摇旋活节手法配合中药外敷对膝骨关节炎关节镜术后患者膝关节功能恢复及生存质量的影响

目的 观察摇旋活节手法配合中药外敷对膝骨关节炎(knee osteoarthritis,KOA)关节镜术后膝关节功能恢复及生存质量的影响.方法 将符合入选标准的160例KOA关节镜术后住院患者采用随机数字表法分为2组,每组80例.手法组在关节镜清理术后采用摇旋活节手法配合中药外敷,对照组在关节镜清理术后采用常规按摩手法配合中药外敷.2组均治疗2周.采用西部安大略麦克马斯特大学骨关节炎指数可视化量表(Western Ontario MacMaster University Osteoarthritis index,WOMAC指数)评价症状的严重程度,采用膝骨关节炎严重性指数(ndex of severity for knee joint osteoarthri,ISOA)评价临床疗效,采用ELISA法检测关节液中IL-1β、TNF-α的含量,采用硝酸还原酶法检测关节液中NO的含量.结果 治疗后,手法组WOMAC评分[(21.26±13.16)分比(31.19±12.67)分,t=8.967]、ISOA评分[(3.28±1.52)分比(6.45±2.31)分,t=5.261]均低于对照组(P<0.05),KPS评分[(88.26±7.42)分比(76.39±8.59)分,t=6.164]高于对照组(P<0.05);手法组关节液中TNF-α[(21.31±10.43)ng/ml比(28.29±11.74)ng/ml,t=6.219]、IL-1β[(11.36±4.22)pg/ml比(16.57±6.44)pg/ml,t=5.645]含量低于对照组(P<0.05).结论 摇旋活节手法配合中药外敷可降低KOA关节镜术后患者关节液中IL-1β、TNF-α含量,改善膝关节功能并减轻其疼痛程度,提高生存质量.

A study on the knee joint function recovery and the quality of life by the massage and manipulation combined external application of Chinese medicine for the patients after knee arthroscope surgery of osteoarthritis

Objectives In order to evaluate the difference of the clinical effect of the knee joint function recovery and the quality of life by the massage and manipulation combined external application of Chinese medicine for the patients after knee arthroscope surgery of osteoarthritis. Methods A total of 160 hospitalized patients after knee joint arthroscope surgery of osteoarthritis from Tongchuan People's Hospital, Shanxi Tongchuan, were randomly divided into manipulation treatment group and control group. The manipulation treatment group revieved the manipulation combined with external application of Chinese medicineafter arthroscope surgery, and the control group received the regular massage combined with external application of Chinese medicine. Both groups were treated for two weeks. The WOMAC scale, ISOA scale and KPS rating scale were evaluated before and after treatment.The joint fluid IL-1β, TNF-α, the content of NO were detected before and after treatment of 3 months.Results After treatment,the WOMAC(21.26 ±13.16 vs.31.19 ± 12.67, t=8.967), ISOA (3.28 ± 1.52 vs. 6.45 ± 2.31, t=5.261) of the manipulation group were significantly lower than those of the control group(P<0.05);the KPS(88.26 ±7.42 vs.76.39 ±8.59,t=6.164)of the manipulation group was significantly higher than the control group (P<0.05); the TNF-α (21.31 ± 10.43 ng/ml vs. 28.29 ± 11.74 ng/ml, t=6.219), IL-1β (11.36 ± 4.22 pg/ml vs. 16.57 ± 6.44 pg/ml, t=5.645) of the manipulation group were significantly lower than the control group (P<0.05); the NO (33.15 ± 10.28 μmol/ml vs.34.22 ± 11.05 μmol/ml, t=1.364) of the manipulation group was higher than the control group without significance(P>0.05). Conclusions Manipulation combined with external application of Chinese medicine can reduce the content of joint fluid IL-1β, TNF-α, and the NO after knee joint arthroscope surgery of osteoarthritis, and can improve the function of knee joint, reduce pain, improve the quality of life.