中医传统关节粘连松解程序治疗胫骨平台骨折术后膝关节僵硬  

Traditional Chinese Medicine Joint Adhesion Release Program in the Treatment of Knee Stiffness after Tibial Plateau Fracture Operation

作　　者：严攀[1] 刘波[1] 张鑫[1] 马晓东[1] 路怀民[1] 刘辉[1] 赵卫侠[1] 张晓芳[1] 陈罗西[1] 付婷婷[1] 李红林 

机构地区：[1]四川省骨科医院,成都610041

出　　处：《中国中医骨伤科杂志》2018年第3期21-25,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：2016年度四川省中医药管理局青年基金课题(2016Q029);2015年度四川省骨科医院院内课题(2015-18)

摘　　要：目的:观察中医传统关节粘连松解程序治疗胫骨平台骨折术后膝关节僵硬的临床疗效。方法:将符合条件的胫骨平台骨折术后膝关节僵硬患者随机分为治疗组和对照组,治疗组给予中医传统关节粘连松解程序,对照组给予西医Maitland关节松动术,两组均给予基础治疗(运动疗法、中成药口服),1次/d,共治疗20次,以VAS疼痛评分、关节活动度、肌力、美国特种外科医院(HSS)膝关节评分和日常生活活动能力Barthel指数评定量表等指标进行综合疗效评价。结果:58例患者完成治疗,治疗组30例,对照组28例,治疗组和对照组治疗后各指标与治疗前差异有统计学意义(P<0.05),治疗后各指标得到改善,治疗均有效;两组患者治疗后膝关节屈曲角度、关节活动范围、VAS,ADL及HSS评分对比差异有统计学意义(P<0.05),而伸直受限角度及肌力对比,两组差异无统计学意义(P>0.05)。结论:中医传统关节粘连松解程序治疗胫骨平台骨折术后膝关节僵硬在改善患者疼痛、关节活动度、HSS膝关节评分以及日常活动能力方面优于西医Maitland关节松动手术组,体现中医药治疗的优势。Objective：To observe the effectiveness of traditional Chinese medicine joint adhesion release program in the treatment of knee stiffness after tibial plateau fracture（TPF）surgery.Methods：Patients who matched the inclusion and exclusion criteria were randomly divided into 2 groups.Participants in treatment group received traditional Chinese medicine joint adhesion release program.Participants in control group received Maitland joint mobilization.In addition,both groups received basic treatment（exercise therapy and Traditional Chinese oral medicine）.Participants received treatment once per day and totally for 20 d.The outcome was the VAS pain score,joint activity degree,muscle strength,the hospital for special surgery（HSS）knee score and ADL Barthel index.Results：58 patients have completed treatment,30 in treatment group and 28 in control group.All the outcomes were significantly improved after the treatment in both the treatment group and control group（P〈0.05）.Scores of knee flexion angle,range of motion,VAS,ADL and HSS score in treatment group were significantly better than those in control group（P〈0.05）.While there was no significant difference in stretch limit angle and muscle strength scores between two groups（P〈0.05）.Conclusion：In the treatment of knee stiffness after tibial plateau fracture（TPF）surgery,traditional Chinese medicine joint adhesion release program has better effect than Maitland joint mobilization in relieving pain,joint mobility,HSS knee score and daily activity ability.It proves TCM treatment＇s advantage.

关 键 词：中医 关节松动 胫骨平台骨折 膝僵硬 

分 类 号：R274.39[医药卫生—中医骨伤科学]