中国中医骨伤科杂志2026，Vol.34Issue(8)：38-45,8.DOI:10.20085/j.cnki.issn1005-0205.260806
通络治痹方联合经筋手法治疗肝肾亏虚、痰瘀互结证早中期膝骨关节炎的随机对照研究
A Clinical Randomized Controlled Study on the Treatment of Early and Middle Stage Knee Osteoarthritis with Liver and Kidney Insufficiency and Phlegm and Blood Stasis Intermingling Syndrome by Tongluo Zhibi Formula Combined with Jingjin Manipulation
摘要
Abstract
Objective:To explore the clinical efficacy of the Tongluo Zhibi formula combined with Jingjin manipulation in the treatment of early and middle-stage knee osteoarthritis(KOA).Methods:From January 2025 to October 2025,152 pa-tients with unilateral KOA were randomly assigned to either a control group or observation group,with 76 patients in each group.Among them,10 cases dropped out from the control group and 6 cases from the observation group.The control group comprised 66 participants,including 27 males and 39 females;34 cases involved the left knee and 32 the right knee;aged 40 to 75 years old,with an average age of(59.87±10.28)years old;disease duration of 8 to 35 months,with an average of(19.59±7.31)months;X-ray K-L grades were 0 in 12 cases,grade Ⅰ in 30 cases,grade Ⅱ in 15 cases,and grade Ⅲ in 9 cases.They were treated with oral celecoxib and glucosamine combined with physical therapy.The observa-tion group had 70 cases,including 26 males and 44 females;34 cases on the left and 36 cases on the right;aged 40 to 75 years old,with an average age of(59.44±9.23)years old;disease duration of 8 to 42 months,with an average of(19.61±7.53)months;X-ray K-L grades were 0 in 15 cases,grade Ⅰ in 36 cases,grade Ⅱ in 12 cases,and grade Ⅲ in 7 cases.They were treated with the Tongluo Zhibi formula combined with Jingjin manipulation therapy.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,Timed Up and Go(TUG)test,gait parame-ters(step length,step speed,double support phase),muscle tension of the quadriceps and gastrocnemius on the affected side,and the Short Form 36 Health Survey(SF-36)scores were compared before and after treatment in both groups.Safe-ty and adverse events were also evaluated.Results:Both the observation group and the control group showed significant improvements in WOMAC scores for pain,stiffness,joint function,and total scores,compared to before treatment(P<0.05),and the observation group had more significant improvements(P<0.05).After treatment,both groups showed significant improvements in TUG test,step length,step speed,and double support phase(P<0.05).The observation group had better improvements than the control group in the TUG test,step length,and double support phase(P<0.05),whereas no significant difference was observed in gait speed(P>0.05).Before treatment,there were no statisti-cally significant differences in the displacement values of muscle tension of the quadriceps and gastrocnemius on the affect-ed side and SF-36 scores between the two groups(P>0.05).After treatment,both groups showed significant improve-ments in the displacement values of muscle tension of the quadriceps and gastrocnemius on the affected side and SF-36 scores compared to before treatment(P<0.05);however,the observation group had more significant improvements than the control group(P<0.05).No serious adverse events occurred in either group,and the safety was good.Conclusion:The Tongluo Zhibi formula combined with Jingjin manipulation can effectively improve the clinical symptoms of early and middle-stage KOA patients,improve the muscle tension of the affected lower extremity,enhance the patients'walking ability,and thereby im-prove their quality of life,with good safety.关键词
膝骨关节炎/肝肾亏虚/痰瘀互结/通络治痹方/经筋手法/随机对照试验Key words
knee osteoarthritis/insufficiency of liver and kidney/intermingling of phlegm and blood stasis/Tongluo Zhibi formula/manipulation of sinew meridians/randomized controlled trial分类
医药卫生引用本文复制引用
邱峰,胡国鹏,石钧文,毛银枫,周雍博,蔡建平..通络治痹方联合经筋手法治疗肝肾亏虚、痰瘀互结证早中期膝骨关节炎的随机对照研究[J].中国中医骨伤科杂志,2026,34(8):38-45,8.基金项目
江苏省中医药学会科研县域联动项目(XYLD2024011)江苏省第四批省名老中医药专家传承工作室项目(苏中医科教[2021]7号)无锡市青年托举人才行动项目(TJXD-2025-221)无锡市中医药管理局科技项目(ZYKJ202123) （XYLD2024011）
