膝关节镜结合中药熏洗治疗膝骨关节炎的临床效果

目的:探讨膝关节镜结合中药熏洗方案治疗膝骨关节炎(KOA)患者的临床效果。方法:收集2014年1月—2016年12月玉田县中医医院诊治的66例KOA患者,按照治疗方案不同分为两组,对照组(32例)行单纯中药熏洗治疗,观察组(34例)行关节镜清理术联合中药熏洗治疗,回顾观察并分析患者疼痛程度、关节症状、炎性因子水平、生活质量等变化情况。结果:观察组治疗后2、4周及3、6个月的视觉模拟评分法(VAS)评分均显著低于对照组(P<0.05);观察组治疗后膝骨性关节炎严重性指数ISOA)、国际膝骨性关节炎(WOMAC)量表评分低于对照组(P<0.05);观察组治疗后的白细胞介素-1(IL-1)、白细胞介素-6(IL-6)及超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平比对照组显著更低(P<0.05);观察组的总有效率为94.12%,显著高于对照组的76.47%,SF-36总评分显著高于对照组,差异均有统计学意义(P<0.05)。结论:联合给予KOA患者膝关节镜手术、中药熏洗治疗,可明显提高患者关节症状改善效果,减轻疼痛程度,提高抗炎效果,获得更理想临床总疗效及预后。

Clinical Study on Treatment of Knee Osteoarthritis by Arthroscopy Combined with Traditional Chinese Medicine

Objective To evaluate the clinical effect of knee arthroscopy combined with traditional Chinese medicine in the treatment of knee osteoarthritis(KOA).Methods The clinical data were 66 patients with KOA from January 2014 to December 2016 in Yutian County,Hebei Hospital of Traditional Chinese medicine.They were analyzed retrospectively and divided into groups according to the treatment plan.The Control Group(32 cases)was treated with traditional Chinese Medicine Fumigation,while the Observation Group(32 cases)was treated with arthroscopic debridement combined with traditional Chinese medicine fumigation.The changes of pain,joint symptoms,inflammatory factors and quality of life were analyzed retrospectively.Results Visual analogue scale(VAS)scores of 2,4 weeks and 3,6 months after treatment in the observation group were significantly lower than those in the control group(P<0.05).Compared with the Control Group,the Observation Group had significantly lower knee osteoarthritis/osteodystrophy severity index ISOA and international knee osteoarthritis/osteodystrophy score(P<0.05).The levels of interleukin-1(IL-1),IL6(IL-6),hs-CRP and tumor necrosis factor INF-αin the observation group were significantly lower than those in the control group(P<0.05).The total effective rate of observation group was 94.12%,which was significantly higher than that of the Control Group(76.47%)and the total score of SF-36 was significantly higher than that of the Control Group(P<0.05).Conclusion KOA patients were treated by arthroscopic surgery and fumigation which washedby Chinese herbs.They can obviously improve the effect of joint symptom,reduce the degree of pain,improve the anti-inflammatory effect and obtain more ideal clinical effect and prognosis.