局部封闭联合小针刀和洛芬待因片口服联合中药热敷治疗膝关节鹅足滑囊炎的疗效比较

目的：比较局部封闭联合小针刀和洛芬待因片口服联合中药热敷治疗膝关节鹅足滑囊炎的临床疗效.方法：单侧膝关节鹅足滑囊炎患者85例,男27例,女58例;年龄38 ～81岁,中位数58岁;左侧34例,右侧51例;病程5d至8年,中位数11个月.按就诊顺序随机分为2组,观察组45例,对照组40例;观察组采用局部封闭联合小针刀治疗,对照组采用洛芬待因片口服联合中药热敷治疗.分别在治疗前、治疗后（观察组为治疗后1周,对照组为治疗1周后）,采用疼痛视觉模拟评分法对2组患者患膝疼痛情况进行评分,并对2组患者的疼痛评分和疗效进行比较.结果：治疗前2组患者患膝压痛、自发痛评分比较,组间差异均无统计学意义（3.166±1.010）分,（3.019±1.069）分,t=0.402,P=0.553;（2.834±0.122）分,（2.791±0.139）分,t=0.523,P=0.326];治疗后2组患者患膝疼痛均有所缓解,且观察组疼痛缓解更明显,压痛和自发病评分均低于对照组（0.938±0.171）分,（1.990±0.630）分,t=2.256,P=0.012;（0.806±0.220）分,（1.381±0.343）分;t=1.652,P =0.036];参照《中医病证诊断疗效标准》膝部滑囊炎疗效评定标准评价疗效,观察组治愈16例、好转24例、未愈5例,对照组治愈8例、好转21例、未愈11例,观察组疗效优于对照组（Z=-2.131,P=0.033）.结论：局部封闭联合小针刀治疗膝关节鹅足滑囊炎,可有效减轻患膝肿胀、缓解疼痛,有利于膝关节功能恢复,疗效优于洛芬待因片口服联合中药热敷.

A clinical comparison of local blocking combined with small knife needle versus oral application of ibuprofen-codeine phosphate tablets combined with hot compress with traditional Chinese drug for treatment of knee articular anserine bursitis

Objective：To compare the clinical curative effect of local blocking combined with small knife needle versus oral application of ibuprofen-codeine phosphate tablets combined with hot compress with traditional Chinese drug for treatment of knee articular anserine bursitis.Methods：Eighty-five patients with unilateral knee articular anserine bursitis consisted of 27 males and 58 females,and ranged in age from 38 to 81 years（Median =58 yrs）,The anserine bursitis located in left knee for 34 patients and right knee for 51 patients,and ranged in course of disease from 5 days to 8 years（Median =11 months）.The patients were randomly divided into 2 groups according to registration order,45 cases in observation group,40 cases in control group.Patients in the observation group were treated with local blocking combined with small knife needle,while patients in the control group were treated with oral application of ibuprofen-codeine phosphate tablets combined with hot compress with traditional Chinese drug.The knee pain degree were evaluated by using visual analogue scale（VAS） before the treatment and after the treatment（observation group：one week after the treatment,control group：after 1-week treatment）,and the pain scores and therapeutic effects were compared between the 2 groups.Results：There were no statistical difference in the knee tenderness and spontaneous pain between the 2 groups before the treatment（3.166 ＋/-1.010 vs 3.019 ＋/-1.069 points,t =0.402,P =0.553;2.834 ＋/-0.122 vs 2.791 ＋/-0.139 points,t =0.523,P =0.326）.The knee pain were relieved after the treatment in the 2 groups,and more obvious pain relief were found in the observation group,and the scores of tenderness and spontaneous pain of the observation group were lower than those of the control group（0.938 ＋/-0.171 vs 1.990 ＋/-0.630 points,t =2.256,P =0.012 ;0.806 ＋/-0.220 vs 1.381 ＋/-0.343 points,t =1.652,P =0.036）.The therapeutic effects were evaluated according to therapeutic effect evaluation standard of kn