加味独活寄生合剂治疗肝肾亏虚、寒湿痹阻型膝骨关节炎的临床观察*

作者：许晓彤1，邱礼国1，叶子丰1，卢 敏1，张申尧2，文 志1，王林华1，董文波3，邝高艳1

单位：1.湖南中医药大学第一附属医院，湖南 长沙 410007； 2.湖南中医药大学第二附属医院，湖南 长沙 410005； 3.株洲市渌口区中医医院，湖南 株洲 412100

引用：引用：许晓彤，邱礼国，叶子丰，卢敏，张申尧，文志，王林华，董文波，邝高艳.加味独活寄生合剂治疗肝肾亏虚、寒湿痹阻型膝骨关节炎的临床观察[J].中医药导报,2025,31(12):127-132,154.

DOI：10.13862/j.cn43-1446/r.2025.12.020

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摘要：目的：观察加味独活寄生合剂治疗肝肾亏虚、寒湿痹阻型膝骨关节炎（KOA）的临床疗效。方法：将126例肝肾亏虚、寒湿痹阻型膝骨关节炎患者按照随机数字表法分为对照组（63例）、治疗组（63例）。对照组予硫酸氨基葡萄糖胶囊口服，治疗组在对照组治疗的基础上口服加味独活寄生合剂。评价治疗前、治疗4周和治疗8周后患者的疼痛视觉模拟评分法（VAS）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分，检测治疗前和治疗8周后血清及关节液中炎症趋化因子水平，记录不良事件及不良反应的发生情况，比较两组临床疗效。结果：总有效率治疗组为92.06%（58/63），对照组为71.43%（45/63），治疗组高于对照组（P<0.01）。两组患者治疗4周、8周后WOMAC疼痛、僵硬和关节功能评分及总评分、VAS评分均降低（P<0.05）；且治疗组均低于对照组（P<0.01）。两组患者治疗后血液及关节液中白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、趋化因子配体2（CCL2）、趋化因子配体5（CCL5）水平均降低（P<0.01），且治疗组均低于对照组（P<0.01）。两组均未出现严重不良事件及不良反应。结论：加味独活寄生合剂可通过靶向抑制CCL2、CCL5等趋化因子，缓解KOA疼痛及炎症反应。

关键词：膝骨关节炎；加味独活寄生合剂；寒湿痹阻；肝肾亏虚；趋化因子配体2；趋化因子配体5

Abstract：

Objective: To observe the clinical efficacy of Jiawei Duhuo Jisheng Mixture (加味独活寄生合剂, JDJM) in treating knee osteoarthritis (KOA) with liver-kidney deficiency and cold-dampness blockage syndrome. Methods: 126 KOA patients with this syndrome were randomly divided into a control group (63 cases) and a treatment group (63 cases). The control group received oral glucosamine sulfate capsules, while the treatment group received JDJM in addition to the control group's treatment. Visual Analog Scale (VAS) pain scores and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated before treatment, at 4 weeks, and 8 weeks. Serum and synovial fluid levels of inflammatory chemokines were measured before and after 8 weeks of treatment. Adverse events were recorded. The clinical efficacy was compared between the two groups. Results: With total effective rates of 92.06% (58/63) and 71.43% (45/63) in the treatment and control groups, respectively, the treatment group demonstrated a statistically superior outcome (P<0.01). WOMAC pain, stiffness, physical function sub-scores, total WOMAC score, and VAS scores decreased significantly at both 4 and 8 weeks after treatment in both groups (P<0.05). At 4 and 8 weeks post-treatment, VAS scores, all WOMAC sub-scores, and the total WOMAC score in the treatment group were significantly lower than those in the control group (P<0.01). Post-treatment levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), chemokine ligand 2 (CCL2), and chemokine ligand 5 (CCL5) in both serum and synovial fluid were significantly reduced in both groups (P<0.01). Furthermore, the post-treatment levels of IL-6, TNF-α, CCL2, and CCL5 in the treatment group were significantly lower than those in the control group (P<0.01). No severe adverse events or adverse reactions were observed in either group. Conclusion: JDJM can alleviate pain and inflammation in KOA by targeting the suppression of chemokines such as CCL2 and CCL5.

Key words：knee osteoarthritis; Jiawei Duhuo Jisheng Mixture; cold-dampness blockage syndrome; liver-kidney deficiency syndrome; CCL2; CCL5

发布时间：2025-12-31

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