关节镜微创术联合补肾利湿法对膝关节急性痛风性关节炎患者血清UA ESR COX-2水平的影响

Effects of Arthroscopic Microcreation Combined with Nephrotic Method on Serum Levels of UA ESR and COX-2 of Patients with Acute Knee Joint Gouty Arthritis

目的:探讨关节镜微创术联合补肾利湿法对膝关节急性痛风性关节炎患者血清尿酸(UA)、血沉(ESR)、环氧化酶-2(COX-2)水平的影响。方法:114例膝关节急性痛风性关节炎患者,参照随机数字表法分作对照组57例和研究组57例。对照组患者接受关节镜微创术治疗,研究组患者在对照组基础上辅以补肾利湿法治疗,对比两组患者临床疗效,体征及症状评分、UA、ESR、COX-2水平、Lysholm评分,和不良反应。结果:治疗后,研究组总有效率较对照组高94.73%比82.45%(P<0.05);两组体征及症状评分、UA、ESR、COX-2水平均低于治疗前(P<0.05),且研究组体征及症状评分、UA、ESR、COX-2治疗前后差值均明显高于对照组(P<0.05),两组Lysholm评分均较治疗前显著上升(P<0.05),研究组Lysholm评分治疗前后差值明显高于对照组(P<0.05)。两组不良反应比较无统计差异(P>0.05)。结论:关节镜微创术联合补肾利湿法治疗膝关节急性痛风性关节炎的效果优于单用关节镜微创术者,可能与其更有效降低血清UA、ESR及COX-2水平有关。

Objective:To research the effects of arthroscopic microcreation combined with nephrotic method on the levels of serum uric acid(UA),erythrocyte sedimentation rate(ESR)and cyclooxygenase-gene(COX-2)of patients with acute knee joint gouty arthritis.Methods:114 patients with acute gouty arthritis of knee joint were divided into control group(57 cases)and study group(57 cases)according to random number table method.Patients in the control group were treated with arthroscopic minimally invasive surgery,while patients in the research group were treated with kidney-tonifying and dampness-removing therapy on the basis of the control group.The clinical efficacy,signs and symptom scores,UA,ESR,COX-2 level,Lysholm score and adverse reactions of the two groups were compared.Results:After treatment,the total effective rate of the research group was significantly higher than that of the control group(P<0.05).The levels of signs and symptoms scores,UA,ESR and COX-2 in the two groups were significantly lower than before treatment(P<0.05),and the differences of signs and symptoms scores,UA,ESR and COX-2 before and after treatment in the research group were significantly higher than those in the control group(P<0.05).The Lysholm scores of the two groups were significantly higher than those before treatment(P<0.05),and the difference of Lysholm scores of the research group before and after treatment was significantly higher than those of the control group(P<0.05).There was no statistical difference in adverse reactions between the two groups(P>0.05).Conclusion:Arthroscopic microtechnique combined with kidney-tonifying and dampnesss-removing therapy is more effective than the single use of arthroscopic minimally invasive surgery in the treatment of acute knee joint gouty arthritis,which may be associated to lower the serum UA,ESR,and COX-2 levels.