关节镜下交叉韧带修复术结合活血祛瘀中药治疗膝关节前后交叉韧带损伤的临床疗效观察  

Therapeutic Effect of Reconstruction of Cruciate Ligament Under Arthroscope Combined with Blood-activating and Stasis-resolving Chinese Medicine for Knee Anterior and Posterior Cruciate Ligament Injuries

作　　者：丁玲[1] 李逸群[1] 杨匡洋[1] 傅强[1] 黄若景[1] 

机构地区：[1]广东省佛山市中医院骨伤科,广东佛山528000

出　　处：《广州中医药大学学报》2014年第4期522-525,共4页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】探讨关节镜下交叉韧带修复术结合活血祛瘀中药治疗膝关节前后交叉韧带损伤的临床疗效。【方法】对2009年4月至2013年2月收治的22例膝关节前后交叉韧带损伤的病例,在关节镜辅助下行修复术;术后外敷活血祛瘀、消肿止痛中药制剂伤科黄水（由大黄、栀子、牛膝等组成）和口服中药制剂骨一方（由桃仁、红花、牛膝、赤芍、三七、木香、独活、杜仲、当归尾、五灵脂等组成）,三七化瘀口服液等。术后随访6~12个月,采用Lysholm评分评估患者手术疗效。【结果】22例均获随访,时间6~12个月,平均8.5个月。所有患者无1例感染或神经血管损伤。22例患者膝关节活动度均达到正常,3例末次随访时前抽屉试验和Lachman试验呈弱阳性,但自述无不稳定症状,其余19例出院后均未出现膝关节不稳定症状。Lysholm评分从术前的（27.9±3.2）分增加到第24周随访时的（91.4±2.3）分,差异有统计学意义（P〈0.05）。【结论】关节镜下交叉韧带修复术结合活血祛瘀中药治疗膝关节前后交叉韧带损伤可取得良好的临床疗效。Objective To explore the therapeutic effect of reconstruction of cruciate ligament under arthroscope combined with blood-activating and stasis-resolving Chinese medicine for knee anterior and posterior crueiate ligament injuries. Methods Twenty-two patients with knee anterior and posterior cruciate ligament injuries admitted from April of 2009 to February of 2013 were given reconstruction under arthroscope, and then were given external application of Shangke Huangshui, activating blood and resolving stasis, and alleviating which is a Chinese medicine recipe with the actions of swelling and relieving pain （mainly composed of Radix et Rhizome Rhei, Fructus Gardeniae, Radix Achyranthis Bidentatae）, and oral use of Guyifang （mainly composed of Semen Persicae, Flos Carthami, Radix Achyranthis Bidentatae, Radix Paeoniae Rubra, Radix Notoginseng, Radix Aucklandiae, Radix Angelicae Pubescentis, Cortex Eucommiae, the root of Radix Angelicae Sinensis, Faeces Trogopterori） and Sanqi Httayu Oral Liquid. After surgery, follow-up was carried out for 6-12 months, and the therapeutic effect was evaluated by Lysholm scoring. Results Twenty-two cases were all given follow-up for 6-12 months, averaging 8.5 months. No case was complicated with infection or injures of nerves and blood vessels. Knee motion range of all patients reached to the normal. Anterior drawer test and Lachman test at the end of follow-up showed weakly positive in 3 cases, but they had no complaints of knee instability. Other 19 cases had no complaints of knee instability after discharge, either. Lachman scores were 27.9 ± 3.2 before surgery, and were 91.4± 2.3 on week 24 during the follow-up, the difference being significant （P 〈0.05） Conclusion Reconstruction of cruciate ligament under arthroscope combined with blood-activating and stasis-resolving Chinese medicine has satisfactory therapeutic effect for knee anterior and posterior cruciate ligament injuries.

关 键 词：膝关节 前后交叉韧带损伤 中药疗法 关节镜 修复 活血祛瘀 

分 类 号：R686.5[医药卫生—骨科学]