根据致病因素制定的综合治疗方案治疗膝骨关节炎

Analysis the Efficacy of the Comprehensive Treatment Based on the Etiologic Factor to 56 Cases of the Knee Osteoarthritis

目的分析根据膝骨关节炎致病因素制定的综合治疗方案的疗效,探讨致病因素的作用机理,尝试制定合理的治疗措施。方法选择临床膝关节骨关节炎(knee osteoarthritis,KOA)患者56例,根据临床症状和体征及辅助检查结果,确定每个患者的致病因素:关节内损失、免疫损伤、代谢异常所致结晶体沉积损伤、腰椎间盘突出症导致的膝关节神经营养障碍损伤,分别采取关节镜清理、抗生素治疗、抗痛风治疗、保守治疗腰椎间盘突出症、应用活血药物防治微循环障碍等综合治疗方案治疗2周,膝关节功能锻炼4周,评估治疗前后患者疼痛、肿胀及日常活动情况的改善程度。结果有50例完成致病因素综合治疗并随访2年,总有效率为100%,疗效优秀20%。结论上述致病因素协同致病,是骨关节炎发病的病因病理基础,膝骨关节炎的致病因素综合治疗(关节镜清理、抗生素治疗、抗痛风治疗、保守治疗腰椎间盘突出症等方法)疗效好,是一种值得推荐的方法。

Objective To analyze the efficacy of comprehensive treatment based on the etiologic factor, to knee osteoar- thritis （ KOA）, and to discuss the etiologic pathology, in order to establish a reasonable treatment for KOA. Methods Fifty-six patients of KOA accepted the therapy of arthroscopy, antibiotic, anti-goutic therapy and nonsurgery treatment on lumber disc herniation. The etiologic factor of KOA were classified as injury in the knee joint, immunologic injury, crystal deposits in the joint derived from metabolic abnormity and malnutrition due to lumbar disc herniation. After 2 week of normal trearmet, functional exercise training of the knee lasted 4 weeks. Pain, swell of the joint, and walking function pre- and post-treatment were used as clinical evaluation parameters. Results The overall response rate of comprehensive treatment based on the etiologic factor of KOA was 100%. The rate of excellent result was 20%. Conclusion The relevant comprehensive treatment based on the etiologic factor of KOA introduced in this article is reasonable and effective method for KOA.