蠲痹健膝方联合关节镜手术对膝骨关节炎的疗效
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摘要
目的:探讨蠲痹健膝方联合关节镜手术对膝骨关节炎的疗效。方法:选择膝骨关节炎病人80例作为研究对象,按照随机数字表法分为观察组和对照组,各40例。2组病人均接受关节镜手术治疗,对照组病人术后单纯接受功能锻炼,观察组病人术后给予蠲痹健膝方结合功能锻炼。采用Lysholm膝关节评分评价病人膝关节功能,采用疼痛视觉模拟评分评价病人疼痛程度,比较2组病人疗效,并比较治疗前后2组病人白细胞介素(IL)-1和肿瘤坏死因子α(TNF-α)水平变化。结果:治疗后2组病人Lysholm评分和VAS评分均较治疗前明显改善(P<0.01),且观察组均明显优于对照组(P<0.01)。2组病人治疗后IL-1和TNF-α水平均较治疗前明显下降(P<0.01),且观察组病人IL-1、TNF-α水平均明显低于对照组(P<0.01)。观察组治疗总有效率为95.00%(38/40),对照组为72.50%(29/40);观察组疗效优于对照组(P<0.05)。结论:蠲痹健膝方联合关节镜手术治疗膝骨关节炎疗效较好,并能有效降低炎症因子水平,值得临床推广。
Objective:To investigate the effects of Juanbi Jianxi recipe combined with arthroscopic surgery in the treatment of knee osteoarthritis.Methods:Eighty patients with knee osteoarthritis were randomly divided into the observation group and control group(40 cases each group).Two groups were treated with arthroscopic surgery,and then the control group and observation group were treated with functional training and Juanbi Jianxi recipe combined with functional training,respectively.The knee joint function score and pain in two groups were evaluated using Lysholm knee joint function scale and visual analogue scale(VAS),and the levels of IL-1 and TNF-α in two groups between before and after treatment were compared.Results:After treatment,the scores of Lysholm and VAS in two groups were significantly improved compared with before with treatment(P<0.01),and which in observation group was significantly better than that in control group(P<0.01).After treatment,the levels of IL-1 and TNF-α in two groups significantly decreased compared before treatment(P<0.01),and which in observation group was significantly lower than that in control group(P<0.01).The total effective rates in observation group and control group were 95.00%(38/40) and 72.50%(29/40),respectively.The treatment effect in observation group was better than that in control group(P<0.05).Conclusions:The effects of Juanbi Jianxi recipe combined with arthroscopic surgery in the treatment of knee osteoarthritis are good,which can effectively decrease the level of inflammatory factor,and is worthy of promotion in clinic.
Objective:To investigate the effects of Juanbi Jianxi recipe combined with arthroscopic surgery in the treatment of knee osteoarthritis.Methods:Eighty patients with knee osteoarthritis were randomly divided into the observation group and control group(40 cases each group).Two groups were treated with arthroscopic surgery,and then the control group and observation group were treated with functional training and Juanbi Jianxi recipe combined with functional training,respectively.The knee joint function score and pain in two groups were evaluated using Lysholm knee joint function scale and visual analogue scale(VAS),and the levels of IL-1 and TNF-α in two groups between before and after treatment were compared.Results:After treatment,the scores of Lysholm and VAS in two groups were significantly improved compared with before with treatment(P<0.01),and which in observation group was significantly better than that in control group(P<0.01).After treatment,the levels of IL-1 and TNF-α in two groups significantly decreased compared before treatment(P<0.01),and which in observation group was significantly lower than that in control group(P<0.01).The total effective rates in observation group and control group were 95.00%(38/40) and 72.50%(29/40),respectively.The treatment effect in observation group was better than that in control group(P<0.05).Conclusions:The effects of Juanbi Jianxi recipe combined with arthroscopic surgery in the treatment of knee osteoarthritis are good,which can effectively decrease the level of inflammatory factor,and is worthy of promotion in clinic.
引文
[1] 张新玉,黄炳仓,吴墅,等.影像学检查及细胞因子与膝骨关节炎病人病情活动的相关性研究[J].临床和实验医学杂志,2015,14(13):1082.
[2] KLEIN-WIERINGA IR,DE LANGE-BROKAAR BJ,YUSUF E,et al.Inflammatory cells in patients with endstage knee osteoarthritis:a comparison between the synovium and the infrapatellar fat pad[J].Journal Rheumatol,2016,43(4):771.
[3] 郭伟雄,魏波.炎症细胞因子及通路在骨关节炎中的研究进展[J].国际检验医学杂志,2015,35(15):2240.
[4] OHTORI S,ORITA S,YAMAUCHI K,et al.Efficacy of direct injection of etanercept into knee joints for pain in moderate and severe knee osteoarthritis[J].Yonsei Med J,2015,56(5):1379.
[5] 刘晓锋,王燕妮,李晨,等.关节镜清理术联合电针治疗对膝骨关节炎病人关节液中细胞因子和蛋白酶的影响[J].海南医学院学报,2015,21(12):1643.
[6] 叶阮炷,韩清民.关节镜结合补肾活血法治疗膝骨关节炎对细胞因子的影响[J].世界科学技术:中医药现代化,2015,17(8):1650.
[7] 何军,宋海瑞.健膝蠲痹汤治疗单纯性膝骨性关节炎的临床应用[J].内蒙古中医药,2012,31(17):52.
[8] 张洪美,邱成新,尚海,等.膝痹通方治疗膝骨关节炎临床疗效研究[J].辽宁中医药大学学报,2017,19(9):5.
[9] 孙文才,白玉江,李玉成,等.骨关节炎病人血清及关节滑液中细胞因子的表达水平研究[J].中国全科医学,2012,15(27):3185.
[10] LARSSON S,ENGLUND M,STRUGLICS A,et al.Interleukin-6 and tumor necrosis factor alpha in synovial fluid are associated with progression of radiographic knee osteoarthritis in subjects with previous meniscectomy[J].Osteoarthritis Cartilage,2015,23(11):1906.
[11] 郑吉元,安文博,姜劲挺.关节镜清理术治疗膝骨性关节炎临床研究进展[J].医学研究生学报,2015,28(7):776.
[12] 郑维蓬.膝骨关节炎关节镜下表现与中医证型、细胞因子相关性及中医药干预研究[D].广州:广州中医药大学,2014.
[13] 程桯,温建民,林新晓,等.关节镜联合电针治疗膝骨性关节炎的分子机制研究[J].中国中医骨伤科杂志,2014,21(12):17.
[14] WEHLING P,MOSER C,MAIXNER W.How does surgery compare with advanced intra-articular therapies in knee osteoarthritis:current thoughts[J].Ther Adv Musculoskelet Dis,2016,8(3):72.
[15] 程园园,刘健.中医药对骨关节炎细胞因子调节作用的研究进展[J].中华中医药学刊,2012,31(10):2200.
[16] 张启栋,俞庆声,程立明,等.生化因素在内翻膝骨关节炎患者外侧间室软骨磨损中的作用[J].中华医学杂志,2015,95(17):1305.
[17] 王景红,夏坤,张志千,等.骨关节炎相关细胞因子及生物标志物的研究进展[J].中国实验方剂学杂志,2015,21(10):225.
[2] KLEIN-WIERINGA IR,DE LANGE-BROKAAR BJ,YUSUF E,et al.Inflammatory cells in patients with endstage knee osteoarthritis:a comparison between the synovium and the infrapatellar fat pad[J].Journal Rheumatol,2016,43(4):771.
[3] 郭伟雄,魏波.炎症细胞因子及通路在骨关节炎中的研究进展[J].国际检验医学杂志,2015,35(15):2240.
[4] OHTORI S,ORITA S,YAMAUCHI K,et al.Efficacy of direct injection of etanercept into knee joints for pain in moderate and severe knee osteoarthritis[J].Yonsei Med J,2015,56(5):1379.
[5] 刘晓锋,王燕妮,李晨,等.关节镜清理术联合电针治疗对膝骨关节炎病人关节液中细胞因子和蛋白酶的影响[J].海南医学院学报,2015,21(12):1643.
[6] 叶阮炷,韩清民.关节镜结合补肾活血法治疗膝骨关节炎对细胞因子的影响[J].世界科学技术:中医药现代化,2015,17(8):1650.
[7] 何军,宋海瑞.健膝蠲痹汤治疗单纯性膝骨性关节炎的临床应用[J].内蒙古中医药,2012,31(17):52.
[8] 张洪美,邱成新,尚海,等.膝痹通方治疗膝骨关节炎临床疗效研究[J].辽宁中医药大学学报,2017,19(9):5.
[9] 孙文才,白玉江,李玉成,等.骨关节炎病人血清及关节滑液中细胞因子的表达水平研究[J].中国全科医学,2012,15(27):3185.
[10] LARSSON S,ENGLUND M,STRUGLICS A,et al.Interleukin-6 and tumor necrosis factor alpha in synovial fluid are associated with progression of radiographic knee osteoarthritis in subjects with previous meniscectomy[J].Osteoarthritis Cartilage,2015,23(11):1906.
[11] 郑吉元,安文博,姜劲挺.关节镜清理术治疗膝骨性关节炎临床研究进展[J].医学研究生学报,2015,28(7):776.
[12] 郑维蓬.膝骨关节炎关节镜下表现与中医证型、细胞因子相关性及中医药干预研究[D].广州:广州中医药大学,2014.
[13] 程桯,温建民,林新晓,等.关节镜联合电针治疗膝骨性关节炎的分子机制研究[J].中国中医骨伤科杂志,2014,21(12):17.
[14] WEHLING P,MOSER C,MAIXNER W.How does surgery compare with advanced intra-articular therapies in knee osteoarthritis:current thoughts[J].Ther Adv Musculoskelet Dis,2016,8(3):72.
[15] 程园园,刘健.中医药对骨关节炎细胞因子调节作用的研究进展[J].中华中医药学刊,2012,31(10):2200.
[16] 张启栋,俞庆声,程立明,等.生化因素在内翻膝骨关节炎患者外侧间室软骨磨损中的作用[J].中华医学杂志,2015,95(17):1305.
[17] 王景红,夏坤,张志千,等.骨关节炎相关细胞因子及生物标志物的研究进展[J].中国实验方剂学杂志,2015,21(10):225.