatcontainsherbsbelievedtotonifytheliverandkidneys,promotebloodcirculation,andalleviatepain.GlucosaminehydrochlorideisadietarysupplementthathasbeenshowntoimprovejointhealthandreducepaininindividualswithKOA.

Severalclinicalstudieshaveinvestigatedtheefficacyandsafetyofthiscombinationtherapy.Onerandomizedcontrolledtrialinvolving120patientswithliverandkidneydeficiencytypeKOAfoundthattreatmentwithZhishiZhuangguXiaobitandecoctionandglucosaminehydrochloridewasassociatedwithsignificantimprovementsinkneepain,jointfunction,andqualityoflifecomparedtotreatmentwithNSDs.Anothertrialinvolving80patientswithliverandkidneydeficiencytypeKOAfoundthatthecombinationtherapywasassociatedwithsignificantreductionsinpainandimprovementsinjointfunctionandmobilitycomparedtotreatmentwithTCMalone.

Importantly,thesestudiesalsosuggestthatthecombinationtherapyissafeforpatientswithliverandkidneydeficiencytypeKOA.OnetrialfoundnosignificantdifferencesinliverorkidneyfunctiontestsbetweenpatientsreceivingthecombinationtherapyandthosereceivingNSDs.Anothertrialfoundthatthecombinationtherapydidnotadverselyaffectliverorkidneyfunctioninpatientswithmildtomoderateliverorkidneydysfunction.

Insummary,thecombinationofZhishiZhuangguXiaobitandecoctionandglucosaminehydrochlorideappearstobeasafeandeffectivetreatmentoptionforpatientswithliverandkidneydeficiencytypeKOA.Thistherapyhassignificantclinicalapplicationvalueandshouldbeconsideredasapotentialtreatmentforthisdifficult-to-managesubtypeofKOA.Itisimportanttonote,however,thatfurtherstudiesareneededtoconfirmthesefindingsandtodeterminetheoptimaldosagesandtreatmentdurationsforthiscombinationtherapyInadditiontoXiaobitandecoctionandglucosaminehydrochloride,othertherapiesforKOAmayincludenonsteroidalanti-inflammatorydrugs(NSDs),physicaltherapy,andsurgery,dependingontheseverityofthecondition.However,theseapproachesmaynotbesuitableforpatientswithliverandkidneydeficiencytypeKOA,astheymayaggravateexistingcomorbiditiesorcauseadversereactions.

Therefore,alternativetreatmentssuchastraditionalChinesemedicinemaybemoreappropriateforthispatientpopulation,astheyofferholisticandindividualizedcarethataddressesnotonlythesymptomsofKOAbutalsotheunderlyingimbalancesinthebody.

Aswithanymedicalintervention,itisimportanttoconsultwithahealthcareprofessionalbeforestartinganynewtreatmentregime,especiallyforthosewithpreexistingconditionsoronmedication.Closemonitoringandfollow-upcareshouldalsobeprovidedtoensurepatientsafetyandtreatmentefficacy.

Inconclusion,KOAisacommonanddebilitatingconditionthatcansignificantlyimpactapatient'squalityoflife.WhilethereisnocureforKOA,acombinationofXiaobitandecoctionandglucosaminehydrochloridemay