| 陈晓冬.（退后重投）防己黄芪汤加减对不同中医证型膝关节骨性关节炎患者COMP、MMP-13水平的影响[J].浙江中西医结合杂志,2026,36(5): |
| （退后重投）防己黄芪汤加减对不同中医证型膝关节骨性关节炎患者COMP、MMP-13水平的影响 |
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| 投稿时间：2025-05-16 修订日期：2025-09-10 |
| DOI： |
| 中文关键词: 防己黄芪汤 中医证型 膝关节骨性关节炎 软骨寡聚基质蛋白 基质金属蛋白酶-13 |
| 英文关键词:Fangji Huangqi decoction TCM syndrome types Knee osteoarthritis Oligomeric matrix protein of cartilage matrix metalloproteinase-13 |
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| 中文摘要: |
| 目的:观察防己黄芪汤加减对不同中医证型膝关节骨性关节炎(Knee Osteoarthritis,KOA)患者软骨寡聚基质蛋白(Cartilage oligomeric matrix proteins,COMP)、基质金属蛋白酶-13(matrix metallopeptidase 13,MMP-13)水平的影响,为不同证型骨性关节炎的临床用药提供参考。方法:回顾性分析2021年3月至2023年4月就诊本院中医骨伤科住院治疗的KOA患者142例,依据患者中医证型分为淤血阻滞组48例、寒湿阻滞组45例、肝肾亏虚组49例,3组患者利用防己黄芪汤加减治疗,比较临床疗效、关节功能、疼痛程度、血清中COMP、MMP-13水平变化及用药不良反应情况。结果:3组治疗后2.4m行走时间比较无统计学意义(P＞0.05),但5次坐立时间及WOMAC评分均以寒湿阻滞组降低更为显著(P＜0.05)；3组患者治疗后疼痛VAS评分均较治疗前下降(P＜0.05),3组疼痛程度变化比较差异无统计学意义(P＞0.05)；3组间治疗后COMP、MMP-13比较均有统计学意义(P＜0.05),事后检验发现,寒湿阻滞组的COMP、MMP-13降低较肝肾亏虚组更为显著(P＜0.05)；寒湿阻滞组的临床总有效率高于肝肾亏虚组(P＜0.05)；3组患者比较治疗期间不良反应发生率差异无统计学意义(P＞0.05)。结论:防己黄芪汤加减治疗不同中医证型KOA患者,寒湿阻滞证型在COMP和MMP-13水平降低及临床疗效上表现优于淤血阻滞证及肝肾亏虚证。 |
| 英文摘要: |
| Objective: To observe the effect of Fangji Huangqi decoction on the levels of cartilage oligomeric matrix proteins (COMP) and matrix metalloproteinase-13 (MMP-13) in patients with different TCM syndromes of knee osteoarthritis (KOA), and to provide reference for clinical medication of different syndromes of knee osteoarthritis. Methods: A retrospective analysis was conducted on 142 patients with knee osteoarthritis (KOA) from March 2021 to April 2023 who were admitted to the Department of TCM Orthopedics in our hospital. By their TCM syndrome types, the patients were divided into a congestion block group of 48 cases, a cold and dampness block group of 45 cases, and a liver and kidney deficiency group of 49 cases. The three groups of patients were treated with modified Fangji Huangqi decoction, and the clinical efficacy, joint function, pain level, changes in serum COMP and MMP-13 levels, and adverse drug reactions were compared. Results: There was no statistically significant difference in the walking time of 2.4m among the three groups after treatment (P>0.05), but the sitting and standing time and WOMAC score decreased more significantly in the cold and dampness block group (P<0.05); After treatment, the VAS scores of pain in all three groups of patients decreased compared to before treatment (P<0.05), and there was no statistically significant difference in the changes in pain severity among the three groups (P>0.05); After treatment, the comparison of COMP and MMP-13 among the three groups showed statistical significance (P<0.05). Post hoc examination revealed that the decrease in COMP and MMP-13 in the cold dampness block group was more significant than that in the liver and kidney deficiency group (P<0.05); The clinical total effective rate of the cold dampness block group was higher than that of the liver and kidney deficiency group (P<0.05); There was no statistically significant difference in the incidence of adverse reactions among the three groups of patients during the treatment period (P>0.05). Conclusion: The modified Fangji Huangqi decoction is more effective in treating KOA patients with different TCM syndrome types. The cold and dampness blocking syndrome type shows lower levels of COMP and MMP-13 and better clinical efficacy than the stasis blocking syndrome and liver and kidney deficiency syndrome. |
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