中药烫熨加贴敷疗法联合腓骨高位截骨术治疗膝内侧间室骨关节炎的疗效分析

Clinical analysis of TCM ironing and sticking therapy combined with fibular osteotomy in the treatment of medial knee compartment osteoarthritis

目的通过临床随机对照试验,对中药烫熨加贴敷疗法联合腓骨截骨术治疗膝内侧间室骨关节炎(OA)进行疗效分析。方法将60例符合入选标准的膝OA患者随机分为两组,各30例。A组进行单纯腓骨高位截骨术。B组在A组的基础上,加用中药烫熨及贴敷疗法,连续治疗4周。分别以治疗前及治疗1周、2周、4周后为观察时间段,通过VAS、KSS、HSS、JKOM评分指标及不良反应情况,进行疗效评估。结果总体上B组有效率(93.3%)大于A组有效率(76.7%);组内比较提示:治疗1周、2周、4周后,两组VAS、KSS、HSS及JKOM评分均优于治疗前(P<0.05);治疗后同时间段内组间比较提示:B组效果均优于A组,其中VAS、HSS评分差异在2周时最为明显,而JKOM、KSS评分差异在4周时最为明显(P<0.05)。此外,除B组有1例切口表面感染外,余无明显不良发应。结论与单用腓骨截骨术相比,中药烫熨加贴敷疗法联合腓骨截骨术治疗膝内侧间室OA效果更好,不仅能有效弥补腓骨截骨术术后短期内疗效不佳这一不足之处,并以2周至4周时明显,且不良反应少,值得推广。

Objective Through clinical randomized controlled trial,to evaluate the effect of TCM ironing and sticking therapy combined with fibular osteotomy to analyze the curative effect on medial compartment osteoarthritis(OA)of knee.Methods 60 patients with knee OA who met the inclusion criteria were randomly divided into two groups,30 cases in each group.Group a un⁃derwent simple high fibular osteotomy.On the basis of group A,group B was treated with TCM ironing and sticking therapy for 4 weeks.The curative effect was evaluated by VAS,KSS,HSS,jkom scoring indexes and adverse reactions before treatment and 1,2 and 4 weeks after treatment.Results Overall,TCM group B(93.3%)was higher than that of group A(76.7%);Intra group comparison showed that after 1,2 and 4 weeks of treatment,VAS,KSS HSS and jkom scores were better than those before treat⁃ment(P<0.05);the comparison between groups at the same time after treatment showed that the effects of group B were better than those of group A,in which the difference of vas and HSS scores was the most obvious at 2 weeks,while the difference of jkom and KSS scores was the most obvious at 4 weeks,and there was little difference from that at 2 weeks(P<0.05).In addition,there was no obvious adverse reaction except 1 case of incision surface infection in group B.Conclusion Compared with fib⁃ular osteotomy alone,TCM ironing and sticking therapy combined with fibular osteotomy has a better effect in the treatment of me⁃dial knee compartment OA.It can not only effectively make up for the deficiency of poor curative effect in the short term after fib⁃ular osteotomy,but also obvious in 2 to 4 weeks,with less adverse reactions,which is worthy of promotion.