伤柏膏辅助关节镜下关节清理术治疗膝关节骨性关节炎的临床价值

Clinical Value of Shangbai Ointment Assisted Arthroscopic Debridement for KOA

目的研究伤柏膏辅助关节镜下关节清理术治疗膝关节骨性关节炎(KOA)的临床价值。方法选取2018年2月—2019年2月收治的94例KOA患者为研究对象,按照数字表随机分组的方案分为观察组和对照组,各47例。对照组患者接受关节镜下关节清理术;观察组在对照组的基础上加用伤柏膏外敷治疗。比较两组术后临床疗效;比较两组术前术后相关临床指标[关节液中一氧化氮(NO)含量、肿瘤坏死因子-α(TNF-α)、白细胞介素1(IL-1)、白细胞介素6(IL-6)];比较两组术前术后病情改善情况[视觉模拟评分(VAS)、Lequesne肿胀评分、西安大略麦马斯特大学骨性关节炎指数可视化量表评分(WOMAC)];比较两组术后1个月内并发症发生情况。结果观察组临床疗效总有效率91.49%显著高于对照组74.47%,差异有统计学意义(P<0.05)。术后,观察组关节液中NO含量、TNF-α、IL-1、IL-6水平均显著低于术前及对照组术后,差异有统计学意义(P<0.05)。术后观察组VAS、肿胀、WOMAC评分均显著低于术前及对照组术后,差异有统计学意义(P<0.05)。观察组并发症总发生率8.51%与对照组14.89%对比差异无统计学意义(P<0.05)。结论伤柏膏辅助关节镜下关节清理术治疗KOA临床效果满意,可降低关节液中NO含量及炎症因子数量,缓解患者疼痛,改善患者病情,同时并发症发生率低,具有较高的安全性,值得临床推广。

Objective To study the clinical value of Shangbai ointment assisted arthroscopic debridement in the treatment of knee osteoarthritis(KOA).Methods From February 2018 to February 2019,94 patients with KOA were enrolled in the study.They were divided into observation group and control group according to the randomized grouping of digital tables,47 cases each.The patients in the control group underwent arthroscopic arthroscopic debridement;the observation group was treated with external application of wound cypress cream on the basis of the control group.The clinical efficacy of the two groups was compared.The clinical indexes of the two groups before and after surgery were compared[nitrogen monoxide(NO)content in the joint fluid,tumor necrosis factor-α(TNF-α),interleukin-1(IL-1).,interleukin-6(IL-6)];comparing the improvement of preoperative and postoperative conditions in the two groups[visual simulation score(VAS),Lequesne swelling score,Western Ontario McMaster University Osteoarthritis Index Visualization Scale score(WOMAC)];Comparison of complications within 1 month after surgery.Results The total effective rate of clinical observation in the observation group was 91.49%,which was significantly higher than that in the control group(74.47%).The difference was statistically significant(P<0.05).After operation,the levels of NO,TNF-α,IL-1 and IL-6 in the joint fluid of the observation group were significantly lower than those of the preoperative and control groups,and the difference was statistically significant(P<0.05).The VAS,swelling and WOMAC scores of the postoperative observation group were significantly lower than those of the preoperative and control groups,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the observation group and the control group(14.89%)(P<0.05).Conclusion Shangbai ointment assisted arthroscopic debridement for KOA has satisfactory clinical effect.It can reduce the NO content in synovial fluid and the number of inflammatory factor,alleviate pain and improve patients’condition.At the same time,the incidence of complications is low.It has high safety and is worthy of clinical promotion.