乌头汤熏洗配合股四头肌肌力训练治疗寒湿痹阻型髌骨软化症的临床观察

Observation on treating chondromalacia patellae of the Hanshi Bizu type with the Wutou decoction plus quadriceps muscle strength training

目的:对比分析乌头汤熏洗配合股四头肌肌力训练治疗寒湿痹阻型髌骨软化症的临床疗效。方法:选取2014年6月-2017年1月由我科诊治的45例寒湿痹阻型髌骨软化症的患者,并按照就诊时间先后顺序将其随机分为治疗组(23例)和对照组(22例),治疗组采用乌头汤熏洗配合股四头肌肌力训练治疗,对照组采用盐酸氨基葡萄糖胶囊口服治疗。治疗后评价疗效,分别检测肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)和超敏C反应蛋白(High-sensitivity C-reactive Protein,hsCRP)水平,并采用疼痛程度视觉模拟评分法(Visual Analogue Scale,VAS)及Lysholm膝关节评分标准进行对比分析。结果:治疗组患者总有效率高于对照组,组间差异有统计学意义(P <0.05);两组患者治疗前TNF-α、hs-CRP水平的差异无统计学意义(P> 0.05),治疗后治疗组上述指标均优于对照组,差异有统计学意义(P <0.05)。两组治疗后VAS评分较前明显降低,治疗组VAS评分低于对照组,差异有统计学意义(P <0.05);两组在治疗后Lysholm膝关节评分分值上均明显升高,与治疗前的差异有统计学意义(P <0.01),两组间差异有统计学意义(P <0.01)。结论:寒湿痹阻型髌骨软化症通过乌头汤外用熏洗配合股四头肌肌力训练后临床效果良好,值得临床推广应用。

Objective: To compare and analyze the clinical efficacy of the Wutou decoction(乌头汤) plus quadriceps muscle strength training on chondromalacia patellae of the Hanshi Bizu type( 寒 湿 痹 阻 型). Methods: 45 cases from June 2014 to January 2017 were selected and randomized into the treatment group(23 cases) and the control group(22 cases) according to attendance time. The treatment group was treated with the Wutou decoction plus quadriceps muscle strength training, and the control group was treated with glucosamine hydrochloride capsules. Results: The total efficiency in the treatment group was higher than that in the control group(P<0.05). TNF-α and hs-CRP in the treatment group were better than those in the control group,(P<0.05). After treatment, the VAS score in the groups was significantly decreased compared with before, and that in the treatment group was lower,(P<0.05). The Lysholm knee scores in the groups after treatment were significantly increased, there were statistically significant differences compared with before(P<0.01), and the difference between the groups was statistically significant(P<0.01). Conclusion: The Wutou decoction plus quadriceps muscle strength training on chondromalacia patellae of the Hanshi Bizu type shows good effects, and is worthy of clinical application.