中药热敷治疗老年膝关节骨性关节炎疗效观察

Therapeutic Effect of Traditional Chinese Medicine Hot Compress on Senile Knee Osteoarthritis

目的探究单踝置换术(unicompartmental knee arthroplasty,UKA)联合中药热敷治疗老年膝关节骨性关节炎的疗效及对疼痛介质、炎性因子的影响。方法选取2017年1月—2019年6月医院收治的老年膝关节骨性关节炎患者100例,随机分为对照组47例和联合组53例。对照组行单纯UKA治疗及常规处理,联合组在对照组基础上增加中药热敷。观察两组临床疗效,比较治疗前后中医证候积分、视觉模拟量表(VAS)评分、膝关节功能量表(HSS)评分及血清疼痛介质[P物质(SP)、缓激肽(BK)、前列腺素E2(PGE2)]、关节液炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及基质金属蛋白酶-3(MMP-3)水平。结果联合组治疗总有效率为94.34%(50/53),明显高于对照组的80.85%(38/47),差异有统计学意义(P<0.05)。治疗后,联合组中医证候积分、VAS评分及血清SP、BK、PGE2和关节液IL-6、MMP-3、TNF-α水平均明显低于对照组(P<0.05),HSS评分明显高于对照(P<0.05)。结论UKA联合中药热敷治疗老年膝关节骨性关节炎的疗效较单纯UKA更好,缓解患者临床症状,减轻疼痛,改善膝关节功能,调节炎性因子水平。

Objective To explore the efficacy of unicompartmental knee arthroplasty(UKA)combined with TCM hot compress therapy in the treatment of senile knee osteoarthritis and its effect on pain mediators and inflammatory factors.Methods A total of 100 elderly patients with knee osteoarthritis treated in the hospital from January 2017 to June 2019 were randomly divided into the control group(47 cases)and the combined group(53 cases).The control group was treated with simple UKA and routine treatment,while the combined group was treated with TCM hot compress therapy on the basis of the control group.The clinical efficacy of the two groups was observed,and the TCM syndrome score,visual analogue scale(VAS)score,knee joint function scale(HSS score)and serum pain mediators[substance P(SP),bradykinin(BK),prostaglandin E2(PGE2)],articular fluid inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and matrix metalloproteinase-3(MMP-3)were compared before and after treatment.Results The total effective rate of the combined group was 94.34%(50/53),which was significantly higher than that of the control group(80.85%,38/47),and the difference was statistically significant(P<0.05).After treatment,the TCM syndrome score,VAS score,serum levels of SP,BK and PGE2 and levels of IL-6,MMP-3 and TNF-αin the synovial fluid in the combined group were significantly lower than those in the control group(P<0.05).The HSS score was significantly higher than that in the control group(P<0.05).Conclusion The curative effect of UKA combined with TCM hot compress therapy in the treatment of senile knee osteoarthritis is better than that of UKA alone.UKA combined with TCM hot compress therapy can relieve the clinical symptoms and pain,improve the knee joint function and regulate the levels of inflammatory factors.