膝关节镜手术联合活血祛瘀汤治疗膝关节炎的效果

Effect of knee arthroscopic surgery combined with Huoxue Quyu decoction on knee arthritis

目的分析膝关节镜手术联合活血祛瘀汤治疗膝关节炎的效果。方法2021年1月至2022年12月选取信阳市人民医院与信阳市中心医院收治的膝关节炎患者,样本总量为105例。按照患者治疗方法的不同将收治病例分为两组,分别为对照组(45例,膝关节镜手术+玻璃酸钠注射液)与观察组(60例,膝关节镜手术+活血祛瘀汤)。对比两组疗效以及治疗前后的骨代谢指标、炎症因子、视觉模拟评分(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分水平差异。结果观察组总有效率高于对照组(91.67%VS 73.33%),差异有统计学意义(P<0.05);两组治疗前的骨代谢指标对比,差异无统计学意义(P>0.05),治疗2周后,与对照组相比,观察组患者的骨保护素(OPG)升高,而软骨寡聚基质蛋白(COMP)、Ⅱ-型胶原蛋白C末端肽(CTX-Ⅱ)、核转录因子-κB受体活化因子配体(RANKL)、基质金属蛋白酶-3(MMP-3)降低(P<0.05);两组治疗前的炎症因子对比,差异无统计学意义(P>0.05),治疗2周后,与对照组相比,观察组患者的白介素1(IL-1)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)降低(P<0.05);两组治疗前的VAS评分、WOMAC评分对比,差异无统计学意义(P>0.05),治疗2周后,与对照组相比,观察组患者的VAS评分、WOMAC评分降低(P<0.05)。结论膝关节镜手术联合活血祛瘀汤治疗膝关节炎的效果较好,可有效改善患者的骨代谢指标,抑制由于膝关节镜手术诱发的炎症因子升高,进而降低患者的疼痛程度,提高患者的膝关节功能。

Objective To analyze the effect of knee arthroscopic surgery combined with Huoxue Quyu Decoction on knee arthritis.Methods From January 2021 to December 2022,105 patients with knee arthritis treated in the Xinyang People’s Hospital and Xinyang Central Hospital were selected.According to the different treatment methods,patients were divided into control group(n=45)and observation group(n=60).Knee arthroscopic surgery was performed in all patients,and sodium hyaluronate injections and Huoxue Quyu Decoction were respectively given to those of control group and observation group.Therapeutic efficacy between groups was compared.In addition,bone metabolism indexes,inflammatory factors,visual analogue scale(VAS)and the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)before and after treatment were compared.Results The total effective rate in the observation group was significantly higher than that in the control group(91.67%VS 73.33%,P<0.05).There were no significant differences in bone metabolism indexes between the two groups before treatment(P>0.05).After 2 weeks of treatment,osteoprotegerin(OPG)level was significantly higher in observation group than that in the control group,while the cartilage oligomeric matrix protein(COMP),C-terminal telopeptide of collagen typeⅡ(CTX-Ⅱ),receptor activator of nuclear factor-kappaB ligand(RANKL),and matrix metalloproteinase-3(MMP-3)levels were significantly lower(P<0.05).There were no significant differences in the inflammatory factors between the two groups before treatment(P>0.05).After 2 weeks of treatment interleukin-1(IL-1),IL-6 and tumor necrosis factor alpha(TNF-α)levels in the observation group were significantly lower than those in control group(P<0.05).There were no significant differences in VAS and WOMAC scores between the two groups before treatment(P>0.05).After 2 weeks of treatment,VAS and WOMAC scores in the observation group were significantly lower than those in the control group(P<0.05).Conclusion The effect of knee arthroscopic surgery combined with Huoxue Quyu Decoction on knee arthritis is good,which can effectively improve the bone metabolism indexes,inhibit the increase of inflammatory factors induced by knee arthroscopic surgery,reduce the pain,and improve the knee joint function.