中药外敷联合膝关节镜清理术治疗湿热内蕴型痛风性膝关节炎临床观察

Clinical Observation on the External Application of Chinese Herbs Combined with Arthroscopic Debridement of Knee Joint in the Treatment of Gouty Knee Arthritis with Dampness-heat Connotation

目的观察中药外敷配合关节镜清理术治疗湿热痹阻型痛风性膝关节炎的临床疗效,从而为该病的治疗提供有效的方法。方法在骨科住院并接受关节镜微创手术的患者中,选取符合纳入标准和排除标准的90例患者,按照就诊顺序编号为1~90号,按照随机化原则,分为A、B、C3组,每组30例。A组采用膝关节镜清理术治疗;B组在采用膝关节镜清理术治疗的基础上外敷中药;C组为对照组单纯的中药外敷。术前、术后1个月、3个月从Lysholm评分、疼痛视觉模拟评分(VAS)2个方面评估,而后将数据导入SPSS17.0软件行统计学分析,从而评估其疗效。结果术前3组Lysholm膝关节评分和疼痛视觉模拟评分(VAS)比较,P>0.05,差异无统计学意义,术后1个月、3个月3组Lysholm膝关节评分和疼痛视觉模拟评分(VAS)比较,P<0.05,进而3组间两两比较,结果提示其差异有统计学意义(P<0.0167)。结论中药外敷联合关节镜清理术治疗湿热内蕴型膝痛风性关节炎有较好的疗效,且其临床疗效优于单纯关节镜清理术和单纯中药外敷治疗。

Objective To observe the clinical effect of external application of traditional Chinese medicine combined with arthroscopic debridement in the treatment of gouty arthritis of dampness-heat obstruction type,and to provide an effective method for the treatment of this disease.Methods Among the patients hospitalized in the orthopaedic department of our hospital who underwent arthroscopic minimally invasive surgery.Ninety patients who met the inclusion and exclusion criteria were selected.Number 1-90 according to the order of visits.According to the principle of randomization,they were divided into groups A,group B and group C,with 30 cases in each group.Group A was treated with arthroscopic debridement of knee joint.Group B was treated with traditional Chinese medicine on the basis of arthroscopic debridement of knee joint.Group C was the control group.Lysholm score and pain visual analogue scale(VAS)were evaluated before operation,1 month and 3 months after operation.Then the data were imported into SPSS17.0 software for statistical analysis.Thereby,the curative effect was evaluated.Results Preoperative Lysholm knee score and pain visual analogue score(VAS)were compared among three groups.The results showed that P values were higher than 0.05,and there was no significant difference between them.The Lysholm knee score and pain visual analogue score(VAS)were compared in three groups at 1 and 3 months after operation.The results showed that P values were less than 0.05.Then two or two comparisons were made among the three groups.The results showed that the difference was significant(P<0.0167).Conclusion External application of Chinese herbal medicine combined with arthroscopic debridement has a good effect in the treatment of damp-heat intrinsic knee gouty arthritis.And its clinical effect is superior to arthroscopic debridement and traditional Chinese medicine external application alone.