关节镜清理术联合中药治疗绝经后膝骨性关节炎疗效分析

Clinical Observation of Arthroscopic Debridement Combined with Traditional Chinese Medicine in the Treatment of Postmenopausal Women with Knee Joint Osteoarthritis

目的 :探讨关节镜清理术联合中药治疗绝经后膝骨性关节炎的临床疗效。方法 :选取2014年9月~2016年2月绝经后膝骨性关节炎患者60例,随机分为关节镜治疗组和关节镜加中药(养血固肾汤)治疗组,每组30例,分别予以相应治疗。于术前及术后8周分别采集静脉血,检测白细胞介素(IL-6)、肿瘤坏死因子(TNF-α)、雌激素(E_2)水平并作对比;术前、术后8周分别按照膝关节Lysholm功能评分对膝骨性关节炎严重性指数进行评分,评价临床疗效。结果:术后8周组内比较,关节镜加中药治疗组IL-6、TNF-α、E_2差异均有统计学意义(P<0.05),而关节镜治疗组只有IL-6、TNF-α差异有统计学意义(P<0.05),E_2差异无统计学意义(P>0.05);术后8周组间比较,IL-6、TNF-α、E_2差异均有统计学意义(P<0.05)。术后8周组内比较及组间比较Lysholm评分差异均有统计学意义(P<0.05)。结论:关节镜清理术联合中药养血固肾汤可明显改善绝经后女性膝骨性关节炎临床症状,临床效果良好,且养血固肾汤对绝经后妇女雌激素水平有明显提升作用,未发现明显不良反应,具有良好安全性。

Objective：To explore the clinical effect of arthroscopic debridement combined with traditional Chinese medicine（TCM） in the treatment of postmenopausal women with knee joint osteoarthritis. Methods： From Sep. 2014 to Feb. 2016,60 postmenopausal women were divided into the arthroscopic group and the arthroseopic combined with TCM（Yangxue Gushen decoction） group,30 cases in each group. Blood samples were collected before surgery and 6 weeks after surgery,to test the levels of IL-6,TNF-a and E〉 Lysholm scores before surgery and 8 weeks after surgery to compare the treatment effect of each groups. Results： Eight weeks after surgery,there was significant change on levels of IL-6,TNF-ot and Ez in the arthroscopic combined with TCM group（P〈0.05）,also there was significant change on levels of IL-6 and TNF in the arthroseopic group（P〈0.05）,but no significant change of the level of E2（P〉0.05）,8 weeks after surgery, IL-6 ,TNF-α,E2 in two groups of comparison before and after the treatment has satitistical significance（P〈 0.05）. Eight weeks after surgery,there was satitistical significance on Lysholm score between the two groups （P〈0.05）. Conelusion：Arthroscopic debridement combined with Yangxue Gushen decoction could relieve the symptoms of knee joint osteoarthritis in postmenopausal women with obvious effect,and Yangxue Gushen decoction also can obviously improve the level of E2 without obvious adverse reactions.