膝痹通络方结合关节镜下关节腔清理术治疗膝骨性关节炎临床研究

Clinical Study of Applying Xibi Tongluo Recipe Combined with Arthroscopic Articular Cavity Debridement in the Treatment of Knee Osteoarthritis

目的:观察膝痹通络方结合关节镜下关节腔清理术治疗膝骨性关节炎(KOA)的临床影响。方法:选取2017年7月~2019年12月于我院收治的60例KOA患者为研究对象,采用随机分组的方法,随机分为治疗组(A组)30例,对照组(B组)30例。对照组患者予以关节镜手术及常规药物治疗,观察组患者在对照组基础上结合实施予以膝痹通络方。比较两组患者术后4周疗效差异,分别记录计算治疗组、对照组患者术前、术后2周、术后3个月、术后6个月的膝关节功能(Lysholm膝关节评分)差异,比较两组患者术前、术后4周炎症情况[白介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白(MMP-3)]差异,比较两组患者术后6个月内再次行关节置换术率差异。结果治疗4周后,两组患者疗效差异显著(P<0.05),但两组患者总有效率差异不显著(P>0.05);治疗前、术后6个月时,两组患者Lysholm膝关节评分比较,差异均不具备统计学意义(P均>0.05);术后2周、术后3个月时,A组患者Lysholm膝关节评分高于B组(P均<0.05);治疗4周后,两组患者IL-1、TNF-α、MMP-3水平均较治疗前下降,且A组低于同期B组(P均<0.05);两组患者膝关节置换手术率比较,差异不具备统计学意义(P<0.05)。结论:膝痹通络方结合关节镜下关节腔清理术治疗KOA对患者总体疗效有较为显著的正面影响,能促进患者膝关节功能恢复,减轻患者炎症。

Objective: To explore the clinical effect of applying Xibi Tongluo Recipe combined with arthroscopic articular cavity debridement in the treatment of knee osteoarthritis(KOA).Methods: A total of 60 patients with KOA who were admitted to our hospital between July 2017 and December 2019 were selected as the research subjects.Using the random grouping method, the patients were randomly divided into a treatment group(group A,30 cases) and a controlled group(group B,30 cases).The patients in the controlled group received arthroscopic surgery and conventional medical treatment, and the patients in the treatment group were given Xibi Tongluo Recipe on the basis of the controlled group.The difference in efficacy at 4 weeks after surgery was compared between the two groups, and the difference in knee joint function(Lysholm knee joint score) was calculated before surgery and at 2 weeks after surgery, at 3 months after surgery and at 6 months after surgery in the treatment group and the controlled group.The differences in inflammation status [interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),matrix metalloprotein(MMP-3)] were compared between the two groups before surgery and at 4 weeks after surgery, and the rate of joint re-replacement within 6 months after surgery was compared between the two groups.Results: After 4 weeks of treatment, there was a significant difference in the efficacy between the two groups(P<0.05),but there was no significant difference in the total effective rate between the two groups(P>0.05).Before and 6 months after the treatment, there was no statistically significant difference in the Lysholm knee joint score between the two groups(all P>0.05).At 2 weeks and 3 months after surgery, the Lysholm knee joint score of the group A was higher than that of the group B(all P<0.05).After 4 weeks of treatment, the levels of IL-1,TNF-α and MMP-3 in the two groups were decreased compared with those before treatment, and the levels in the group A were lower than those in the group B during the same period(all P<0.05).There was nostatistically significant difference in the rate of knee replacement between the two groups(P<0.05).Conclusion: Xibi Tongluo Recipe combined with arthroscopic articular cavity debridement for KOA has a significant positive impact on the overall efficacy of patients, and it can promote the recovery of knee joint function and relieve inflammation of patients.