腓骨近端截骨联合中医药治疗膝关节内侧间室骨关节炎肝肾不足、气滞血瘀证

目的比较腓骨近端截骨术联合中医药与单纯腓骨近端截骨术治疗膝关节内侧间室骨关节炎肝肾不足、气滞血瘀证的疗效。 方法回顾性分析2014年10月至2017年5月收治的符合纳入及排除标准的膝关节骨关节炎肝肾不足、气滞血瘀证患者58例，其中单纯行腓骨近端截骨术28例（A组），行腓骨近端截骨术结合中药热敷、口服中药治疗30例（B组）。A组男性8例，女性20例，年龄51~64岁，平均年龄为（58.4±2.1）岁。B组男性7例，女性23例，年龄53~63岁，平均龄为（59.4±3.3）岁。分别术后1 w、1个月、3个月、6个月及12个月随访并比较两组患者的疼痛视觉模拟评分（VAS）、美国特种外科医院（HSS）膝关节评分、患者满意度、住院时间和医疗费用等。 结果单纯腓骨近端截骨术（A组）26例患者得到随访，2例失访，腓骨近端截骨术结合中药热敷、口服中药（B组）26例得到随访，4例失访，随访时间10~26个月，平均（12.5±3.4）个月。术前A组与B组的VAS评分、HSS评分比较，差异均无统计学意义（P>0.05）。术后A组患者的VAS评分（5.8±0.7）分]高于B组（2.8±0.6）分]，差异具有统计学意义（t=11.548，P<0.05），A组的HSS评分（69.2±1.1）分]低于B组（75.7±1.8）分]，差异具有统计学意义（t=11.071，P<0.05），患者满意度（53.8%）低于B组（76.9%），差异具有统计学意义（t=7.721，P<0.05），两组住院时间、医疗费用比较，差异无统计学意义（P>0.05）。 结论腓骨近端截骨联合中医药治疗膝关节内侧间室骨关节炎肝肾不足、气滞血瘀证的效果优于单纯腓骨近端截骨术，可明显减轻患者的疼痛，有利于患肢肿胀的消退，提高患者满意度，快速康复患肢的功能，值得临床推广。

Proximal fibular osteotomy combined with traditional Chinese medicine in the treatment of osteoarthritis of medial compartment of knee joint with liver and kidney insufficiency,qi stagnation and blood stasis syndrome

ObjectiveTo compare the efficacy of Proximal Fibular Osteotomy (PFO) combined with traditional Chinese medicine and proximal fibular osteotomy alone in the treatment of medial compartment osteoarthritis of knee joint with liver and kidney insufficiency and qi stagnation and blood stasis syndrome. MethodsA retrospective analysis was made on 58 patients with osteoarthritis of knee joint with liver and kidney insufficiency and qi stagnation and blood stasis syndrome from October 2014 to May 2017. Among them, 28 patients were treated with PFO alone (group A), 30 patients were treated with PFO combined with traditional Chinese medicine hot compress and oral Chinese medicine (group B). There were 8 males and 20 females in group A, aged 51-64 years, with an average age of (58.4+2.1) years. In group B, there were 7 males and 23 females, aged from 53 to 63 years, with an average age of (59.4+3.3) years. The patients were followed up for 1 w, 1 month, 3 months, 6 months and 12 months after operation. VAS and HSS were compared between the two groups. And patient satisfaction, hospitalization time and medical expenses. Results26 patients in group A were followed up, 2 patients were lost, 26 patients in group B were followed up, and 4 patients were lost. The follow-up period ranged from 10 months to 26 months, with an average of (12+3) months. There were no significant differences in VAS scores and HSS scores between group A and group B before surgery (P>0.05). The VAS score (5.8±0.7) of group A patients was higher than that of group B (2.8±0.6), the difference was statistically significant (t=11.548, P<0.05), HSS score (69.2±1.1) of group A was lower than group B (75.7±1.8), the difference was statistically significant (t=11.071, P<0.05), patient satisfaction (53.8%) of group A was lower than group B (76.9%), the difference was statistically significant (t=7.721, P<0.05). There was no significant difference in the length of hospital stay and medical expenses between the two groups (P>0.05). ConclusionsThe treatment of proximal humerus osteotomy combined with traditional Chinese medicine for the treatment of medial compartment osteoarthritis of the knee joint with liver and kidney deficiency and qi stagnation and blood stasis syndrome is better than the proximal humerus osteotomy. The postoperative pain can significantly reduce the patient's pain and benefit the patient. The decline of limb swelling, improve patient satisfaction, and quickly recover the function of the affected limb is worthy of clinical promotion.