[1]杨世荣.全膝关节置换术配合中药热敷 治疗膝骨关节炎肝肾不足、筋脉瘀滞证[J].中医正骨,2018,30(09):64-66.
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全膝关节置换术配合中药热敷 治疗膝骨关节炎肝肾不足、筋脉瘀滞证()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年09期
页码:
64-66
栏目:
骨关节炎
出版日期:
2018-09-20

文章信息/Info

作者:
杨世荣
浙江省宁波市奉化区中医医院,浙江 宁波 315500
关键词:
骨关节炎 关节成形术置换 中药疗法 热敷 白细胞介素1 血清素 地诺前列酮
摘要:
观察全膝关节置换术(total knee arthroplasty,TKA)配合中药热敷治疗膝骨关节炎(knee osteoarthritis,KOA)肝肾不足、筋脉瘀滞证的临床疗效。方法:2017年1月至2018年1月,采用TKA配合中药热敷治疗KOA肝肾不足、筋脉瘀滞证患者50例。男23例,女27例。年龄40~75岁,中位数66岁。病程3~26年,中位数13年。TKA术后2周切口愈合后开始进行中药热敷,每次15~20 min,每日1次,连续治疗4周。分别于治疗前及治疗结束后,采用酶联免疫吸附法测定患者血清中白细胞介素(interleukin,IL)-1、5-羟色胺(5-hydroxytryptamine,5-HT)、前列腺素E2(prostaglandin E2,PGE2)的含量; 测定膝关节屈曲畸形角度及活动度; 采用美国特种外科医院(hospital for special surgery,HSS)膝关节评分标准评价患膝运动功能。结果:治疗结束后,患者血清IL-1、5-HT、PGE2含量均较治疗前降低[(3.18±0.51)pg·mL-1,(6.53±0.75)pg·mL-1,t=26.118,P=0.000;(82.63±8.56)pg·mL-1,(228.26±20.21)pg·mL-1,t=46.918,P=0.000;(92.61±9.35)pg·mL-1,(306.67±30.15)pg·mL-1,t=47.951,P=0.000],膝关节屈曲畸形角度较治疗前减小(2.65°±0.59°,17.12°±2.36°,t=42.061,P=0.000),膝关节活动度较治疗前增加(95.67°±9.63°,50.12°±5.35°,t=29.237,P=0.000); HSS评分中的疼痛、功能、活动范围、肌力、固定畸形、不稳定评分均较治疗前增高[(27.58±8.86)分,(1.97±0.73)分,t=20.370,P=0.000;(21.38±6.26)分,(1.78±0.67)分,t=22.014,P=0.000;(18.36±6.13)分,(3.92±1.19)分,t=16.352,P=0.000;(9.25±3.52)分,(2.49±0.98)分,t=13.082,P=0.000;(9.51±3.32)分,(3.49±1.31)分,t=11.927,P=0.000;(9.23±3.97)分,(2.56±1.07)分,t=11.471,P=0.000]。结论:TKA配合中药热敷治疗KOA肝肾不足、筋脉瘀滞证,可以减轻炎症反应、矫正膝关节屈曲畸形、增加膝关节活动度、促进膝关节运动功能恢复。

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更新日期/Last Update: 2018-09-20