针刺与中药熏蒸加运动疗法治疗膝关节术后功能障碍

目的：观察针刺、中药熏蒸加运动疗法治疗胫骨平台骨折术后膝关节功能障碍的临床疗效。方法将84例胫骨平台骨折术后患者采用随机数字表法分为两组，行针刺、中药熏蒸加运动疗法的（治疗组）56例，行单纯运动疗法的（对照组）28例。采用视觉模拟评分（ visual analogue scale，VAS ）评估患者疼痛改变，根据Harris评分法标准进行康复评定。结果治疗组治疗前VAS评分8.14±0.94，治疗后1.93±1.08；对照组治疗前 VAS 评分8.03±1.02，治疗后2.71±0.99，差异均有统计学意义（ P＜0.05）。治疗组与对照组治疗后的VAS评分比较，差异有统计学意义（ P＜0.05）。膝关节功能改善总有效率比较，治疗组为96%（优35例，良14例，中5例，差2例），对照组为82%（优12例，良7例，中4例，差5例），差异有统计学意义。结论与单纯运动疗法相比，针刺、中药熏蒸加运动疗法对治疗胫骨平台骨折术后膝关节功能障碍疗效更佳，值得临床推广应用。

Acupuncture,herbal fumigation and kinesitherapy for postoperative dysfunction of the knee joint

Objective To observe the clinical results of acupuncture, herbal fumigation and kinesitherapy in the treatment of knee joint dysfunction after the operation for tibial plateau fractures.Methods A total of 84 patients with knee joint dysfunction after the operation for tibial plateau fractures were randomly divided into 2 groups, including the treatment group of needle acupuncture, herbal fumigation and kinesitherapy （n=56 ） and the control group of simple kinesitherapy （n=28 ）. The Visual Analogue Scale （ VAS ） was used for pain assessment, and the Harris score standard for rehabilitation evaluation.Results The VAS scores were 8.14±0.94 points and 1.93±1.08 points before and after the treatment respectively in the treatment group, with statistically significant differences （P〈0.05 ）. The VAS scores were 8.03±1.02 points and 2.71±0.99 points before and after the treatment respectively in the control group, with statistically signiifcant differences （P〈0.05 ）. The differences in the VAS score after the treatment were statistically significant between the 2 groups （P〈0.05 ）. The total improvement rates of knee joint function were 96% and 82% in the treatment group and the control group respectively, with statistically signiifcant differences. The results were excellent in 35 cases, good in 14 cases, fair in 5 cases and poor in 2 cases in the treatment group, and excellent in 12 cases, good in 7 cases, fair in 4 cases and poor in 5 cases in the control group.Conclusions When compared with that of the simple kinesitherapy, the curative outcomes of acupuncture, herbal fumigation and kinesitherapy are better in the treatment of knee joint dysfunction after the operation for tibial plateau fractures, which is worthy of clinical application.