中药离子导入联合膝关节镜清理术治疗膝骨性关节炎的临床疗效及机制  

Clinical effect and mechanism of traditional Chinese medicine ion implantation combined with knee arthroplasty in the treatment of knee osteoarthritis

作　　者：庾明 张廷玖[1] 张东[1] YU Ming;ZHANG Tingjiu;ZHANG Dong(Orthopedics Department,Central Hospital of Dazhou,Dazhou 635000,Sichuan,Chin)

机构地区：[1]达州市中心医院骨科,四川达州635000

出　　处：《西部医学》2018年第8期1138-1142,共5页Medical Journal of West China

基　　金：四川省教育厅科研项目(12ZB223)

摘　　要：目的分析中药离子导入联合膝关节镜清理术治疗膝骨性关节炎(KOA)的临床疗效,并探讨其作用机制。方法选取2010年1月~2016年12月我院收治的146例KOA患者作为研究对象,按其治疗方法分为对照组和观察组,每组各73例。对照组在KOA常规治疗基础上采用膝关节镜清理术治疗。观察组在对照组治疗基础上予以加用中药离子导入治疗,2周治疗结束后比较2组金属基质蛋白酶-13(MMP-13)、白介素-1(IL-1)、肿瘤坏死因子-ɑ(TNF-ɑ)和转化生长因子-β(TGF-β)水平以及膝关节疼痛、膝关节功能、肿胀程度、骨关节炎指数评分(WOMAC)和临床疗效情况。结果观察组治疗后IL-1、TNF-ɑ和TGF-β水平均较对照组降低或升高(P<0.05)。观察组治疗后其VAS和Lysholm评分降低和升高程度大于对照组(P<0.05)。治疗结束后,观察组膝关节肿胀程度较对照组降低(P<0.05)。观察组治疗后其WOMAC各项评分降低程度均大于对照组(P<0.05)。观察组临床总有效率高于对照组(P<0.05)。结论中药离子导入联合膝关节镜清理术可通过调控机体炎症系统和调节炎症因子水平以达到较好的临床疗效,可作为临床上治疗KOA的优选治疗方案。Objective To analyze the clinical efficacy of traditional Chinese medicine ion implantation combined with knee arthroplasty in the treatment of knee osteoarthritis（KOA）and explore its mechanism.Methods From January 2010 to December2016,146 patients with KOA were enrolled in this study.According to their treatment,they were divided into control group and observation group.The control group was treated with knee arthroscopic debridement on the basis of KOA routine treatment.The observation group was treated with Chinese medicine ion implantation on the basis of control group＇3 treatment.MMP-13,interleukin-1（IL-1）,tumor necrosis factor-a（TNF-ɑ）,transforming growth factor-β（TGF-β）,knee pain,knee function,swelling degree,osteoarthritis index score and clinical efficacy were observed.Results The levels of IL-1,TNF-ɑand TGF-βin the observation group were significantly lower than those in the control group（P〈0.05）.The VAS and Lysholm scores in the observation group were significantly lower than that in the control group（P〈0.05）.At the end of treatment,the degree of knee swelling in the observation group was significantly lower than that in the control group（P〈0.05）.The scores of WOMAC scores in the observation group were significantly higher than those in the control group（P〈0.05）.The total effective rate in the observation group（95.89%）was significantly higher than that in the control group（84.93%）（P〈0.05）.Conclusion Chinese medicine ion implantation combined with knee arthroplasty can be used as a clinical treatment for the treatment of KOA by regulating the inflammation system and regulate the level of inflammatory factors in order to achieve good clinical efficacy and certain safety.

关 键 词：中药离子导入 膝关节镜清理术 膝骨性关节炎 临床价值 作用机制 

分 类 号：R684.3[医药卫生—骨科学]