補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯治療肝腎虧虛型膝骨關(guān)節(jié)炎的臨床療效觀察

補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯治療肝腎虧虛型膝骨關(guān)節(jié)炎的臨床療效觀察摘要：目的：探討補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯對肝腎虧虛型膝骨關(guān)節(jié)炎的臨床療效。方法：選取2019年1月至2021年1月于本院就診的64例肝腎虧虛型膝骨關(guān)節(jié)炎患者，按照隨機(jī)數(shù)字表法分為兩組，每組32名患者。采用隨機(jī)數(shù)字表法，第一組患者給予口服補(bǔ)腎活血湯治療，第二組患者在口服補(bǔ)腎活血湯的基礎(chǔ)上，再行超聲引導(dǎo)下神經(jīng)阻滯治療。治療8周之后，觀察兩組治療前后VAS評分、膝功能指數(shù)(KSF)評分及臨床療效。結(jié)果：在VAS評分、KSF評分方面，兩組治療前后評分比較，治療后兩組患者評分均有所改善，但第二組患者改善幅度更大(P<0.05)。治療后第一組患者有效率為62.5%，第二組患者有效率為87.5%，第二組患者的有效率更高(P<0.05)。結(jié)論：補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯治療肝腎虧虛型膝骨關(guān)節(jié)炎具有顯著的臨床療效，可以改善患者的癥狀，提高生活質(zhì)量。

關(guān)鍵詞：補(bǔ)腎活血湯；神經(jīng)阻滯；超聲引導(dǎo)；膝骨關(guān)節(jié)炎；肝腎虧虛

Introduction:膝骨關(guān)節(jié)炎是一種會影響患者生活質(zhì)量的疾病。肝腎虧虛型膝骨關(guān)節(jié)炎在臨床中常常見到。傳統(tǒng)的治療方法以中草藥口服為主，但其療效緩慢。超聲引導(dǎo)下神經(jīng)阻滯作為一種治療方法已經(jīng)在臨床上應(yīng)用。本文旨在探討補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯治療肝腎虧虛型膝骨關(guān)節(jié)炎的臨床療效。

Methods:選取2019年1月至2021年1月于本院就診的64例肝腎虧虛型膝骨關(guān)節(jié)炎患者，按照隨機(jī)數(shù)字表法分為兩組，每組32名患者。采用隨機(jī)數(shù)字表法，第一組患者給予口服補(bǔ)腎活血湯治療，第二組患者在口服補(bǔ)腎活血湯的基礎(chǔ)上，再行超聲引導(dǎo)下神經(jīng)阻滯治療。治療8周之后，觀察兩組治療前后VAS評分、膝功能指數(shù)(KSF)評分及臨床療效。

Results:在VAS評分、KSF評分方面，兩組治療前后評分比較，治療后兩組患者評分均有所改善，但第二組患者改善幅度更大(P<0.05)。治療后第一組患者有效率為62.5%，第二組患者有效率為87.5%，第二組患者的有效率更高(P<0.05)。

Conclusion:補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯治療肝腎虧虛型膝骨關(guān)節(jié)炎具有顯著的臨床療效，可以改善患者的癥狀，提高生活質(zhì)量。

Keywords:補(bǔ)腎活血湯；神經(jīng)阻滯；超聲引導(dǎo)；膝骨關(guān)節(jié)炎；肝腎虧虛；臨床療效觀。Introduction:膝骨關(guān)節(jié)炎是老年人常見的疾病，其中肝腎虧虛型是較為常見的亞型。傳統(tǒng)口服藥物治療效果緩慢，超聲引導(dǎo)下神經(jīng)阻滯治療已成為一種新的治療選擇。本研究旨在探討補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯治療肝腎虧虛型膝骨關(guān)節(jié)炎的臨床療效。

Methods:選取2019年1月至2021年1月于本院就診的64例肝腎虧虛型膝骨關(guān)節(jié)炎患者，按照隨機(jī)數(shù)字表法分為兩組，每組32名患者。第一組患者給予口服補(bǔ)腎活血湯治療，第二組患者在口服補(bǔ)腎活血湯的基礎(chǔ)上，再行超聲引導(dǎo)下神經(jīng)阻滯治療。治療8周之后，觀察兩組治療前后VAS評分、膝功能指數(shù)(KSF)評分及臨床療效。

Results:在VAS評分、KSF評分方面，兩組治療前后評分比較，治療后兩組患者評分均有所改善，但第二組患者改善幅度更大(P<0.05)。治療后第一組患者有效率為62.5%，第二組患者有效率為87.5%，第二組患者的有效率更高(P<0.05)。

Conclusion:補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯治療肝腎虧虛型膝骨關(guān)節(jié)炎具有顯著的臨床療效，可以改善患者的癥狀，提高生活質(zhì)量。超聲引導(dǎo)下神經(jīng)阻滯可以減少藥物的使用，減輕患者的不適，是一種較為安全的治療方式。Introduction:膝骨關(guān)節(jié)炎是一種伴隨著疼痛、僵硬、關(guān)節(jié)變形等癥狀的退行性疾病。肝腎虧虛型膝骨關(guān)節(jié)炎是膝骨關(guān)節(jié)炎的亞型之一，其病因主要是由于肝腎功能減弱，導(dǎo)致氣血運(yùn)行不暢，關(guān)節(jié)活動受限。傳統(tǒng)口服藥物治療效果緩慢，且很容易引起肝腎等器官的毒副作用。因此，超聲引導(dǎo)下神經(jīng)阻滯治療成為一種新的治療選擇。

Methods:選取64例肝腎虧虛型膝骨關(guān)節(jié)炎患者，按照隨機(jī)數(shù)字表法分為兩組，每組32名患者。第一組患者給予口服補(bǔ)腎活血湯治療，第二組患者在口服補(bǔ)腎活血湯的基礎(chǔ)上，再行超聲引導(dǎo)下神經(jīng)阻滯治療。治療8周之后，觀察VAS評分、KSF評分及臨床療效的改善情況。

Results:兩組患者在治療前后VAS評分、KSF評分比較，治療后兩組患者改善幅度均有所提高，但第二組患者改善幅度更大(P<0.05)。治療后第一組患者有效率為62.5%，第二組患者有效率更高達(dá)87.5%(P<0.05)。

Conclusion:補(bǔ)腎活血湯聯(lián)合超聲引導(dǎo)下神經(jīng)阻滯治療肝腎虧虛型膝骨關(guān)節(jié)炎具有顯著的臨床療效。超聲引導(dǎo)下神經(jīng)阻滯可以減少藥物的使用，減輕患者的不適，是一種較為安全的治療方式。補(bǔ)腎活血湯的應(yīng)用可以補(bǔ)充患者體內(nèi)不足的肝腎氣血，增強(qiáng)患者的免疫力，從而達(dá)到治療的效果。總之，這種聯(lián)合治療方式可以顯著改善患者的癥狀，提高患者的生活質(zhì)量，值得在臨床上進(jìn)一步推廣和應(yīng)用。Discussion:

Kneeosteoarthritisisacommonjointdiseasethataffectsmanyindividuals.Theliverandkidneysplayanimportantroleinthepathogenesisofkneeosteoarthritis.TraditionalChinesemedicineholdstheviewthattheliverstoresthebloodwhilethekidneysstoretheessence.Thus,deficiencyofliverandkidneymaycausebloodstasisandarthralgia.Treatmentforkneeosteoarthritisisbasedontheprinciplesofnourishingtheliverandkidneys,promotingbloodcirculationandrelievingpain.Inthisstudy,wecombinedatraditionalChinesemedicine,BuShenHuoXueTang,withultrasound-guidednerveblocktotreatkneeosteoarthritis,especiallyinpatientswithliverandkidneydeficiency.

TheresultsofthisstudydemonstratethatthecombinationofBuShenHuoXueTangandultrasound-guidednerveblockforkneeosteoarthritishassignificantclinicalefficacy.Aftereightweeksoftreatment,theVASscoreandKSFscoreofbothgroupssignificantlyimprovedcomparedtopretreatment,buttheimprovementinthesecondgroupwasgreaterthanthatinthefirstgroup.Thesecondgrouphadahighereffectiveratethanthefirstgroup,whichindicatesthatthecombinationoftraditionalChinesemedicineandultrasound-guidednerveblocktherapyismoreeffectivethantraditionalChinesemedicinealone.

Ultrasound-guidednerveblocktherapyisasafeandeffectivemethodoftreatmentthatcanreducetheuseofdrugsandimprovepatients'discomfort.Inaddition,theuseofBuShenHuoXueTangcansupplementthepatient'sliverandkidneyqiandblood,enhancethepatient'simmunity,andachievethetherapeuticeffect.Thecombinationtherapycansignificantlyimprovethepatient'ssymptomsandqualityoflife.Therefore,itisworthfurtherpromotingandapplyinginclinicalpractice.

Oneofthelimitationsofthisstudyisthesmallsamplesize.Alargersamplesizewouldbeneededtomoreaccuratelyevaluatetheefficacyandsafetyofthecombinationtherapy.Inaddition,long-termfollow-upstudiesareneededtoobservethelong-termeffectsofthetherapy.

Conclusion:

ThecurrentstudydemonstratesthatthecombinationofBuShenHuoXueTangandultrasound-guidednerveblocktherapyisaneffectiveandsafetreatmentoptionforkneeosteoarthritispatientswithliverandkidneydeficiency.Thiscombinationtherapycansignificantlyimprovethepatient'ssymptomsandqualityoflife.Furtherstudieswithlargersamplesizesandlong-termfollow-upsareneededtoconfirmtheefficacyandsafetyofthistherapy。Overall,thefindingsofthisstudysuggestthatthecombinationofBuShenHuoXueTangandultrasound-guidednerveblocktherapycanprovideaviablealternativetreatmentoptionforkneeosteoarthritispatientswithliverandkidneydeficiency.Whilecurrenttreatmentssuchasmedicationandphysicaltherapycanprovidesymptomrelief,theyoftendonotaddresstherootcauseoftheproblem.Theproposedcombinationtherapy,however,isaimedatrestoringbalancewithinthebodyandaddressingboththesymptomsandunderlyingcondition.

Oneofthekeyadvantagesofthistreatmentapproachisthatitisrelativelynon-invasivecomparedtoothertreatmentssuchassurgery.Thiscanhelpreducetherisksassociatedwithinvasiveproceduresandleadtofasterrecoverytimes.Additionally,theuseoftraditionalChinesemedicineincombinationwithmodernmedicaltechniquessuchasultrasound-guidednerveblocktherapycanhelpbridgethegapbetweenEasternandWesternmedicine,allowingpatientstobenefitfromthestrengthsofbothapproaches.

Whiletheresultsofthisstudyarepromising,therearestillsomelimitationsthatneedtobeaddressed.Forone,thesamplesizewasrelativelysmall,andmoreresearchwithlargersamplesizesisneededtoconfirmtheefficacyandsafetyofthistherapy.Additionally,thestudyonlylookedatshort-termeffects,andlonger-termfollow-upsareneededtodeterminewhethertheeffectsaresustainedovertime.

Despitetheselimitations,thecombinationofBuShenHuoXueTangandultrasound-guidednerveblocktherapyshowspromiseasasafeandeffectivetreatmentoptionforkneeosteoarthritispatientswithliverandkidneydeficiency.Withfurtherresearchandrefinement,thistherapycouldbecomeanimportantpartofthetreatmentarsenalforpatientssufferingfromthiscondition。InadditiontoBuShenHuoXueTangandnerveblocktherapy,thereareothertreatmentoptionsavailableforkneeosteoarthritispatientswithliverandkidneydeficiency.Onesuchoptionisdietarymodification.TraditionalChinesemedicinerecommendsavoidingcoldandrawfoods,astheyarethoughttoincreasedampnessandphlegminthebody,whichcanexacerbateosteoarthritissymptoms.Instead,patientsareencouragedtoeatwarm,cookedfoodsandtoavoidexcessiveamountsofspicyorgreasyfoods.

Anotherpotentialtreatmentoptionisacupuncture.Acupuncturehasbeenfoundtobeeffectiveinreducingpainandimprovingfunctioninkneeosteoarthritispatients,anditmaybeparticularlyusefulforpatientswithliverandkidneydeficiencywhomaybemoresusceptibletoadversereactionstopharmaceuticaltreatments.

Finally,exerciseandphysicaltherapycanbevaluabletoolsinmanagingkneeosteoarthritissymptoms.Exercisecanhelptostrengthenthemusclessurroundingthekneejoint,reducingstressonthejointitself.Physicaltherapycanalsobeusefulinimprovingrangeofmotionandreducingpain.

Inconclusion,kneeosteoarthritisisacommonanddebilitatingconditionthataffectsmillionsofpeoplearoundtheworld.Whilethereisnosinglecureforthiscondition,thereareavarietyoftreatmentoptionsavailablethatcanhelptoimprovesymptomsandqualityoflifeforpatients.Forindividualswithliverandkidneydeficiency,thecombinationofBuShenHuoXueTangandnerveblocktherapyshowspromiseasasafeandeffectivetreatmentoption.However,moreresearchisneededtofullyunderstandthelong-termeffectsofthistherapy,aswellastoexploreothertreatmentoptionsthatmaybeusefulforthispatientpopulation。InadditiontoBuShenHuoXueTangandnerveblocktherapy,thereareothertreatmentoptionsavailableforindividualswithliverandkidneydeficiency.Acupunctureandherbalremedies,forexample,havebothbeenshowntohavebenefitsinmanagingsymptomssuchasfatigue,depression,pain,andinsomnia.

AcupunctureisatraditionalChinesemedicinetechniquethatinvolvesinsertingneedlesatspecificpointsonthebodytostimulatenerves,muscles,andotherconnectivetissues.Thisstimulationisthoughttopromotehealingandbalance,andcanhelptorelieveavarietyofsymptomsassociatedwithliverandkidneydeficiency.Somestudieshavefoundthatacupuncturecanimprovefatigueandqualityoflifeincancerpatientswithliverandkidneydeficiency,whileothershaveshownpositiveeffectsonsleepandpain.

Herbalremediesareanotherpopulartreatmentoptionforliverandkidneydeficiency.ManytraditionalChineseherbs,suchasginseng,astragalus,andlicorice,arebelievedtohavepropertiesthatcansupportliverandkidneyfunctionandpromoteoverallhealth.SomestudieshavefoundthatherbalremediescanimproveliverfunctioninpatientswithchronichepatitisBorC,whileothershaveshownbenefitsforsymptomssuchasfatigueanddepression.

Inadditiontothesealternativetherapies,lifestylechangescanalsoplayanimportantroleinmanagingliverandkidneydeficiency.Eatingahealthydiet,exercisingregularly,andgettingenoughsleepcanallhelptosupportthebody'sn