目的 探讨自拟中药组方联合七叶皂苷钠、甘露醇治疗轻中度膝骨性关节炎(KOA)伴骨髓水肿(BME)患者的疗效。方法 选取2018年1月～2020年9月就诊于我院KOA伴BME患者260例。按照治疗方案分为观察组、对照组,每组130例。两组均给予常规干预,对照组采用七叶皂苷钠、甘露醇治疗,观察组在对照组基础上,联合自拟中药组方治疗。比较两组疗效、不良反应发生情况及治疗前后BME情况、骨关节疼痛情况［视觉模拟评分(VAS)、骨关节炎指数(WOMAC)］。结果 观察组治疗总有效率93.08%(121/130)高于对照组84.62%(110/130)(P＜0.05)；治疗后观察组BME、VAS、WOMAC评分均低于对照组(P＜0.05)；观察组不良反应发生率为1.54%(2/130),对照组为3.85%(5/130),两组对比无显著差异(P＞0.05)。结论 自拟中药组方联合七叶皂苷钠、甘露醇治疗轻中度KOA伴BME,能有效减轻患者膝关节痛感,缓解骨关节炎症,减轻患者水肿状况,疗效显著。

Objective To investigate the efficacy of self-made Chinese medicine prescription combined with sodium aescinate and mannitol in the treatment of patients with mild to moderate knee osteoarthritis (KOA) with bone marrow edema (BME). Methods A total of 260 patients with KOA and BME in our hospital from January 2018 to September 2020 were selected. According to the treatment plan, they were divided into observation group and control group, with 130 cases in each group. Both groups were given conventional intervention. The control group was treated with sodium aescinate and mannitol, and the observation group was treated with a self-made Chinese medicine prescription on the basis of the control group. The efficacy, occurrence of adverse reactions, BME and bone and joint pain before and after treatment were compared between the two groups [Visual Analog Scale (VAS), Osteoarthritis Index (WOMAC)]. Results The total effective rate of treatment in the observation group was 93.08% (121/130) higher than that of the control group 84.62% (110/130) (P＜0.05); after treatment, the scores of BME, VAS and WOMAC in the observation group were lower than those of the control group (P＜0.05) ); The incidence of adverse reactions in the observation group was 1.54% (2/130) and the control group was 3.85% (5/130). There was no significant difference between the two groups (P>0.05). Conclusion The self-made traditional Chinese medicine prescription combined with sodium aescinate and mannitol in the treatment of mild to moderate KOA with BME can effectively alleviate knee joint pain, relieve osteoarthritis, and reduce the patient"s edema. The effect is significant.