中药治疗下肢骨折后遗膝关节功能障碍疗效观察

目的：探讨中药治疗下肢骨折后遗膝关节功能障碍的方法和疗效。方法：100例下肢骨折后膝关节功能障碍患者平均随机分为中药CPM组和单纯CPM组，两组均予下肢关节恢复器（CPM）治疗，中药CPM组在此基础上加用中药方剂熏洗，比较两组的总体治疗效果和治疗前后JOA各项膝关节功能评分变化。结果：中药CPM组治愈率为72％，单纯CPM组治愈率为10％，两组治愈率差异有统计学意义（P〈0．05）。治疗效果经秩和检验组间比较，H=6．32，P〈0．05，中药CPM组优于单纯CPM组。治疗后，中药CPM组JOA膝关节步行疼痛、上下楼梯、关节活动度、肿胀评分均优于术前（d=9．1±2．3，d=8．3±2．1，d=11．1±2．4，d=4．3±0．9，均有P〈O．05），单纯CPM组各项评分也均优于术前（d=5．2±2．2，d=4．0±1．9，d=6．9±2．1，d=2．7±0．9，均有P〈0．05）。中药CPM组各项评分增幅大于单纯CPM组（P〈0．05）。结论：CPM机牵引治疗下肢骨折后膝关节功能障碍疗效肯定，在此基础上配合中药熏洗治疗可进一步增进总体疗效，提高治愈率，改善症状，提高关节活动度，获得更好的治疗效果。

Effective observation on treating Knee joint dysfunction following lower limb fracture in TCM

Objective： To explore the method and the effect of treating knee joint dysfunction after lower limb fracture in TCM. Methods： Divide 100 cases of patients with knee joint dysfunction after lower limb fracture into TCM CPM group and single CPM group randomly, the two groups all were treated with CPM, on the bases, TCM CPM group added TCM fumigation and washing on the bases, compared the effect of treatment of the two groups and JOA score changes of the function of knee joint before and after treatment. Result： In TCM CPM group, the cure rate for 72%, the cure rate of sigle CPM group for 10%, the difference of the cure rate in the two groups had statistically significant （P〈0.05）. Compared the effect of treatment testing by the rank test in the two groups, 1-1--6.32, P〈0.05, TCM CPM group was better than single CPM group after treatment, TCM CPM group JOA knee walking pain, up and down stairs, range of motion, swelling scores were better than before surgery （d=9.1±2.3, d=8.3±2.1, d=11.1±2.4, d=4.3±0.9, all for P〈0.05）, simple CPM group were better than the before surgery scores （d=5.2±2.2, d=4.0, 1.9, d=6.9±2.1, d=2.7±0.9, all for P〈0.05）. An increase of the score of TCM CPM group was more than a simple CPM group （P〈0.05）. Conclusion： The effect on treating knee joint dysfunction after lower limb fracture with CPM traction was good, on the bases, treating the diseases added TCM fumigation, it can increase the effect, raise the cure rate, improve syndrome, increase joint range of motion, get better effect of treatment.