“丰盛特色手法”结合关节镜下清理术治疗重度膝骨关节炎临床研究

Clinical Study on Fengsheng Hospital-specialized Manipulation Combined with Arthroscopic Debridement for Treatment of K-L 4 Knee Osteoarthritis

目的观察"丰盛特色手法"结合关节镜下清理术治疗重度(K-L 4级)膝骨关节炎的临床疗效。方法采用随机数字表法将170例患者分为治疗组和对照组各85例。2组均行关节镜下清理术,术后锻炼;治疗组术后予"丰盛特色手法",隔日1次,每次20 min。2组均连续治疗4周。比较2组术前及术后2、4、12周日本骨科协会评估治疗分数(JOA)评分、视觉模拟评分法(VAS)评分、Lysholm膝关节功能评分表(Lysholm)评分,评价2组临床疗效。结果与本组术前比较,2组术后各时点Lysholm评分明显升高(P<0.05);2组术后同一时点比较,治疗组Lysholm总分、与术前差值及疼痛、爬楼梯评分均明显优于对照组(P<0.05,P<0.01,P<0.001)。与本组术前比较,2组术后各时点JOA评分明显升高(P<0.05);2组术后同一时点比较,治疗组JOA总分、与术前差值及步行、上下楼评分均优于对照组(P<0.05,P<0.01,P<0.001)。与本组术前比较,2组术后各时点VAS评分明显降低(P<0.05);2组术后同一时点比较,治疗组VAS评分及差值均明显优于对照组(P<0.05,P<0.001)。术后4、12周,2组JOA、Lysholm评分系统优良率比较差异有统计学意义(P<0.01,P<0.001)。结论"丰盛特色手法"结合关节镜下清理术治疗重度(K-L 4级)膝骨关节炎可明显改善患者骨关节炎症状,促进膝关节功能康复,提高临床疗效。

Objective To observe the clinical efficacy of Fengsheng hospital-specialized manipulation combined with arthroscopic debridement for the treatment of K-L 4 knee osteoarthritis. Methods Totally 170 patients were randomly divided into treatment group and control group, with 85 cases in each group. Both groups have undergone arthroscopic debridement and postoperative function exercise. Base on this, the treatment group was treated with the Fengsheng hospital-specialized manipulation, once every other day, 20 min each time. The treatment for both groups lasted for 4 weeks. JOA, VAS, Lysholm scoring systems were used to quantify the scores in order to understand the symptoms of osteoarthritis and changes in knee joint functions before and after 2, 4, and 12 weeks of surgery. The clinical efficacy of both groups was evaluated. Results Compared with before surgery, the Lysholm scores in each time points of the two groups were significantly increased(P<0.05);Compared in the same time point, the total scores of Lysholm, preoperative difference, pain, and stair climbing scores of the treatment group were significantly better than those of the control group(P<0.05, P<0.01, P<0.001). Compared with before treatment, the JOA scores of the two groups were significantly increased at each time point(P<0.05);Compared in the same time point, the total scores of JOA, preoperative difference, walking, and upper and lower building scores of the treatment group were better than those of the control group(P<0.05, P<0.01, P<0.001). Compared with before treatment, the VAS scores of the two groups were significantly lower(P<0.05);Compared in the same time point, the VAS scores and differences of the treatment group were significantly better than those of the control group(P<0.05, P<0.001). At 4 and 12 weeks after surgery, there was statistical significance in the excellent rates of JOA and Lysholm scoring systems in the two groups(P<0.01, P<0.001). Conclusion Fengsheng hospital-specialized manipulation combined with arthroscopic debridement for the treatment of K-L 4 knee osteoarthritis has obvious advantages in improving symptoms of osteoarthritis and rehabilitation of knee functions, which can enhance clinical efficacy.