辨证施护配合康复训练对双膝骨性关节炎患者血清炎症因子水平的影响

Effect of Dialectical Nursing Combined with Rehabilitation Training on Serum Inflammatory Cytokines in Patients with Bilateral Knee Osteoarthritis

【目的】评价辨证施护配合康复训练对双膝骨性关节炎(KOA)血清炎症因子水平与关节功能的影响。【方法】将60例双膝KOA患者随机分为观察组和对照组各30例。治疗期间2例脱落,1例退出,最终纳入病例对照组29例、观察组28例。对照组在中医治疗基础上给予常规护理,观察组在对照组常规护理基础上给予辨证施护(分风寒湿痹、风湿热痹、瘀血闭阻、肝肾亏虚4型)配合康复训练,评价2组患者的临床疗效及护理干预前后膝关节功能、血清炎症因子的变化情况。【结果】(1)观察组的总有效率为89.3%,优于对照组的72.4%,差异有统计学意义(P<0.05)。(2)护理干预后,2组Lysholm评分均较护理干预前显著提高(P<0.05),且观察组的提高作用优于对照组(P<0.05)。(3)护理干预后,2组白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均较护理干预前显著下降(P<0.05),且观察组的下降作用优于对照组(P<0.05)。【结论】辨证施护配合康复训练干预治疗双膝KOA患者,临床疗效确切,可显著改善患者的膝关节功能,调控患者的血清炎症因子水平。

Objective To investigate the effect of dialectical nursing combined with rehabilitation training on the levels of serum inflammatory cytokines and joint function of patients with bilateral knee osteoarthritis （KOA）. Methods A total of 60 cases of bilateral KOA patients were randomized into observation group and control group, 30 case in each group. During the treatment, 2 cases of observation group were dropped out and one case of the control group quitted, and therefore, the number of the final cases of the observation group and control group was 28, 29 respectively. The control group was given routine nursing and Chinese medicine therapy, and the observation group was given dialectical nursing care combined with rehabilitation training on the basis of the treatment for the control group. The dialectical nursing was performed for the four syndromes of wind-cold-damp arthralgia, wind-damp-heat arthralgia, blood-stasis blockage, and liver-kidney insufficiency.The therapeutic effect was evaluated after treatment, and the changes in knee joint function and serum inflammatory cytokines before and after treatment were observed. Results （1） The total effective rate of the observation group was 89.3%, superior to 72.4% in the control group （P〈0.05）.（2）After treatment, Lysholm scores of both groups were increased （P〈0.05 compared with those before treatment） , and the increase of the observation group was superior to that of the control group （P〈0.05）. （3）After treatment, serum levels of interleukin 1 （IL-1）, interleukin 6（IL-6）, and tumor groups （P〈0.05 compared with those before treatment） , necrosis factor alpha （TNF-a） were declined in the two and the decrease of the observation group was superior to that of the control group （P〈0.05）. Conclusion Dialectical nursing combined with rehabilitation training is effective tor the treatment of bilateral KOA, and the combined therapy has certain effect on improving knee joint function and regulating the levels of serum inflammatory cytokines.