骨洗方联合持续被动活动治疗膝关节镜下前交叉韧带重建术后关节僵硬  

"Guxifang" Combined with continuous passive motion in the treatment of stiffness of the knee joint after the anterior cruciate ligament reconstruction

作　　者：李卫平[1] 王立晖[1] 宋斌[1] 杨睿[1] 张正政[1] 

机构地区：[1]中山大学孙逸仙纪念医院骨科,广东广州510120

出　　处：《岭南现代临床外科》2010年第5期364-365,368,共3页Lingnan Modern Clinics in Surgery

基　　金：中西医结合治疗对关节镜下前交叉韧带重建术后膝关节功能的影响;广东省中医药局科研课题(No.2008091)

摘　　要：目的观察骨洗方联合持续被动活动(CPM)治疗膝关节前交叉韧带(ACL)重建术后关节僵硬的疗效。方法对我院2009年1月至2010年3月24例(24膝)膝关节镜下ACL重建术后关节僵硬患者,随机分为两组(A组、B组),每组12例,A组给予中药骨洗方(由薄荷、桂枝、半枫荷、两面针、红花、宽筋藤等组成)熏洗联合CPM训练,B组仅进行CPM训练,定期随访,以Lysholm膝关节功能评估系统(0-100分)和膝关节活动度(ROM)分别评估膝关节功能。结果 24例患者均获得随访,A组随访时间6-12个月,平均随访10个月,B组随访时间7-12个月,平均10.5个月。A组ROM由治疗前78.6°±16.2°(62-95°),提高到治疗后125.5°±12.1°(112-135°),差别有统计学意义(t=8.035,P<0.001)。B组由治疗前80.2°±13.7°(65-91°)提高到治疗后115.4°±10.1°(102-131°),差别有统计学意义(t=7.164,P<0.001)。A、B组治疗前ROM无统计学差异(t=0.261,P>0.05),治疗后ROM有统计学差异(t=2.220,P<0.05)。A组Lysholm评分由治疗前74.3±5.8,提高到治疗后86.7±6.5,差别有统计学意义(t=4.931,P<0.001)。B组Lysholm评分由治疗前72.7±6.3,提高到治疗后81.5±5.5,差别有统计学意义(t=3.645,P<0.001)。A、B组治疗前Lysholm评分无统计学差异(t=0.647,P>0.05),治疗后Lysholm评分有统计学差异(t=2.116,P<0.05)。两组无一例患者出现皮肤过敏等并发症。结论中药骨洗方熏洗联合CPM训练对膝关节镜下ACL重建术后关节僵硬患者的膝关节活动功能恢复有明显的促进作用,且效果优于单纯行CPM训练。Objective To overview the curative effect of ＂guxifang＂ combined with continuous passive motion（CPM） in the treatment of stiffness of the knee joint after anterior cruciate ligament（ACL）reconstruction.Method In a randomized control clinical trial,twenty-four cases of knee joint stiffness after the ACL reconstruction were divided randomly into two groups（A group and B group）,and each group had 12 cases.A group was treated by Chinese formulated products ＂Guxifang＂combined with CPM,B group was treated by only CPM,followed up regularly,evaluate the function of the knee joint by Lysholm system and range of motion（ROM）.Result Twenty-four cases were followed up from six to twelve months.ROM of group A increased from 78.6°±16.2°（62-95°）to 125.5°±12.1°（112-135°）,the difference has statistical significance（T=8.035,P0.001）.ROM of group B increased from 80.2°±13.7°（65-91°）to 115.4°±10.1°（102-131°）,the difference has statistical significance（T=7.164,P0.001）.The ROM before treatment between group A and group B has no statistical significance（T=0.261,P0.05）.The ROM after treatment between group A and group B has statistical significance（T=2.220,P0.05）.Lysholm scores of group A increased from 74.3±5.8 to 86.7±6.5,the difference has statistical significance（T=4.931,P0.001）.Lysholm scores of group B increased from 72.7±6.3 to 81.5±5.5,the difference has statistical significance（T=3.645,P0.001）.The Lysholm scores before treatment between group A and group B has no statistical significance（T=0.647,P0.05）.The Lysholm scores after treatment between group A and group B has statistical significance（T=2.116,P0.05）.None of the cases suffered complications,such as skin allergy and so on.Conclusion To the patients with knee joint stiffness after the ACL reconstruction under arthroscope,＂guxifang＂ combined with continuous passive motion could facilitate the recovery course of the movement function of the knee joint,and its therapeutic effect was o

关 键 词：前交叉韧带 重建 关节僵硬 持续被动活动 骨洗方 

分 类 号：R684[医药卫生—骨科学]