解毒消瘀膏外敷治疗人工膝关节置换术后膝骨关节炎患者的随机对照研究

A Randomized Controlled Study on Jiedu Xiaoyu Cream Topical in the Treatment of Knee Osteoarthritis After Artificial Knee Arthroplasty

目的:探讨解毒消瘀膏外敷治疗人工膝关节置换术(TKA)后膝骨关节炎(KOA)患者的临床疗效。方法:选取2015年5月至2017年1月衡水市第四人民医院收治的行TKA治疗的KOA患者126例作为研究对象,按照随机数字表法分为对照组和观察组,每组63例,2组均于TKA术后进行常规康复训练,对照组给予局部涂抹双氯芬酸二乙胺乳胶剂,观察组给予解毒消瘀膏外敷治疗,2组均连续治疗4周。统计2组临床疗效及治疗期间不良反应;治疗前后分别采用WOMAC及视觉模拟评分法(VAS)评估患者膝关节功能及疼痛程度;检测并比较2组股静脉血流峰度及平均速度。结果:治疗后,观察组临床治疗有效率93.65%,明显高于对照组的73.01%(P<0.05)。与术前比较,术后2组骨关节炎指数可视化量表(WOMAC)、VAS评分逐渐降低,其中术后7d、21d2组WOMAC、VAS评分均较治疗前明显降低,且观察组显著低于对照组,差异有统计学意义(P<0.05)。术后21d2组股静脉血流峰值及平均速度均较术前明显升高,且观察组明显高于对照组,差异有统计学意义(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论:解毒消瘀膏外敷及双氯芬酸二乙胺乳胶剂均有可有效治疗TKA后KOA,但外敷解毒消瘀膏可更有效提高患者的膝关节功能,降低疼痛程度,提高局部血流速度。

Objective: To explore the effect of Jiedu Xiaoyu Cream topical in the treatment of knee osteoarthritis(KOA)after artificial knee arthroplasty(TKA). Methods: A total of 126 KOA patients treated with TKA in Hengshui Fourth People′s Hospital from May 2015 to Jan.2017 were enrolled and randomly divided into a control group( n =63)and an observation group( n =63).The 2 groups were given routine rehabilitation training after TKA.The control group was treated with diclofenac diethylamine latex,and the observation group was given JieduXiaoyu Cream topical.The 2 groups were treated continuously for 4 weeks.The clinical efficacy and adverse reactions during treatment were calculated,and the WOMAC and VAS scores were used to evaluate the knee function and pain before and after treatment.The peak wave velocity and mean velocity of the 2 groups were detected and compared. Results: The total effective rates of the observation group was 93.65%,which was significantly higher than 73.01% of the control group( P <0.05).Compared with pre-operation,the WOMAC and VAS scores of the 2 groups decreased gradually post-operation,and the WOMAC and VAS scores of the 2 groups at 7 days and 21 days after operation were significantly decreased( P <0.05 or P < 0.01),and the observation group was significantly lower than the control group( P <0.01).The peak wave velocity and mean velocity of the 2 groups at 21 days after operation were significantly increased than those before operation( P <0.01),and the observation group was significantly higher than the control group( P <0.01).There was no significant difference in the incidence of adverse reactions between the 2 groups( P >0.05). Conclusion: Both the external application of Jiedu Xiaoyu Cream and diclofenac diethylamine emulsion can effectively treat KOA patients after TKA,but the external application of Jiedu Xiaoyu Cream can effectively improve the knee joint function,reduce the degree of pain and improve the local blood flow velocity.