半月板成形术联合中药治疗单纯半月板损伤的临床观察  

Clinical Efficacy Observation of Meniscoplasty Combined with Traditional Chinese Medicine Decoction in the Treatment of Simple Meniscus Injury

作　　者：李安石[1] 齐志明 李志君[1] 刘挺[1] 刘大凯[1] Li Anshi;Qi Zhiming;Li Zhijun;Liu Ting;Liu Dakai(Dalian Second People's Hospital/Dalian Integrated Traditional Chinese and Western Medicine Hospital,Liaoning,Dalian 116011,China)

机构地区：[1]辽宁省大连市第二人民医院,大连市中西医结合医院,辽宁大连116011

出　　处：《中国中医急症》2023年第6期1072-1075,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：辽宁省自然基金资助计划(2020-MS-336)。

摘　　要：目的 观察关节镜半月板成形术后应用中药汤剂治疗半月板损伤的疗效并探讨其作用机制。方法120例患者按照随机数字表法分为观察组与对照组各60例。两组均实施关节镜半月板成形术,术后常规处理,观察组术后给予中药汤剂连续治疗2周。比较两组的临床效果,膝关节功能恢复指标[视觉模拟量表(VAS)评分、关节活动度、Lysholm评分、日本骨科协会量表(JOA)评分]、关节液细胞因子水平白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、一氧化氮、透明质酸及不良反应。结果 两组患者均至少随访2周,无失访病例。观察组总有效率为95.00%,高于对照组的81.67%(P <0.05)。两组术后2周VAS疼痛评分较术前降低,且观察组低于对照组(均P <0.05);两组术后2周膝关节活动度、Lysholm膝关节评分、膝关节JOA评分均较术前增高,且观察组高于对照组(均P <0.05)。两组术后2周关节液IL-6、TNF-α、一氧化氮水平较术前降低,且观察组低于对照组(P <0.05);而关节液透明质酸水平较术前增高,观察组高于对照组(均P <0.05)。两组患者的手术切口均为I期愈合并拆线,治疗期间未发生严重不良反应;血尿常规、心电图、肝肾功均无异常。结论关节镜半月板成形术后应用中药汤剂治疗半月板损伤的疗效显著,能有效缓解疼痛,促进膝关节功能恢复,改善关节液细胞因子水平,安全性高。Objective:To discusstheefficacy of traditional Chinesemedicinedecoction on meniscusinjury after arthroscopic meniscoplasty and its effect on recovery of knee function and cytokines in joint fluid.Methods:A total of 120 patients with meniscus injury were divided into the observation group and control group according to random number table method,with 60 cases in each group.Both groups were treated with arthroscopic menis-cinoplasty with routine postoperative management;the observation group was added with traditional Chinese medi-cine decoction for 2 weeks.The clinical effects,knee function recovery indicators(VAS pain score,range of motion,Lysholm score,JOA score),the level of cytokines[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),nitric oxide,hyaluronic acid]in joint fluid and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 95.00%,which was significantly higher than 81.67%of the control group(P<0.05).Two weeks after surgery,the VAS pain score and the levels of IL-6,TNF-α,nitric oxide in joint fluid of the two groups were significantly lower than those before surgery(P<0.05),and the observation group were significantly lower than those of the control group(P<0.05).The range of motion,Lysholm score,JOA score and hyaluronic acid in the articular fluid of the two groups were significantly higher than those before operation(P<0.05),and the observation group were significantly higher than those of the control group(P<0.05).All surgi-cal incisions were stage I healing,and no serious adverse reactions occurred.Conclusion:Traditional Chinese medicine decoction after arthroscopic meniscoplasty is effective in the treatment of meniscus injury,which could effectively relieve pain,promote the recovery of knee joint function,improve the level of cytokines in joint fluid,with high safety.

关 键 词：半月板损伤 关节镜半月板成形术 中药汤剂 膝关节功能 细胞因子 

分 类 号：R684.7[医药卫生—骨科学]