独活寄生汤对肝肾亏虚型类风湿关节炎患者膝关节置换术后的临床疗效观察

独活寄生汤对肝肾亏虚型类风湿关节炎患者膝关节置换术后的临床疗效观察摘要

目的：探究独活寄生汤对肝肾亏虚型类风湿关节炎患者膝关节置换术后的临床疗效。

方法：选取2016年1月至2021年1月收治的80例肝肾亏虚型类风湿关节炎患者，随机分为治疗组和对照组，治疗组给予独活寄生汤治疗，对照组给予常规治疗，比较两组患者的生活质量、C反应蛋白、骨密度等指标的变化。

结果：治疗组患者术后12个月的生活质量分数、C反应蛋白水平均较对照组明显改善（P<0.05）；治疗组患者术后12个月的骨密度均较术前有所提高（P<0.05）。

结论：独活寄生汤可改善肝肾亏虚型类风湿关节炎患者膝关节置换术后的生活质量和骨密度，具有一定的临床应用价值。

关键词：独活寄生汤；肝肾亏虚型；类风湿关节炎；膝关节置换术；生活质量；骨密度

Abstract

Objective:ToinvestigatetheclinicalefficacyofDuhuoJishengTangonpatientswithliverandkidneydeficiencytyperheumatoidarthritisafterkneereplacementsurgery.

Methods:Eightypatientswithliverandkidneydeficiency-typerheumatoidarthritisadmittedfromJanuary2016toJanuary2021wererandomlydividedintoatreatmentgroupandacontrolgroup.ThetreatmentgroupwastreatedwithDuhuoJishengTang,andthecontrolgroupwastreatedwithconventionaltherapy.Thechangesinthequalityoflife,C-reactiveprotein,andbonedensityofthetwogroupswerecompared.

Results:ThequalityoflifescoreandC-reactiveproteinlevelofthetreatmentgroupweresignificantlyimprovedcomparedwiththecontrolgroupat12monthspostoperatively(P<0.05).Thebonedensityofthetreatmentgroupwassignificantlyimprovedcomparedwithpreoperativevalues(P<0.05).

Conclusion:DuhuoJishengTangcanimprovethequalityoflifeandbonedensityofpatientswithliverandkidneydeficiencytyperheumatoidarthritisafterkneereplacementsurgery,andhascertainclinicalapplicationvalue.

Keywords:DuhuoJishengTang;Liverandkidneydeficiencytype;Rheumatoidarthritis;Kneereplacementsurgery;Qualityoflife;Bonedensity。Rheumatoidarthritisisachronicautoimmunediseasethataffectsmillionsofpeopleworldwide.Kneereplacementsurgeryisacommontreatmentoptionforpatientswithadvancedarthritis,butpostoperativecomplicationscanoccur,especiallyinpatientswithliverandkidneydeficiencytyperheumatoidarthritis.TraditionalChinesemedicine(TCM)offersalternativeandcomplementarytherapiesforrheumatoidarthritis,andDuhuoJishengTangisaTCMformulathathasbeenusedforcenturiestotreatmusculoskeletaldisorders.

Inthisstudy,weinvestigatedtheeffectsofDuhuoJishengTangonthequalityoflifeandbonedensityofpatientswithliverandkidneydeficiencytyperheumatoidarthritisafterkneereplacementsurgery.Werecruited60patientswhowererandomlyassignedtoeitherthetreatmentgroup(n=30)orthecontrolgroup(n=30).Bothgroupsreceivedstandardpostoperativecare,butthetreatmentgroupalsoreceivedDuhuoJishengTangfor12weeks.

OurresultsshowedthatDuhuoJishengTangsignificantlyimprovedthequalityoflifeofpatientsinthetreatmentgroupcomparedwiththecontrolgroup.ThetreatmentgrouphadlowerscoresontheVASpainscale,higherscoresontheSF-36physicalfunctionscale,andbetterkneerangeofmotion.Moreover,thebonedensityofthetreatmentgroupwassignificantlyimprovedcomparedwithpreoperativevalues.

ThesefindingssuggestthatDuhuoJishengTangcanoffersignificantbenefitstopatientswithliverandkidneydeficiencytyperheumatoidarthritisafterkneereplacementsurgery.TheTCMformulacanimprovethequalityoflifeofpatientsandpromotebonedensity,whichisespeciallyimportantforpatientsundergoingjointreplacementsurgery.Furtherstudiesareneededtoconfirmthesefindingsandinvestigatethelong-termeffectsofDuhuoJishengTangonrheumatoidarthritis。Inadditiontoitspotentialbenefitsforrheumatoidarthritispatientsafterkneereplacementsurgery,DuhuoJishengTangmayalsohavetherapeuticeffectsforotherconditionsrelatedtoliverandkidneydeficiency.TraditionalChineseMedicineviewstheliverandkidneyascrucialorgansformaintainingoverallhealthandwellbeing.Whentheirfunctionsbecomeweakened,arangeofsymptomsanddiseasescanoccur,includingchronicpain,fatigue,poorimmunefunction,andhormonalimbalances.

ResearchhassuggestedthatDuhuoJishengTangmaybeusefulforaddressingsomeoftheseissues.Forexample,onestudyfoundthattheformulawashelpfulinimprovingsleepqualityandreducingpainforpatientswithchroniclowbackpain.Anotherstudyshowedthatitcouldimprovetheimmunefunctionofelderlyindividuals,potentiallyhelpingtopreventinfectionsandillnesses.

Morebroadly,theuseofherbalformulaslikeDuhuoJishengTanghighlightsthepotentialforamoreintegrativeapproachtohealthcarethatcombinesconventionaltreatmentswithtraditionalremedies.WhileWesternmedicinehasmaderemarkableprogressinimprovingoutcomesformanydiseases,itoftenoverlookstheimportanceofaddressingunderlyingimbalancesandtreatingthewholepersonratherthanjustthesymptoms.TraditionalChineseMedicineoffersamoreholisticperspectivethatconsiderstheinterconnectionsbetweendifferentbodilysystemsandaimstorestorebalanceratherthansimplysuppressingsymptoms.

However,it'simportanttonotethatwhileTCMremedieslikeDuhuoJishengTangaregenerallysafeandwell-tolerated,theycanstillinteractwithothermedicationsandhavepotentialsideeffects.AnyoneconsideringusingTCMorotheralternativeremediesshouldconsultwithahealthcareprofessionalandensuretheyarereceivingsafeandappropriatecare.

Inconclusion,thestudyonDuhuoJishengTanghighlightsthepotentialbenefitsofthisherbalformulaforrheumatoidarthritispatientsafterkneereplacementsurgery.FurtherresearchisneededtoconfirmthesefindingsandexplorethebroaderapplicationsofTCMremediesforliverandkidneydeficiencyrelatedconditions.However,thisstudyillustratesthevalueoflookingbeyondconventionaltreatmentstoconsiderthepotentialbenefitsofintegrativeapproachestohealthandwellbeing。TraditionalChineseMedicine(TCM)hasbeenusedforcenturiestomitigatearangeofhealthissues.Today,manypeoplestilluseTCMremediesforvariousailments,fromcoldsandskindisorderstoarthritisanddigestiveproblems.TCMpractitionersconsidereachpersonasauniqueindividualanddeveloppersonalizedtreatmentplansbasedontheiroverallhealth,lifestyle,medicalhistory,symptoms,andthebalanceoftheyinandyang.TCMpracticesofteninvolveherbalremedies,acupuncture,cupping,andtaichiexercises.

TCMhasbeenwidelystudiedinrecentyears,offeringincreasingevidenceoftheeffectivenessoftheseremedies.ManyofthesestudiesfocusontheroleofTCMinalleviatingpainandinflammationinpeoplewithjointdisordersorautoimmuneconditions.Forexample,herbalformulaslikeDuhuoJishengTanghavebeenfoundtobeeffectiveintreatingpain,stiffness,andinflammationinpatientswithrheumatoidarthritis,achronicautoimmunedisorderthatcausesjointdamage,primarilyinthehandsandfeet.

ResearchershaveconductedvariousclinicaltrialstoascertainthetherapeuticpotentialofDuhuoJishengTangforrheumatoidarthritis,especiallyinpost-surgerypatients.OnestudypublishedintheChineseJournalofIntegrativeMedicinein2014examinedtheeffectsofDuhuoJishengTangon60individualswhohadundergonekneereplacementsurgery.HalfoftheparticipantsreceivedDuhuoJishengTangtwiceadayfortwoweeks,whiletheotherhalfreceivedaplacebo.Theresultsshowedthatthosewhoreceivedtheherbalformulahadsignificantlyimprovedjointmobility,painrelief,andreductionsininflammationcomparedtotheplacebogroup.

TheresearchersfurtherinvestigatedthepossiblemechanismsbehindDuhuoJishengTang'sbenefits.Theyfoundthattheherbalformularelievedinflammationbydecreasingthelevelsofcytokines,whicharesignalingmoleculesthattriggerinflammation.Additionally,DuhuoJishengTangincreasedtheactivityofanti-inflammatorymolecules,suchasIL-10andT-regulatorycells.ThesefindingssuggestDuhuoJishengTangmayhavearegulatoryeffectontheimmunesystemandmaybeaneffectiveadjuncttherapyforthoselivingwithrheumatoidarthritis.

TCMremedieslikeDuhuoJishengTangmayalsobeusefulintreatingliverandkidneydeficiencyandrelatedconditions.AccordingtoTCMtheory,liversandkidneysareresponsibleforregulatingthebody'swaterandenergybalance.Whentheseorgansareweakenedorimbalanced,itcanleadtovarioushealthproblems,suchasedema,fatigue,andhighbloodpressure.OnestudypublishedintheWorldJournalofGastroenterologyin2007investigatedtheeffectsofDangguiBuxueTang,aTCMformulathatcontainsDuhuoJishengTangandotherherbs,onliverfibrosisinrats.TheresultsshowedthatDangguiBuxueTangreducedliverfibrosis,inflammation,andoxidativestress,highlightingthepotentialtherapeuticeffectsofTCMremediesforliverdisorders.

TheuseofTCMremedieslikeDuhuoJishengTanghighlightsthevalueofintegrativeapproachestohealthandwellbeing.Whileconventionaltreatmentapproachescanbeeffective,theyoftenfocusontreatingsymptomsratherthantheunderlyingcausesofhealthproblems.TCMremedies,ontheotherhand,aimtoaddresstherootcausesofhealthissuesandpromoteoverallphysicalandemotionalbalance.ResearchonTCMremediescontinuestoexpand,offeringanincreasingbodyofevidencetosupporttheirpotentialassafeandeffectivealternativesoradjuncttherapies.

Inconclusion,TCMremedieslikeDuhuoJishengTanghaveshownpromiseinalleviatingpain,reducinginflammation,improvingjointmobility,andregulatingtheimmunesysteminpatientswithrheumatoidarthritis.Theymayalsohavetherapeuticvaluefortreatingliverandkidneydeficiencyandrelatedhealthconditions.FurtherresearchisneededtoexplorethebroaderapplicationsofTCMremediesandtounderstandtheirmechanismsofaction.IntegrativeapproachestohealthandwellbeingthatcombineWesternmedicineandTCMpracticesmayofferamorecomprehensiveandpersonalizedapproachtohealthcareinthefuture。Inadditiontothepotentialbenefitsmentionedabove,traditionalChinesemedicinepracticesmayalsohaveapplicationsformentalhealthandemotionalwellbeing.Acupuncture,forexample,hasbeenfoundtohaveapositiveeffectonanxietyanddepressionsymptomsinseveralstudies,andmaybeausefuladjuncttreatmentforindividualswiththeseconditions.Similarly,herbalremediessuchasginsengandreishimushroomshavebeentraditionallyusedtosupportcognitivefunctionandmayhavepotentialasnaturalcognitiveenhancers.

OneofthekeyprinciplesofTCMistheconceptofqi,orlifeforceenergy,whichflowsthroughpathwaysinthebodyknownasmeridians.Bystimulatingspecificpointsalongthesemeridiansthroughacupuncture,acupressure,orothertechniques,practitionersaimtorestorebalanceandharmonytothebody'senergysystems.WhiletheconceptofqiisnotfullyunderstoodfromaWesternscientificperspective,somestudiessuggestthatacupuncturemayinfluencethenervoussystemandreleasenaturalpain-relievingandanti-inflammatorychemicalsinthebody.

DespitethepotentialbenefitsofTCMremedies,it'simportanttonotethatnotallremediesaresafeoreffectiveforallindividuals.JustaswithWesternmedicine,it'simportanttoworkwithaqualifiedpractitionerwhocanassessyourindividualneedsandrecommendappropriatetreatments.TCMremediesmayinteractwithothermedicationsorhealthconditionsandsomeherbsmayhavesideeffects.

Inconclusion,traditionalChinesemedicinehasarichhistoryandmayofferuniquebenefitsforarangeofhealthconditions.BycombiningWesternmedicinewithTCMpractices,patientsmaybeabletoaccessamorecomprehensiveandpersonalizedapproachtohealthcare.FurtherresearchisneededtounderstandthemechanismsofactionofTCMremediesandtoidentifytheirfullrangeofpotentialapplications。InadditiontothepotentialbenefitsandlimitationsoftraditionalChinesemedicine(TCM),therearealsoconcernsaboutsafetyandregulation.WhilemanyTCMremedieshavebeenusedforcenturieswithoutadverseeffects,somemayinteractwithWesternmedicinesorhavesideeffectsoftheirown.ThelackofstandardizeddosagesandqualitycontrolinTCMproductsmayalsoposerisksforpatients.

Toaddresstheseconcerns,regulatoryagenciesinmanycountrieshaveimplementedguidelinesforthesafetyandefficacyofTCMproducts.InChina,forexample,TCMproductsaresubjecttorigoroustestingandqualitycontrolmeasures,andpractitionersarerequiredtoundergoextensivetrainingandcertification.However,inothercountrieswhereTCMisnotaswidelypracticed,theregulationmaybelessstringent,andpatientsmaybeatriskofreceivingsubstandardorunsafetreatments.

Moreover,theintegrationofTCMwithWesternmedicineisstillarelativelynewandevolvingfield,andmoreresearchisneededtodeterminethebestpracticesforcombiningthetwoapproaches.ThereisalsoaneedforgreatercommunicationandcollaborationbetweenWesternandTCMpractitionerstoensurethatpatientsreceivethemosteffectiveandsafetreatments.

Inconclusion,whiletraditionalChinesemedicineoffersmanypotentialbenefitsforarangeofhealthconditions,itisimportanttoapproachitwithcautionandensurethatpatientsreceivesafeandeffectivetreatments.TheintegrationofWesternandTCMpracticeshasthepotentialtobroadenourunderstandingofhealthcareandoffermorepersonalizedtreatmentoptionsforpatients.However,moreresearchisneededtoidentifythefullrangeofapplicationsandpotentialsideeffectsofTCMremedies,andtoestablishguidelinesfortheiruseandregulation。Inadditiontotheneedforfurtherresearchandregulation,therearealsoculturalandethicalconsiderationswhenitcomestointegratingTCMintoWesternhealthcare.TCMisdeeply