健脾法改善脾虚湿蕴型膝骨关节炎患者骨骼肌功能的前瞻性队列研究OA

Objective:This study aimed to evaluate the clinical efficacy of the spleen-strengthening method in enhancing muscle function in knee osteoarthritis(KOA).Methods:Patients with KOA of the spleen deficiency with dampness exu-berance pattern were prospectively enrolled and divided into an exposure group or a control group according to whether they received the modified Shenling Baizhu San decoction.All patients were followed up for at least 6 weeks.Assessments at baseline and the final follow-up included the quadriceps peak torque/body weight ratio,appendicular skeletal muscle index,handgrip strength,five-times-sit-to-stand test dura-tion,VAS score,WOMAC score,and TCM syndrome score.Exercise compliance and actual follow-up time were also re-corded.Results:A total of 155 patients were included(exposure group,n=86;control group,n=69).Baseline characteristics,such as age and sex,exhibited significant differences between the two groups(P<0.05).After propensity score matching,48 pa-tients were included in each group,with balanced baseline charac-teristics.Intragroup comparisons showed significant improve-ment in most outcome indicators after treatment in both groups(P<0.05).Intergroup analysis revealed that the exposure group demonstrated superior improvement in the quadriceps peak torque/body weight ratio,WOMAC score,and spleen deficiency syn-drome score compared to the control group(P<0.05).After further adjusting for baseline muscle strength,follow-up time,and compliance,the spleen-strengthening method was identified as an independent factor predicting improved quadriceps peak torque(β=0.107,P<0.001).Conclusion:The spleen-strengthening method can effectively alleviate joint pain and demonstrates unique advantages in improving skeletal muscle function in KOA patients with spleen deficiency and dampness exuberance.This high-lights the clinical value of applying this method tailored to the Lingnan region's characteristics and provides a basis for optimizing regional integrated traditional Chinese and Western medicine diagnosis and therapeutic strategies.