逐瘀消肿汤联合间歇加压冷疗治疗气滞血瘀型膝关节前交叉韧带损伤术后临床观察

Clinical observation of Zhuyu Xiaozhong Decoction combined with intermittent pressure cryotherapy on postoperative anterior cruciate ligament injury of knee joint of Qi stagnation and blood stasis

目的观察逐瘀消肿汤联合间歇加压冷疗治疗气滞血瘀型膝关节前交叉韧带(ACL)损伤术后的临床疗效。方法将68例气滞血瘀型膝关节ACL损伤术后患者按照随机数字表法分为2组,2组均给予术后常规治疗,对照组34例加用间歇加压冷疗,治疗组34例在对照组基础上加用逐瘀消肿汤治疗。2组均治疗4周后统计疗效,比较2组治疗前后中医症状积液积血、关节肿胀、肌肉粘连、伤口疼痛评分变化情况,比较2组治疗前后疼痛视觉模拟评分(VAS)、Lysholms膝关节评分、膝关节本体感觉(采用被动运动感知阈值差值法检测)变化情况,比较2组治疗前后步态分析参数步长、步速、步宽变化情况。结果治疗组总有效率97.06%(33/34),对照组82.35%(28/34),治疗组总有效率高于对照组(P<0.05)。2组治疗后中医症状积液积血、关节肿胀、肌肉粘连、伤口疼痛评分与本组治疗前比较均降低(P<0.05),且治疗组治疗后各项评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后疼痛VAS均降低(P<0.05),Lysholms膝关节评分、被动运动感知阈值差值均升高(P<0.05),且治疗组治疗后各指标改善均优于对照组(P<0.05)。2组治疗后步长、步速、步宽与本组治疗前比较均增加(P<0.05),且治疗组治疗后步长、步速改善均优于对照组(P<0.05)。结论逐瘀消肿汤联合间歇加压冷疗治疗气滞血瘀型膝关节ACL损伤术后疗效确切,可明显改善患者中医症状,缓解疼痛,促进膝关节功能恢复。

Objective To observe the clinical efficacy of Zhuyu Xiaozhong Decoction combined with Intermittent pressure cryotherapy on postoperative anterior cruciate ligament injury(ACLI)of knee joint of Qi stagnation and blood stasis.Methods A total of 68 patients with postoperative ACLI(Qi stagnation and blood stasis)were enrolledand divided into two equle groups according to the random numbertable,in addition of conventional treatment,patients in control group was treated with intermittent pressure cryotherapy and those in observation group additionally with Zhuyu Xiaozhong Decoction on basis of control group.continuously 4-week treatment counted the clinical efficacy,the key observation between groups wasbefore and after treatment the changes of traditional Chinese medicine(TCM)symptoms scores(effusion and hemorrhage,joint swelling,muscle adhesion,wound pain,ect);the changes of visual analogue scale(VAS)pain scorce and Lysholms knee function score,knee proprioception scorce(detection of difference method of passive movements perception threshold)and parameters of gait analysis(step length,step speed,step width).Results The response rate of treatment in observation group was significantly higher than that in control group(97.06%[33/34]vs82.35%[28/34],[P<0.05]respectively).After treatment,TCM syndromes scores(effusion and hemorrhage,joint swelling,muscle adhesion,wound pain,ect)were lower,which in observation group were lower than those in control group(P<0.05).After treatment,VAS pain in groups was milder(P<0.05),Lysholms knee function score,perception threshold of passive movements in groups were increased(P<0.05),and improvement were better in observation group than in control group(P<0.05);the results of overall gait analysis(step length,pace)in groups were increased(P<0.05),the parameters of step size,step speed were better in observation group than in control group(P<0.05).Conclusion For patients with postoperative ACLI(Qi stagnation and blood stasis),Zhuyu Xiaozhong Decoction combined with intermittent pressure cryotherapy has a definite postoperative effect,which is capable of improving patient's TCM symptoms,relieving pain,and promoting recovery of knee joint function.