关节镜下髌骨支持带松解结合内推髌骨、中药熏洗治疗髌股关节炎临床研究

Clinical Study on Arthroscopic Patellar Retinacular Release Combined with Patellar Inward Pushing and Chinese Herbal Fumigation for Patellofemoral Osteoarthritis

目的:观察关节镜下髌骨支持带松解结合内推髌骨、中药熏洗治疗髌股关节炎(PFOA)的临床疗效及对患者血清前列腺素E2(PGE2)、白细胞介素-1β(IL-1β)、C-反应蛋白(CRP)水平的影响。方法:选取50例(50膝)PFOA患者,按随机数字表分为对照组与研究组各25例(25膝)。对照组给予塞来昔布胶囊联合玻璃酸钠针治疗,研究组给予关节镜下髌骨支持带松解结合内推髌骨、中药熏洗治疗。比较2组临床疗效及治疗前后数字分级法(NRS)评分,Kujala髌股关节评分,血清PGE2、IL-1β、CRP水平。结果:总有效率研究组92.00%,对照组68.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组NRS评分均较治疗前降低(P<0.05),研究组NRS评分低于对照组(P<0.05)。治疗后,2组Kujala髌股关节评分均较治疗前提高(P<0.05),研究组Kujala髌股关节评分高于对照组(P<0.05)。治疗后,2组血清PGE2、IL-1β、CRP水平均较治疗前降低(P<0.05),研究组血清PGE2、IL-1β、CRP水平均低于对照组(P<0.05)。结论:关节镜下髌骨支持带松解结合内推髌骨、中药熏洗治疗PFOA可提高临床疗效,降低PGE2、IL-1β、CRP水平,值得临床推广应用。

Objective : To observe the clinical effect of arthroscopic patellar retinacular release combined with patellar inward pushing and Chinese herbal fumigation for patellofemoral osteoarthritis( PFOA), and the effect on the levels of prostaglandin E2( PGE2), interleukin-1β( IL-1β) and C-reactive protein( CRP) in serum in patients. Methods : A total of 50 cases( 50 knees) of PFOA patients were selected and divided into the control group and the study group according to the random number table method, 25 cases( 25 knees) in each group. The control group was treated with celecoxib capsules combined with sodium hyaluronate injection, and the study group was treated with arthroscopic patellar retinacular release combined with patellar inward pushing and Chinese herbal fumigation. The clinical effect as well as the scores of Number Rating Scale( NRS), the Kujala patellofemoral scores and the levels of PGE2, IL-1β and CRP in serum before and after treatment in the two groups were compared. Results : The total effective rate was 92. 00 % in the study group and 68. 00 %in the control group, the difference being significant( P < 0. 05). After treatment, the NRS scores in the two groups were decreased when compared with those before treatment( P < 0. 05), and the NRs score in the study group was lower than that in the control group( P < 0. 05). After treatment, the Kujala patellofemoral scores in the two groups were increased when compared with those before treatment( P < 0. 05), and the Kujala Patellofemoral score in the study group was higher than that in the control group( P < 0. 05). After treatment, the levels of PGE2, IL-1β and CRP in serum in the two groups were decreased when compared with those before treatment( P < 0.05), and the levels of PGE2, IL-1β and CRP in the study group were lower than those in the control group( P < 0.05). Conclusion : The therapy of arthroscopic patellar retinacular release combined with patellar inward pushing and Chinese herbal fumigation in treating PFOA can improve the clinical effect, reduce the levels of PGE2, IL-1β and CRP, which is worthy of clinical promotion and application.