药物滑膜切除术配合中药外敷治疗类风湿关节炎疗效观察

目的：观察药物滑膜切除术配合中药外敷治疗膝关节类风湿炎的疗效及其安全性并与关节镜下滑膜切除术进行对比。方法：将60例类风湿关节炎引起的膝关节滑膜炎患者随机均分为两组，治疗组行药物滑膜切除术配合中药外敷，每周治疗1次，疗程4周；对照组行关节镜下滑膜切除。均于术后1周观察临床症状改善、实验室指标变化情况及不良反应。结果：治疗组30例中显效18例，好转11例，无效1例，总有效率96．7％。对照组30例中显效19例，好转9例，无效2例，总有效率93．3％。经，检验两纽显效及总有效率比较无明显差别（P≥0．05）说明两种治疗方法都能明显改善患者的临床症状、体征及实验室指标。结论：药物滑膜切除术（曲安奈德和甲氨蝶呤联合使用关节腔内汁射）及外敷中药可以达到关节镜下手术滑膜切除的效果，但该方法对患者创伤更小、操作简单、容易掌握、花费低廉、无需特殊设备、疗效明显。

Clinical observation on curative effect of synovectomy with medicine compounded with TCM applied outside to cure rheumatoid arthritis

Objective ： To observe curative effect and safety of synovectomy with medicine compounded with TCM applied outside to cure rheumatoid arthritis, and compare with synovectomy under arthroscope. Methode： 60 cases of patients with gonarthromeningitis caused by rheumatoid arthritis, were randomly divided equally into two groups, therapy group （ synovectomy with medicine compounded with TCM applied outside, treated once a week, the course of treatment was 4 weeks） and control group （synovium resection under arthroscope）. A week post - operation they were observed improvement of clinical symptoms, changes of laboratory indexes and adverse effects. Results ： In therapy group, excellence 18 cases, improvement 11 cases, inefficacy 1 case, the total effective rate was 96.7%. In control group, the numbers above were respectively 19 cases, 9 cases, 2 cases and 93.3%. there had no obvious difference on excellence and total effective rate in two groups by x2 test （P≥0.05）. It showed that both of them could obviously patients＇clinical symptoms, objective signs and la- boratory indexes. Conclusions： The method of synovectomy with medicine （ triamcinolone united with methopterin, intraarticular injection） compounded with TCM applied outside,could achieve the same effect as synovectomy under arthroscope. But it had such merits as small wound, simple handling, easily grasping, cheap cost, without special equipment and manifest curative effect.