关节镜下清理结合仙方活命饮治疗急性化脓性膝关节炎的临床观察

Clinical Observation of Arthroscopic Debridement Combined with Xianfang Huoming Decoction in Treating Acute Suppurative Arthritis

目的观察关节镜下清理术结合仙方活命饮治疗化脓性膝关节炎的临床效果。方法对2014年3月-2017年12月南京中医药大学连云港附属医院及南京中医药大学附属中西医结合医院住院期间的68例急性化脓性关节炎患者,随机分为2组各34例,68例患者均行关节镜下清理术,术后用含庆大霉素的生理盐水(8万U/500mL)灌洗引流1～2周,根据药敏实验选择敏感抗生素静脉滴注2周,治疗组加仙方活命饮治疗;对照组单纯行关节镜下清理术治疗方案;术后3周,观察2组治疗前后Lysholm评分、疼痛视觉模拟评分(VAS)、Judet膝关节屈曲度和功能评价。结果治疗后治疗组Lysholm膝关节评分明显高于对照组(P<0.05);疼痛视觉模拟评分(VAS)治疗组明显低于对照组(P<0.05);Judet膝关节屈曲度和功能评价优良率治疗组(91.18%)优于对照组(70.59%),P<0.05,临床疗效治疗组(94.12%)优于对照组(76.47%),P<0.05。2组均未见明显不良反应。结论关节镜下清理术结合仙方活命饮可明显缩短化脓性膝关节炎的治疗疗程,关节功能恢复快,优良率高,是较理想的治疗方法。

OBJECTIVE To observe the clinical efficacy of arthroscopic debridement combined with Xianfang Huoming Decoction in treating acute suppurative arthritis.METHODS 68 patients with acute suppurative arthritis during the hospitalization of Lianyungang TCM Hospital Affiliated to Nanjing University of Chinese Medicine and Integrated Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,from March 2014 to December 2017,were randomly divided into 2 groups,34 patients in each group.All the 68 patients were under the arthroscopic debridement treatment.The patients were lavaged and drainaged with gentamicin-containing physiological saline(80 000 U/500 mL)for 1 to 2 weeks after the operation.According to the drug sensitivity test,the sensitive antibiotics were selected for intravenous infusion for 2 weeks,and the treatment group was treated with Xianfang Huoming Decoction.The control group was only under the arthroscopic debridement treatment.Three weeks after the operation,observe the Lysholm score,pain visual analogue scale(VAS),Judet knee flexion and functional evaluation of two groups before and after treatment.RESULTS After treatment,the Lysholm knee joint score of the treatment group was significantly higher than that of the control group(P<0.05).The pain visual analog score(VAS)of the treatment group was significantly lower than the control group(P<0.05).Judet knee flexion and function evaluation excellent rate of the treatment group(91.18%),the excellent rate of the control group(70.59%).The treatment group was significantly higher than the control group(P<0.05).No significant adverse reactions were observed in the two groups.CONCLUSION Arthroscopic debridement combined with Xianfang Huoming Decoction can significantly shorten the treatment course of suppurative knee arthritis,rapid recovery of joint function and high rate of excellent,which is an ideal treatment.