中药熏蒸联合利多卡因局部浸润麻醉治疗膝关节骨性关节炎临床研究

Clinical Study on Chinese Herbal Fumigation Combined with Lidocaine for Knee Osteoarthritis by Local Infiltration Anesthesia

目的:观察中药熏蒸联合利多卡因局部浸润麻醉治疗膝关节骨性关节炎的临床疗效。方法:将130例膝关节骨性关节炎患者随机分为对照组和观察组,各65例。对照组给予关节腔注射玻璃酸钠治疗,观察组采用2%利多卡因局部浸润麻醉联合中药熏蒸治疗,均持续治疗5周。采用疼痛视觉模拟评分法(VAS)和Lysholm的膝关节功能评分量表(LKSS)评价2组治疗前后疼痛缓解和膝关节功能改善情况,比较2组治疗效果和不良反应发生情况。结果:治疗后,2组运动性疼痛和压痛点疼痛的VAS评分均较治疗前显著下降(P<0.05),且观察组两项VAS评分均低于对照组(P<0.05)。治疗后,2组膝关节功能LKSS评分均较治疗前明显升高(P<0.05),且观察组LKSS评分及评分前后差值均高于对照组(P<0.05)。总有效率观察组为100%,对照组为90.77%,2组比较,差异有统计学意义(P<0.05)。2组治疗期间均未出现明显不良反应。结论:中药熏蒸联合利多卡因局部浸润麻醉可显著缓解膝关节骨性关节炎患者的疼痛,改善膝关节活动功能,且安全性好,值得临床推广应用。

Objective:To observe the clinical effect of Chinese herbal fumigation combined with lidocaine for knee osteoarthritis by local infiltration anesthesia. Methods:Divided 130 cases of patients with knee osteoarthritis pain randomly into the control group and the observation group,with 65 cases in each group. The control group was treated with intra-articular injection of sodium hyaluronate,and the observation group was treated with 2% lidocaine local infiltration anesthesia combined with Chinese herbal fumigation. All patients were treated for 5 weeks. Evaluated the improvement of pain relief and knee function in the two groups before and after treatment by applying visual analogue pain score(VAS) and lysholm knee function rating scale(LKSS) and compared the treatment effects and the occurrence of adverse reactions in the two groups. Results: After treatment, the VAS scores of exercise pain and tenderness pain in the two groups were significantly lower than those before treatment(P < 0.05);the two VAS scores of the observation group were lower than those of the control group(P < 0.05). After treatment,the LKSS scores of knee joint function in both groups were evidently higher than those before treatment(P < 0.05). The LKSS score and the difference between the scores before and after treatment in the observation group were higher than those in the control group(P < 0.05). The total effective rate was 100% in the observation group and 90.77% in the control group, compared the two groups, difference being significant(P < 0.05). No significant adverse reactions were found in the two groups during treatment. Conclusion: The application of Chinese herbal fumigation combined with lidocaine for knee osteoarthritis by local infiltration anesthesia can significantly relieve pain in patients with knee osteoarthritis and improve knee joint function. It is safe and worthy of clinical promotion and application.