中药熏洗对半月板损伤性膝骨性关节炎关节镜术后功能恢复的影响

Effect of fumigation and washing with traditional Chinese drugs on functional recovery of knee osteoarthritis of meniscus injury after arthroscopic surgery

目的:观察中药熏洗对伴有半月板损伤膝骨性关节炎患者行关节镜术后关节功能康复的影响。方法:80例确诊为伴有半月板损伤的膝骨性关节炎行关节镜修复或缝合术的患者,采用简单随机法分为对照组和观察组各40例。对照组采用常规功能康复训练;观察组配合中医熏洗,两组于术后1周、2周、4周通过疼痛指数(VAS法)评分、股四头肌萎缩程度、膝关节Lysholm评分和关节活动度,术前、术后4周检测血浆IL-17水平,进行安全性和有效性评价。结果:疼痛指数(VAS法)评分、膝关节Lysholm评分、关节活动度后2周、4周组间比较差异有统计学意义(P﹤0.05)。股四头肌萎缩程度术后2周组间比较差异有统计学意义(P﹤0.01);术后4周组间比较差异无统计学意义(P﹥0.05)。血浆IL-17水平术后4周较术前均有明显降低,但观察组较对照组明显,组间比较差异有统计学意义(P﹤0.01)。结论:半月板损伤关节镜术后配合中药熏洗,在疼痛指数(VAS法)评分和膝关节Lysholm评分方面能提高疗效;在改善肌肉萎缩程度、关节活动范围及炎症吸收方面也有积极影响。

Objective:To observe the effect of fumigation and washing with traditional Chinese drugs on jointfunction recovery of knee osteoarthritis of meniscus injury after arthroscopic surgery.Methods:80 cases of diagnosed patients with knee osteoarthritis of meniscus injury,who were operated by arthroscopic repairing or suturing,were randomly divided into control group and treatment group,40 cases in each group.The control group was treated with conventional training of functional rehabilitation,while the treatment group was treated by fumigation and washing with traditional Chinese drugs.In 1 week,2 and 4 weeks after surgery in both groups,the safety and effectiveness were evaluated by score of pain indexes(VAS method),atrophic degree of quadriceps femoris muscle,Lysholm score of knee joint,jointrange of motion and level of plasma IL-17 detected in the 4 th week after surgery.Results:In score of pain indexes(VAS method),Lysholm score of knee jointand jointrange of motion,the comparative difference between groups in 2 weeks and 4 weeks after surgery was statistically significan(P<0.05).In atrophic degree of quadriceps femoris muscle,the comparative difference between groups in 2 weeks after surgery was statistically significant(P<0.01);the comparative difference between groups in 4 weeks after surgery was not statistically significant(P >0.05).The level of plasma IL-17 in 4 weeks after surgery was obviously lower than before surgery,but the treatment group was more obviously lower than control group,and the comparative difference between groups was statistically significant(P<0.01).Conclusion:The arthroscopic surgery of meniscus injury combined with fumigation and washing with traditional Chinese drugs can improve the curative effect in score of pain indexes(VAS method)and Lysholm score of knee joint,also has a positive effect on improving atrophic degree of muscle,jointrange of motion and absorption of inflammation.