肥胖的2型糖尿病患者体质成分变化及对骨密度的影响

目的：分析肥胖的2型糖尿病患体质成分及骨密度变化，以阐明机体脂肪含量和肌肉含量在维持骨量中的作用。方法：采用双能X线分析仪（DEXA）测定76例2型糖尿病患全身各部位的骨密度和肌肉、脂肪含量，并根据体重指数将病人分为肥胖组24例与正常体重组52例。结果：两组间骨密度和肌肉含量无显差异（P＞0．05），肥胖组全身及局部脂肪含量明显增高（P＜0．01）。两组糖尿病患骨密度与全身及局部及局部肌肉含量呈显正相关（P＜0．05－0．01）。肥胖组全身骨密度与手臂脂肪含量呈显负相关（P＜0．05），且各部位脂肪含量与肌肉含量呈显负相关（P＜0．05）。结论：肥胖的2型糖尿病患以脂肪含量升高为主，肌肉组织含量和脂肪异常分布对骨密度有显的影响作用。     

肥胖的2型糖尿病患者体质成分变化及对骨密度的影响

目的分析肥胖的2型糖尿病患者体质成分及骨密度变化,以阐明机体脂肪含量和肌肉含量在维持骨量中的作用。方法采用双能X线分析仪(DEXA)测定76例2型糖尿病患者全身各部位的骨密度和肌肉、脂肪含量,并根据体重指数将病人分为肥胖组24例与正常体重组52例。结果两组间骨密度和肌肉含量无显著差异(P>0.05),肥胖组全身及局部脂肪含量明显增高(P<0.01)。两组糖尿病患者骨密度与全身及局部肌肉含量呈显著正相关(P<0.05～0.01)。肥胖组全身骨密度与手臂脂肪含量呈显著负相关(P<0.05),且各部位脂肪含量与肌肉含量呈显著负相关(P<0.05)。结论肥胖的2型糖尿病患者以脂肪含量升高为主,肌肉组织含量和脂肪异常分布对骨密度有显著的影响作用。     

女性体重、体脂含量、下肢肌力与骨密度的关系

目的：分析妇女体重、体重指数、体脂含量、下肢肌力与骨密度的关系，从生物力学角度探讨骨量的影响因素。方法：以在本中心进行保健的1109例女性为研究对象，分别测量身高、体重，计算体重指数（BMI），用肌肉功能分析仪测定体脂含量（FAT％）、下肢最大肌力（MLF），用双能X线吸收法（DEXA）测定股骨颈骨密度（FBMD）。结果：股骨颈骨密度与体重、体重指数、体脂含量、下肢肌力呈显著正相关，相关系数分别为0．145（P〈0．001）、0．182（P〈0.001）、0．189（P〈0.001）、0．074（P〈0.05）。结论：体重、体重指数、体脂含量、下肢肌力是骨密度的影响因素，适宜体重和运动有益于骨质疏松的防治。     

新型活动式膝关节支撑器的研制与应用

目的探讨＂新型活动式膝关节支撑器＂的研制、使用方法及临床效果。方法将256例各种骨折患者按随机数字表法分为2组,每组128例。观察组使用＂新型活动式膝关节支撑器＂进行早期患肢膝关节功能锻炼;对照组患肢膝关节垫睡枕、卫生纸或毛巾等进行早期膝关节屈伸功能锻炼。对2组患者膝关节屈伸功能的恢复的情况进行比较。结果观察组膝关节屈伸功能优为64.06%,总有效率为96.09%,对照组膝关节屈伸功能优为7.81%,总有效率为82.81%,观察组膝关节屈伸功能恢复明显高于对照组（均P〈0.05）。结论使用＂新型活动式膝关节支撑器＂可有效地防止关节粘连、关节僵硬、肌肉萎缩,减轻下肢疼痛肿胀,预防血栓形成,有利于骨折与伤口愈合。     

空气波压力治疗预防全膝关节置换后下肢深静脉血栓

背景：大量文献研究表明,空气波压力治疗在预防髋部大手术后下肢深静脉血栓形成中有重要作用。目的：探讨空气波压力治疗仪对预防全膝关节置换后下肢深静脉血栓的效果。方法：80例全膝关节置换患者随机数字表法均分为试验组和对照组,对照组行常规治疗与护理加个人行为功能锻炼,试验组在对照组基础上,置换后第2天采用空气波压力治疗仪治疗双下肢;比较两组患者患肢肿胀指数、凝血综合指数及发生下肢深静脉血栓的例数。结果与结论：治疗后2周,试验组肿胀指数、凝血综合指数及发生下肢深静脉血栓的例数明显减少,其效果明显优于对照组,差异有显著性意义（P〈0.05）。全膝关节置换后早期应用空气波压力治疗仪能有效缓解患肢肿胀,改善凝血综合指数,改善患者的血凝状态,预防人工全膝关节置换后的下肢深静脉血栓形成。     

中药电透入治疗膝关节骨关节炎

2002年以来我科治疗膝关节骨关节炎168例，均符合美国风湿病学会推荐的骨关节炎诊断标准，X线片均显示不同程度骨质增生、关节间隙狭窄及关节软骨下骨质硬化，男75例，女93例；年龄52480岁，平均65．3岁；病程3个月～17年，平均18．1个月。临床表现为膝关节肿胀疼痛、伸屈活动受限，尤其是活动时加重，并可闻及骨擦感。168例患者分为观察组96例和对照组72例，2组一般资料比较差异无显著性意义。     

体脂含量与骨量的关系

目的:探讨骨量(骨密度、骨矿量)与体重、全身各部位脂肪量及肌肉量的关系.方法:对287例汉族健康志愿者测量体重、全身、躯干、上肢、下肢这些部位的脂肪量、肌肉量及骨量(骨密度和骨矿量).脂肪量、肌肉量、体重与全身各部位的骨量(骨密度和骨矿量)的关系探索采用偏相关分析.结果:体重同全身总骨密度(r=0.692)、全身总矿量(r=0.751)、躯干密度(r=0.752)、躯干矿量(r=0.707)、上肢密度(r=0.659)、上肢矿量(r=0.690)、下肢密度(r=0.690)、下肢矿量(r=0.800),在控制性别和年龄的影响后均显著正相关(P均为0.000).在控制性别和年龄的影响后.全身、躯干、上肢、下肢这些部位的肌肉量及脂肪量同相应部位的骨密度和骨矿量均显著正相关(P均为0.000),r值在0.271～0.905之间,而肌肉量比脂肪量同骨密度和骨矿量的相关程度更高.结论:全身、躯干、上肢、下肢的骨量(骨密度和骨矿量)的同相应部位的肌肉量及脂肪量及总体重正相关,其中与肌肉量的相关性更大.     

骨关节炎患者全膝关节置换：多中心的随机对照

背景：年龄在60岁以上存在关节疼痛、功能障碍和关节畸形的骨关节炎患者均可以考虑行全膝关节置换。目的：比较传统全膝关节置换、微创全膝置换和避开股四头肌的微创全膝置换后早期膝关节功能恢复情况的差异。方法：选择北京301医院、山东省立医院、山东省交通医院获得随访的120例骨关节炎患者,其中42例接受常规全膝关节置换,42例接受微创全膝关节置换,36例接受避开股四头肌的微创全膝关节置换。所有患者置换后第2,6,12周进行膝关节HSS评分及关节活动度检测。结果与结论：微创全膝关节置换组及避开股四头肌的微创全膝关节置换组较常规全膝关节置换组手术时间长（P〈0.01）,出血量少（P〈0.01）;两微创手术组间差异无显著性意义（P〉0.05）。置换后2周微创全膝关节置换组及避开股四头肌的微创全膝关节置换组关节活动度、HSS评分均优于常规全膝关节置换组（P〈0.01）,两微创组间关节活动度差异无显著性意义（P〉0.05）,但避开股四头肌的微创全膝关节置换组HSS评分优于微创全膝关节置换组（P〈0.01）;置换后6,12周3组HSS评分及关节活动度差异无显著意义（P〉0.05）。提示避开股四头肌的微创全膝关节置换与微创全膝关节置换以及常规全膝关节置换相比,手术损伤较小,术后疼痛程度更轻,术后能早期进行康复锻炼。     

半月板突出在膝骨性关节炎关节间隙狭窄中的作用

目的:探讨膝关节半月板突出在膝骨性关节炎(osteoarthritis,OA)的关节间隙狭窄中作用。方法:2003-01/2004-06对65骨关节炎膝及36正常自愿者膝在复旦大学附属华山医院骨科进行正侧位X射线检查和MRI扫描,根据X射线片进行内侧关节间隙Kellgren-Lawrence(K-L)分级,同时在MRI冠状面上评估内侧半月板突出程度。比较膝关节OA和正常膝关节半月板突出程度差异,并分析膝关节OA关节间隙狭窄和半月板突出的关系。结果:膝OA组K-L分级:Ⅰ级狭窄13膝、Ⅱ级狭窄19膝、Ⅲ级狭窄22膝、Ⅳ级狭窄8膝,对照组均为0级;膝OA组半月板突出:正常3膝,轻度突出16膝,中度突出20膝,重度突出23膝。对照组半月板突出:正常11膝,轻度突出20膝,中度突出5膝。OA组内侧半月板突出程度与正常对照组比较差异有显著性意义(P<0.01);骨关节炎组内不同K-L分级与内侧半月板突出程度有关系r=0.461,P<0.01)。(结论:内侧半月板突出是膝关节OA的一个重要特征,并且与关节间隙狭窄有关。     

膝关节功能障碍患者的下肢肌力训练

下肢骨折由于其固定时间较长,解除固定后,患肢可出现不同程度的肌肉萎缩和关节挛缩,影响患者的步行能力和日常生活。对下肢骨折后膝关节功能障碍患者进行下肢肌力训练有利于恢复关节功能。     

绝经妇女身体软组织重量与骨密度的相关性

目的 :探讨绝经后妇女身体软组织重量和骨密度 (BMD)之间的关系。方法 :选择 6 2例绝经期健康日本妇女 ,应用双能X 线法 (Dexa)测定其第 2～ 4腰椎、双侧股骨转子间和桡骨中、下 1/ 3交界处BMD ,同时测定身体肌肉组织 (TLM)和脂肪组织 (TFM )重量 ,并对软组织重量与身体各部位的BMD进行相关性分析。结果 :全身TLM重量及体重与正位腰椎BMD呈正相关 (r =0 .4 5及 0 .35 ) ,而TFM百分比与腰椎、股骨转子间和桡骨远端BMD呈负相关 (r=- 0 .17)。随着年龄增长 ,BMD呈下降趋势 ,6 0岁组与 5 0及 70岁组比较差异有显著性 (分别P <0 .0 1,P <0 .0 5 )。结论 :身体内软组织重量中TLM重量、体重与全身各部位的BMD有相关性 ,其中体重和TLM重量与腰椎BMD的相关性较好 ,TFM重量与BMD的相关性不明显。     

Dual energy X-ray absorptiometry assessment of fat mass distribution and its association with the insulin resistance syndrome.

OBJECTIVE: To determine which dual energy X-ray absorptiometry (DXA)-derived indices of fat mass distribution are the most informative to predict the various parameters of the metabolic syndrome. RESEARCH DESIGN AND METHODS: A total of 87 healthy men, 63 lean (% fat < or =26) and 24 obese (% fat >26), underwent DXA scanning to evaluate body composition with respect to the whole body and the trunk, leg, and abdominal regions from L1 to L4 and from L3 to L4. These regions were correlated with insulin sensitivity determined by the euglycemic-hyperinsulinemic clamp, insulin area under the curve after oral glucose tolerance test (AUC I); triglyceride; total, HDL, and LDL cholesterol; free fatty acids; and blood pressure. The analyses were performed in all subjects, as well as in lean and obese groups separately. RESULTS: Among the various indices of body fat, DXA-determined adiposity in the abdominal cut at L1-4 level was the most predictive of the metabolic variables, showing significant relationships with glucose infusion rate ([GIR], mg kg(-1) lean body mass x min(-1)), triglyceride, and cholesterol, independent of total-body mass (r = -0.267, P<0.05; r = 0.316, P<0.005; and r = 0.319, P<0.005, respectively). Upon subanalysis, these correlations remained significant in lean men, whereas in obese men, only BMI and the amount of leg fat (negative relationship) showed significant correlations with triglyceride and cholesterol (r = 0.438, P<0.05; r = 0.458, P<0.05; r = -0.439, P<0.05; and r = -0.414, P<0.05, respectively). The results of a multiple regression analysis revealed that 47% of the variance in GIR among all study subjects was predicted by AUC I, fat L1-4, diastolic blood pressure (dBP), HDL, and triglyceride as independent variables. In the lean group, fat L1-4 alone accounted for 33% of the variance of GIR, whereas in obese men, AUC I and dBP explained 68% of the variance in GIR. CONCLUSIONS: The DXA technique applied for the evaluation of fat distribution can provide useful information regarding various aspects of the insulin resistance syndrome in healthy subjects. DXA can be a valid, accurate, relatively inexpensive, and safer alternative compared with other methods to investigate the role of abdominal body fat distribution on cardiovascular risk factors.     

下肢全长负重位X线检查在膝关节炎内外翻畸形中的临床价值

目的:探讨膝关节炎患者下肢全长负重位X线片对膝内、外翻畸形诊断的临床价值。方法:选取32例临床诊断为膝关节炎51膝分别拍摄下肢全长负重X线片,测量下肢力线和机械轴偏距(mechanical axis offset distance,MAD),解剖学股胫骨角(anatomical femor-tibial angle,aFTA),股骨远端力学外侧角(mechanical lateral distal femoral angle,mLDFA),胫骨近端力学内侧角(mechanical medial proximal tibial angle,mMPTA),对图像数据进行分析,对膝关节炎进行X线K/L分级,通过SPSS 17.0统计对下肢力线各参数与关节炎的相关性进行分析。结果:①膝关节下肢全长负重位X线片显示,关节有不同程度骨质增生,关节间隙变窄。②51膝骨关节炎中确诊膝内翻畸形38膝(74.51.%)和膝外翻畸形8膝(10.42%),5膝均无内外翻畸形。③膝关节炎X线K/L分级显示,0级:5膝(9.8%),I级:12膝(23.5%),II级:22膝(43.1%);III级:9膝(17.6%);IV级:3膝(59%)。④膝内翻组中股骨内翻7膝(18.42%),胫骨内翻18膝(47.36%),股骨、胫骨均内翻13膝(34.21%);膝外翻组中股骨外翻6膝,股骨、胫骨均外翻2膝。⑤在膝内翻组中,aFTA与骨关节炎X线K/L分级呈正相关(B值=0.132,t=2.648,P=0.012,P<0.05)。结论:下肢全长负重X线显示下肢结构清晰、完整,通过测量下肢力线参数评估,可全面诊断膝关节炎的内翻畸形或外翻畸形,膝内翻中以胫骨内翻显著,膝外翻中则以股骨外翻显著。因此,膝关节骨性关节炎的下肢全长负重X线检查具有较高的临床价值。     

绝经后女性膝骨关节炎的骨量变化

目的 探讨绝经后女性膝骨关节炎( knee osteoarthritis,KOA)患者骨量变化相关因素.方法 收集参研医院100例绝经后女性KOA住院患者一般情况、血液生化、骨代谢指标血清碱性磷酸酶(ALP)、骨钙素(OC)、β胶原特殊序列(β-crosslaps)及骨密度、X线、MRI影像学、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分等临床资料,分析绝经后女性KOA患者骨量变化相关因素.结果 ①100例绝经后KOA女性骨质疏松症(OP)发生率23.0％(23/100),骨量减少发生率50.0％(50/100).②绝经后女性KOA骨量与体质量指数(BMI)、高密度脂蛋白胆固醇(HDL-C)呈正相关(P＜0.05),与年龄、血尿酸(UA)、OC、β-crosslaps呈负相关(P＜0.05).③BMI、HDL-C在骨质疏松症组低于骨量减少组(P＜0.05),骨量减少组低于骨量正常组(P＜0.05).④UA、OC、β-Crosslaps在骨质疏松症组高于骨量减少组(P＜0.05),骨量减少组高于骨量正常组(P＜0.05).ALP骨质疏松症组低于骨量减少组和骨量正常组(P＜0.05).⑤依据X线片Kellgen和Lawrence诊断分级标准,绝经后女性KOA的X线片分级Ⅱ与Ⅲ、Ⅲ与Ⅳ级之间骨量变化有统计学意义(P＜0.05).结论 绝经后女性KOA患者骨量受多因素影响,其骨量变化与BMI、HDL C呈正相关,与年龄、UA、OC、β-Crosslaps呈负相关;绝经后女性KOA骨量减少具有高转换型骨代谢特点,患者骨量变化随X线分级病情从轻到重并非线性变化规律,而是呈曲线波动.     

Hemiparetic muscle atrophy and increased intramuscular fat in stroke patients

OBJECTIVE: To determine if skeletal muscle atrophy and greater fat deposition within the muscle are present in the hemiparetic limb of chronic (>6 mo) hemiparetic stroke patients. DESIGN: Cross-sectional study. SETTING: Hospital-based research center. PARTICIPANTS: Sixty patients (47 men, 13 women; mean age +/- standard deviation, 65+/-9 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patients underwent a total body scan by dual-energy x-ray absorptiometry to determine percentage of body fat, total lean mass, fat mass, and lean mass of the paretic and nonaffected legs, thighs, and arms. Thirty patients received computed tomography (CT) scans of their midthigh to determine muscle area, subcutaneous fat, and low-density lean tissue, as a measure of fat within the muscle area, of the paretic and nonaffected midthigh. RESULTS: Patients were deconditioned (VO(2)peak: 1.2+/-0.3 L/min) with a percentage of body fat of 31.4%+/-9.8% and total lean mass of 51.4+/-9.1 kg. Lean mass of the paretic leg and thigh were 4% and 3% lower than the nonaffected leg (P<.001), but leg fat was not different. Arm lean mass of the paretic side was 7% lower than the nonaffected side, whereas arm fat was not different. CT studies showed that midthigh muscle area was 20% lower in the paretic limb than in the nonaffected leg (P<.001), midthigh subcutaneous fat was similar, and midthigh low-density lean tissue showed a trend to be 3% higher in the paretic leg (P=.06). The ratio of midthigh low-density lean tissue to muscle area was higher in the paretic leg (P<.001), which indicates a greater intramuscular fat relative to muscle area in the affected limb. CONCLUSIONS: Our results show hemiparetic skeletal muscle atrophy and more fat within the muscle, factors that may contribute to functional disability and increased cardiovascular disease risk in chronic hemiparetic stroke patients.     

Body composition after stroke

The aim of this study was to compare the body composition, including lean tissue mass, fat tissue mass, and bone mineral content, of the paretic leg with that of the nonaffected leg in patients with stroke and to evaluate the effects of time since stroke, spasticity, and motor recovery on the body composition specifically within the first year after stroke. Thirty-five stroke patients with mean age and standard deviation of 62.69+/-9.54 years were included in the study. A full physical examination including Brunnstrom motor recovery and modified Ashworth spasticity scale was performed. Fat tissue mass (grams), lean tissue mass (grams), and bone mineral content (grams) of both the paretic and nonaffected lower extremities were obtained from the total body scans determined by using dual-energy X-ray absorptiometry (Lunar DPX-PRO). Lean tissue mass and bone mineral content of the paretic side were found to be significantly lower than those of the nonaffected side (P<0.05). A significant correlation was found between the lean tissue mass and bone mineral content of both the paretic and nonaffected legs after adjusting for age and weight (P=0.000, r=0.679; P=0.000, r=0.634, respectively). Bone mineral content and lean tissue mass of both the paretic and nonaffected sides showed a significant negative correlation with time since stroke in patients with stroke for < or =1 year (P<0.05). A higher lean tissue mass and bone mineral content were found in patients with moderate to high spasticity in comparison with patients with low or no spasticity (P<0.05). Stroke causes loss of lean tissue mass and bone mineral content prominently in the paretic side. The loss increases with increasing time since stroke. Spasticity seems to help in preventing the loss of bone mineral content and lean tissue mass.     

Healthy body mass index values often underestimate body fat in men with spinal cord injury

OBJECTIVE: To examine the relation between body mass index (BMI) and adiposity in men with spinal cord injury (SCI). DESIGN: Cross-sectional study. SETTING: Outpatient study in 2 centers in New Zealand. PARTICIPANTS: Nineteen men with traumatic SCI were age-, height-, and weight-matched with 19 able-bodied men. INTERVENTIONS: Not applicable.Main Outcome Measures: BMI (kg/m(2)) and dual-energy x-ray absorptiometry measures of total and regional lean tissue mass and fat mass. RESULTS: Although the groups had similar BMIs, the total lean tissue mass was 8.9kg lower (95% confidence interval [CI], -12.7 to -5.2; P<.001) whereas total fat mass was 7.1kg greater (95% CI, 1.3-12.8; P<.05) in the SCI group. Body fat percentage was 9.4% (95% CI, 3.6-15.1; P<.01) greater in the SCI group. Regional measures showed a similar pattern. Truncal fat mass increased 3.7kg (95% CI, 0.5-6.9; P<.05) in the SCI group compared with controls. CONCLUSIONS: Body fat mass was greater for any given BMI in the SCI group. Many patients with SCI do not appear to be obese, yet they carry large amounts of fat tissue. BMI is widely used to estimate adiposity, but it may underestimate body fat in men with SCI.     

复方倍他米松联合透明质酸钠治疗膝骨关节炎45例体会

目的观察关节腔内注射复方倍他米松与透明质酸钠治疗膝骨性关节炎的效能。方法 45例关节腔积液膝骨性关节炎患者随机分为治疗组(30例)和对照组(15例)。治疗组采用复方倍他米松与透明质酸钠治疗膝骨关节炎,对照组单用透明质酸钠。观察两组临床疗效、VAS评分及不良反应发生情况。结果 2组治疗后1周、2周、4周、3个月的VAS评分均较治疗前明显降低,经比较差异有统计学意义(P<0.05);与对照组比较,治疗组治疗后VAS评分降低的更加明显,经比较差异有统计学意义(P<0.05)。治疗组总有效率达96.8%,明显高于对照组有效率(70%)(P<0.01)。结论对关节腔内有关节液的骨性关节炎联合治疗比单纯用透明质酸钠效果更好。     

Are the kinematics of the knee joint altered during the loading response phase of gait in individuals with concurrent knee osteoarthritis and complaints of joint instability? A dynamic stereo X-ray study

Background

Joint instability has been suggested as a risk factor for knee osteoarthritis and a cause of significant functional decline in those with symptomatic disease. However, the relationship between altered knee joint mechanics and self-reports of instability in individuals with knee osteoarthritis remains unclear.

Methods

Fourteen subjects with knee osteoarthritis and complaints of joint instability and 12 control volunteers with no history of knee disease were recruited for this study. Dynamic stereo X-ray technology was used to assess the three-dimensional kinematics of the knee joint during the loading response phase of gait.

Findings

Individuals with concurrent knee osteoarthritis and joint instability demonstrated significantly reduced flexion and internal/external rotation knee motion excursions during the loading response phase of gait (P < 0.01), while the total abduction/adduction range of motion was increased (P < 0.05). In addition, the coronal and transverse plane alignment of the knee joint at initial contact was significantly different (P < 0.05) for individuals with concurrent knee osteoarthritis and joint instability. However, the anteroposterior and mediolateral tibiofemoral joint positions at initial contact and the corresponding total joint translations were similar between groups during the loading phase of gait.

Interpretations

The rotational patterns of tibiofemoral joint motion and joint alignments reported for individuals with concurrent knee osteoarthritis and joint instability are consistent with those previously established for individuals with knee osteoarthritis. Furthermore, the findings of similar translatory tibiofemoral motion between groups suggest that self-reports of episodic joint instability in individuals with knee osteoarthritis may not necessarily be associated with adaptive alterations in joint arthrokinematics.     

关节镜下关节清理术联合红花化瘀汤熏蒸对膝关节骨关节炎患者的近远期疗效及血液流变学的影响*

目的探讨关节镜下关节清理术联合红花化瘀汤熏蒸治疗膝关节骨性关节炎(KOA)患者的近期、远期疗效及其对血液流变学的影响。方法选择2015年1月-2017年1月收治的120例KOA患者,依据随机数字表法分为观察组和对照组,观察组采用关节镜下关节清理术联合红花化瘀汤熏蒸治疗,对照组采用关节镜下关节清理术治疗,对比两组患者的血液流变学变化及近远期疗效。结果观察组总有效率高于对照组(P<0.05),两组患者术后膝关节肿胀程度逐渐缓解,组间、不同时间点、组间×不同时间点比较,差异有统计学意义(P<0.05)。两组患者治疗后全血黏度、血浆黏度、红细胞聚集指数降低(P<0.05),红细胞变形指数升高(P<0.05),组间比较,差异有统计学意义(P<0.05)。随访2年,两组治疗后骨性关节炎指数评分(WOMAC)、关节活动度、最大屈曲度、疼痛视觉模拟评分(VAS)改善,组间、不同时间点、组间×不同时间点比较,差异有统计学意义(P<0.05)。两组患者无不良反应发生。结论关节镜下关节清理术联合红花化瘀汤熏蒸对于KOA患者血液流变学的改善、膝关节功能的调节及术后疼痛、肿胀的缓解具有积极的促进作用,能够从根本上提高KOA临床治疗的近远期疗效。