健脾益气汤联合持续被动运动对膝关节前交叉韧带重建术后功能锻炼的影响

Effect of Jianpi Yiqi Decoction combined with continous passive motion,CPM on functional exercise after anterior cruciate ligament reconstruction of knee joint

目的观察健脾益气汤联合持续被动运动(CPM)对膝关节前交叉韧带重建术后(湿阻筋络型)关节功能锻炼的影响。方法2016年10月至2019年12月在我院接受取绳肌腱作为移植物,关节镜下膝关节前交叉韧带重建术患者,共48例;数字法分成2组。2组在常规治疗的基础上,对照组采用CPM机器行关节持续匀速被动屈伸锻炼;而治疗组在对照组的基础上,另外加用健脾益气汤口服治疗,均以7 d为1个疗程,持续治疗2个疗程后根据2组中医症状、证候;西医症状、关节功能统计对比。结果中医证候疗效评价:治疗组24例,总有效率达95.8%;对照组24例,总有效率为87.5%;显著高于对照组(P<0.05),中医症状、证候治疗组均优于对照组(P<0.05)。且在早期疼痛缓解方面,治疗后患侧膝关节最大主动屈伸活动度及IKDC膝关节功能评分方面,治疗组均有更大优势。结论健脾益气汤联合CPM有助于膝关节前交叉韧带重建术后(湿阻筋络型)关节功能锻炼,临床具有明显优势,值得推广应用。

Objective To observe the effect Jianpi Yiqi Decoction and CPM on joint function exercise(wet obstruction and collaterals)after knee anterior cruciate ligament reconstruction.Methods From October 2016 to December 2019,a total of 48 patients underwent arthroscopic anterior cruciate ligament reconstruction with hamstring tendon as graft in our hospital;they were randomly divided into two groups.On the basis of conventional treatment,the control group was given CPM machine for continuous passive flexion and extension exercise at a constant speed;while the treatment group was additionally given Jianpi Yiqi Decoction orally on the basis of the control group,with 7 days as 1 session.Course of treatment,after continuous treatment for 2 courses,according to the TCM symptoms and syndromes of the two groups.Western medicine symptoms and joint function statistical comparison.Results Evaluation of the efficacy of TCM syndromes:the treatment group of 24 cases,the total effective rate was 95.8%;the control group of 24 cases,the total effective rate was 87.5%;significantly higher than the control group(P<0.05),the TCM symptoms and syndrome treatment groups were all excellent in the control group(P<0.05).And in terms of early pain relief,the maximum active flexion and extension range of motion of the affected knee joint and IKDC knee joint function score after treatment,the treatment group has greater advantages.Conclusion Combine spleen and qi soup with CP M contributes to joint function exercise after knee anterior cruciate ligament reconstruction,which has obvious clinical advantages and is worth promotion and application.