关节镜清理术联合中药薰蒸与单纯关节镜清理术治疗早期膝骨关节炎的对比研究  

A retrospective trial of arthroscopic debridement integrated and nonintegrated with Chinese herbal steaming for treatment of early knee osteoarthritis

作　　者：倪力刚[1] 胡劲涛 

机构地区：[1]浙江省杭州市余杭区第五人民医院,浙江杭州311100 [2]浙江省绍兴市柯桥区中医医院,浙江绍兴312030

出　　处：《中医正骨》2015年第12期41-45,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的：比较关节镜清理术联合中药薰蒸与单纯关节镜清理术治疗早期膝骨关节炎的临床疗效。方法：回顾性分析64例早期膝骨关节炎患者的病例资料,其中采用单纯关节镜清理术治疗35例,采用关节镜清理术联合中药薰蒸治疗29例。男26例,女38例。年龄53~67岁,中位数59岁。按照骨关节炎Kellgren-Lawrence影像学分级,Ⅰ级22例、Ⅱ级42例。分别比较术前、术后6个月及术后12个月时2组患者的膝关节疼痛视觉模拟量表（visual analogue scale,VAS）评分、健康调查简表（36-item short form health survey,SF-36）评分及Lysholm膝关节评分。结果：手术前后不同时间点膝关节疼痛VAS评分比较,差异有统计学意义,存在时间效应（F=1032.375,P=0.000）;2组患者膝关节疼痛VAS评分比较,组间差异有统计学意义,存在分组效应（F=6.772,P=0.012）;术前2组患者膝关节疼痛VAS评分比较,差异无统计学意义[（8.2±0.8）分,（8.3±0.7）分,t=0.354,P=0.554];术后6个月和术后12个月,关节镜清理术联合中药薰蒸组的膝关节疼痛VAS评分均低于单纯关节镜清理术组[（1.2±1.0）分,（1.9±1.0）分,t=7.512,P=0.008;（2.0±1.0）分,（2.6±1.0）分,t=4.326,P=0.042];时间因素和分组因素存在交互效应（F=3.567,P=0.031）。手术前后不同时间点SF-36评分比较,差异有统计学意义,存在时间效应（F=2501.188,P=0.000）;2组患者SF-36评分比较,组间差异有统计学意义,存在分组效应（F=40.308,P=0.000）;术前2组患者SF-36评分比较,差异无统计学意义[（55.5±3.6）分,（56.0±3.7）分,t=0.363,P=0.549];术后6个月和术后12个月,关节镜清理术联合中药薰蒸组的SF-36评分均高于单纯关节镜清理术组[（91.7±3.0）分,（87.9±2.9）分,t=25.938,P=0.000;（88.8±2.6）分,（83.7±3.2）分,t=55.254,P=0.000];时间因素和分组因素存在交互效应（F=9.868,P=0.000）。手术前后不同时间点Lysholm膝关节评分比较,差异有统计学Objective：To compare the clinical curative effects of combination therapy of arthroscopic debridement and Chinese herbal steaming versus monotherapy of arthroscopic debridement in the treatment of early knee osteoarthritis （KOA）. Methods： The medical re- cords of 64 patients with early KOA were analyzed retrospectively. Thirty - five patients were treated with monotherapy of arthroseopic de- bridement（ monotherapy group ） while the others were treated with combination therapy of arthroscopic debridement and Chinese herbal steaming （combination therapy group）. The patients consisted of 26 males and 38 females, and ranged in age from 53 to 67 years （Median = 59 yrs）. According to Kellgren - Lawrence imaging classification,the KOA belonged to types I （22） and II （42）. The visual analogue scale（VAS） scores, 36 -item short form health survey（ SF -36）scores and Lysholm knee scores were compared between the 2 groups before the surgery and at 6 and 12 months after the surgery respectively. Results：There was statistical difference in the knee pain VAS scores between different time points, in other words, there was time effect（ F = 1052. 375, P = 0. 000）. There was statistical difference in the knee pain VAS scores between the two groups, in other words, there was group effect（ F = 6. 772, P = 0.012）. There was no statistical difference in preoper- ative knee pain VAS scores between the 2 groups（8.2 ＋/- 0.8 vs 8.3 ＋/- 0.7 points, t = 0. 354, P = 0. 554）. The knee pain VAS scores were lower in combination therapy group compared to monotherapy group at 6 and 12 months after the surgery（ 1.2 ＋/- 1.0 vs 1.9 ＋/- 1.0 points,t = 7. 512,P = 0.008 ;2.0 ＋/- 1.0 vs 2.6 ＋/- 1.0 points, t = 4. 326, P = 0. 042 ）. There was interaction between time factor and group factor（ F = 3. 567 ,P = 0. 031 ）. There was statistical difference in the SF - 36 scores between different time points, in other words, there was time effect （F = 2501. 188, P = 0. 000）. There was statis

关 键 词：骨关节炎 膝 关节镜检查 薰洗 治疗 临床研究性 

分 类 号：R687.4[医药卫生—骨科学]