逐瘀生骨汤联合双侧全膝关节置换手术治疗膝骨关节炎的效果

Effects of Zhuyu Shenggu Tang Combined with Bilateral Total Knee Replacement Surgery for Knee Osteoarthritis Patients

目的分析逐瘀生骨汤联合双侧全膝关节置换手术治疗膝骨关节炎的效果。方法采用随机数字表法将2021年6月至2022年6月南阳市第一人民医院收治的90例膝骨关节炎患者分为两组,各45例。对照组接受双侧全膝关节置换手术治疗,观察组在对照组基础上联合逐瘀生骨汤治疗。治疗3个月时,比较两组临床效果。观察两组患者治疗前、治疗3个月时X线下生物学指标[Insall-Salvati指数(IS)、Blackburne-Peel指数(BP)、髌骨指数(PFI)]、关节角(股骨胫骨角、胫骨关节间隙角)、瞬时转动中心轨迹角及膝关节功能[美国特种外科医院膝关节评分(HSS)]。结果两组临床疗效比较差异无统计学意义(P>0.05);治疗后,两组IS、BP、PFI指数与股骨胫骨角、胫骨关节间隙角低于治疗前,观察组比对照组低(P<0.05);治疗后,两组20°、40°、70°、90°瞬时转动中心轨迹角与HSS量表各维度评分及总分高于治疗前,观察组比对照组低高(P<0.05);观察组术后并发症发生率(4.44%)与对照组(8.89%)相比,差异无统计学意义(χ^(2)=0.179,P=0.673)。结论逐瘀生骨汤联合双侧全膝关节置换手术能够有效改善膝骨关节炎患者膝关节功能,缓解生物力学失衡。

Objective To analyze the effect of Zhuyu Shenggu Tang combined with bilateral total knee replacement surgery for knee osteoarthritis patients.Methods A random number table method was used to divide 90 patients with knee osteoarthritis admitted to the First People’s Hospital of Nanyang from June 2021 to June 2022 into two groups,with 45 cases in each group.The control group was treated with bilateral total knee joint replacement surgery,and the observation group was treated with Zhuyu Shenggu Tang on the basis of the control group.After 3 months of treatment,the clinical efficacy of the two groups was compared.The biological indexes[Insall-Salvati index(IS),Blackburne-Peel index(BP),patellofemoral index(PFI)],joint angle(femoral tibial angle,tibial joint gap angle),instantaneous rotation center trajectory angle and knee joint function[hospital for special surgery knee score(HSS)]were observed before treatment and after 3 months of treatment.Results There was no statistical difference in clinical efficacy of the two groups(P>0.05).After treatment,the IS,BP,PFI,femoral tibial angle and tibial joint gap angle were lower in both groups than before treatment,and those in the observation group were lower than the control group(P<0.05).After treatment,the 20°,40°,70°and 90°instantaneous center of rotation trajectory angles and HSS scale scores of each dimension and total scores were higher in both groups than before treatment,and those in the observation group were lower than the control group(P<0.05).The incidence of postoperative complications in the observation group(4.44%)was not statistical different from the control group(8.89%)(χ^(2)=0.179,P=0.673).Conclusion The combination of Zhuyu Shenggu Tang with bilateral total knee replacement surgery can effectively improve knee joint function and alleviate biomechanical imbalance in patients with knee osteoarthritis.