针灸辅助关节镜联合富血小板血浆治疗半月板损伤临床观察

Clinical Observation of Acupuncture Assisted Arthroscopy Combined with Platelet Rich Plasma in Treatment of Meniscus Injury

目的:观察针灸辅助关节镜联合富血小板血浆(PRP)疗法对半月板损伤患者的疗效。方法:选取2018年3月至2020年7月期间解放军北戴河康复疗养中心收治的90例膝关节半月板损伤患者,采用随机数字表法分为对照组和观察组各45例。对照组给予关节镜联合PRP治疗,观察组在此基础上给予针灸辅助治疗。治疗结束后3个月时,观察两组患者的疗效、膝关节功能、Lysholm评分、视觉模拟评分法(VAS)疼痛评分、股四头肌萎缩程度、膝关节活动度以及血清基质金属蛋白酶1(MMP-1)、骨钙素(BGP)的表达水平,记录研究期间发生的不良反应。结果:治疗后观察组疗效优于对照组(P<0.05)。观察组的膝关节功能优良率高于对照组(P<0.05)。治疗后,两组患者的Lysholm评分和膝关节活动度均显著升高(P<0.01),VAS疼痛评分、股四头肌萎缩程度、血清MMP-1和BGP的表达水平均显著下降(P<0.01);与对照组比较,观察组治疗后Lysholm评分和膝关节活动度较高(P<0.01),VAS评分、股四头肌萎缩程度、血清MMP-1和BGP的表达水平较低(P<0.01)。研究期间两组患者的不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:针灸辅助关节镜联合PRP的治疗方案可有效改善半月板损伤患者的膝关节功能、膝关节活动度,降低血清MMP-1和BGP的表达水平,具有较高的临床应用价值。

Objective:To observe the curative effect of acupuncture assisted arthroscopy combined with platelet rich plasma(PRP) therapy on patients with meniscus injury. Methods:Total 90 patients with meniscus injury admitted to Beidaihe Rehabilitation Center of PLA from March 2018 to July 2020 were randomly divided into the control group and observation group,with 45 cases in each group. The control group was treated with arthroscopy combined with PRP treatment,the observation group was treated with acupuncture on the basis of the treatment of the control group. Three months after the treatments,the efficacy,knee joint function,Lysholm scores,pain score,degree of quadriceps femoris atrophy,knee joint mobility,expression levels of serum MMP-1 and BGP of two groups were detected. The adverse reactions during the research were recorded. Results:After treatment,the curative effect of the observation group was better than that of the control group(P<0.05). The excellent rate of knee joint function of the observation group was higher than that of the control group(P<0.05). After the treatment,the Lysholm scores and knee joint mobility of two groups were all increased(P<0.01),while the visual analogue scale(VAS) pain scores,degree of quadriceps femoris atrophy,expression levels of serum MMP-1 and BGP were decreased(P<0.01).Compared with the control group,the Lysholm scores and knee joint mobility of the observation group were higher(P<0.01),while the VAS scores,degree of quadriceps femoris atrophy,expression levels of serum MMP-1 and BGP were lower(P<0.01). There was no significant difference in the adverse reactions between the two groups during the study period(P>0.05). Conclusions:Acupuncture assisted arthroscopy combined with PRP therapy could significantly ameliorate the knee joint function and knee joint mobility of patients with meniscus injury,decrease the expression levels of serum MMP-1 and BGP,which shows high clinical application value.