通络洗药熏洗联合玻璃酸钠踝关节腔内注射治疗TakakuraⅡ型创伤性踝关节炎的临床效果

Clinical efficacy of fumigation and washing with Tongluo Lotion plus intra-articular injection of sodium hyaluronate for treating TakakuraⅡtraumatic ankle arthritis

目的观察通络洗药熏洗联合玻璃酸钠踝关节腔内注射治疗TakakuraⅡ型创伤性踝关节炎的临床疗效。方法将77例TakakuraⅡ型创伤性踝关节炎患者随机分为观察组39例和对照组38例。两组均给予玻璃酸钠踝关节腔内注射治疗,观察组在此基础上予中药通络洗药熏洗治疗,两组均治疗5周。比较两组患者治疗前后疼痛视觉模拟量表(VAS)评分、关节活动范围(ROM)、美国足踝外科协会(AOFAS)评分,并采用McGuire踝关节评分标准评价治疗后患者患踝功能。结果观察组患者患踝功能优于对照组,疗效优良率高于对照组(均P<0.05)。两组患者治疗后VAS评分均低于治疗前,AOFAS评分及踝关节跖屈活动度、背伸活动度均高于治疗前,且观察组VAS评分低于对照组,AOFAS评分及踝关节跖屈活动度、背伸活动度均高于对照组(均P<0.05)。结论相比于单纯的玻璃酸钠踝关节腔内注射治疗,通络洗药熏洗联合玻璃酸钠踝关节腔内注射治疗TakakuraⅡ型创伤性踝关节炎,更能减轻患者疼痛,改善踝关节活动功能,疗效更好。

Objective To observe the clinical efficacy of fumigation and washing with Tongluo Lotion plus intra-articular injection of sodium hyaluronate for treating TakakuraⅡtraumatic ankle arthritis.Methods Seventy-seven patients with TakakuraⅡtraumatic ankle arthritis were randomly divided into observation group(39 cases)and control group(38 cases).Both groups were treated with intra-articular injection of sodium hyaluronate,based on which the observation group received fumigation and washing with Chinese medicine Tongluo Lotion.Both groups were treated for five weeks.The two groups were compared with respect to the Visual Analogue Scale(VAS)scores,range of motion(ROM),American Orthopedic Foot and Ankle Society(AOFAS)scores before and after treatment;besides,the McGuire ankle joint scoring system was applied to assessment on patients′affected ankle function after treatment.Results The observation group had superior function of affected ankle and a higher good to excellent efficacy rate than the control group(all P<0.05).After treatment,VAS score was lower,AOFAS score as well as ankle planter flexion and dorsiextension ROM was higher than those before treatment in the two groups,moreover,the observation group had lower VAS score,higher AOFAS score,as well as higher ankle planter flexion and dorsiextension ROM as compared with the control group(all P<0.05).Conclusion Compared with simple intra-articular injection of sodium hyaluronate,fumigation and washing with Tongluo Lotion combined with intra-articular injection of sodium hyaluronate can ameliorate patients′pain more effectively and improve ankle joint movement in TakakuraⅡtraumatic ankle arthritis,achieving a better efficacy.