海桐皮汤熏蒸联合关节镜下髌骨外侧支持带松解及髌骨成形术治疗髌股外侧高压综合征的疗效观察  

Clinical Observation on Lateral Patellofemoral Hypertension Syndrome by Haitongpi Decoction(海桐皮汤)Fumigation Combined with Arthroscopic Release of Lateral Retinaculum and Patellar Formation

作　　者：袁小波[1] 袁吉 陈天宇 YUAN Xiaobo;YUAN Ji;CHEN Tianyu(Neijiang Traditional Chinese Medicine Hospital,Neijiang Sichuan 641000,China)

机构地区：[1]内江市中医医院,四川内江641000

出　　处：《中医药导报》2023年第6期87-92,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：内江市科技支撑计划项目。

摘　　要：目的:观察海桐皮汤熏蒸联合关节镜下髌骨外侧支持带松解及髌骨成形术治疗髌股外侧高压综合征的临床疗效。方法:将70例(70膝)髌股外侧高压综合征患者随机分为对照组和治疗组,每组35例(35膝)。对照组患者采用关节镜下髌骨外侧支持带松解及髌骨成形术,术后进行肢体功能锻炼,治疗组患者在对照组基础上加海桐皮汤熏蒸治疗,连续治疗4周,随访3个月。治疗前、治疗第3天、治疗第7天、治疗结束时、随访结束时观察两组患者膝关节疼痛及膝关节功能,治疗前、随访结束时检查髌骨轴位X线片髌骨适合角(CA)、髌骨倾斜角(PTA)及髌骨外移度(PLS),评定临床疗效。结果:治疗组失访1例,对照组失访2例。治疗组总有效率为94.12%(32/34),对照组总有效率为84.85%(28/33);治疗组总有效率高于对照组,差异有统计学意义(P<0.01)。两组患者治疗后VAS评分均逐渐降低(P<0.01);治疗第3天、治疗第7天及治疗结束时,治疗组患者VAS评分均低于对照组,差异均有统计学意义(P<0.05或P<0.01);随访结束时,两组患者VAS评分比较,差异无统计学意义(P>0.05)。两组患者治疗后Lysholm膝关节功能评分均逐渐升高(P<0.01);治疗第3天、治疗第7天两组患者Lysholm膝关节功能评分比较,差异无统计学意义(P>0.05);治疗结束时、随访结束时,治疗组患者Lysholm膝关节功能评分均高于对照组,差异均有统计学意义(P<0.01)。与治疗前比较,两组患者随访时CA、PTA及PLS均降低,差异均有统计学意义(P<0.01);随访结束时治疗组患者CA、PTA及PLS均低于对照组,差异有统计学意义(P<0.01)。结论:海桐皮汤熏蒸联合关节镜下髌骨外侧支持带松解及髌骨成形术治疗髌股外侧高压综合征,可有效缓解患者关节疼痛,促进患者膝关节功能恢复。Objective:To observe the clinical effect of Haitongpi decoction combined with articulatory release of lateral patellar support band and patellar formation in the treatment of lateral patellofemoral high pressure syndrome.Methods:Totally 70 patients(70 knees)with lateral patellofemoral hypertension syndrome were randomly divided into control and treatment groups,with 35 patients(35 knees)in each group.Control group received arthroscopic lateral patellar support band release and patellar formation,and limb function exercise after surgery.Treatment group was additionally given Haitongpi decoction fumigation treatment on the basis of control group,continuous treatment for 4 weeks,follow-up for 3 months.Knee pain and knee function were observed in the two groups before treatment,after treatment,at the third and seventh day of treatment,at the end of treatment and at the follow-up.Axial X-ray patellar fit Angle(CA),patellar inclination Angle(PTA)and patellar outward shift(PLS)were examined before treatment and at the follow-up to evaluate the clinical efficacy.Results:There was one case lost to follow-up in the treatment group and two cases in control group.The total effective rate was 94.12%(32/34)in treatment group and 84.85%(28/33)in control group.The treatment group showed higher total effective rate than control group,and the difference was statistically significant(P<0.01).The VAS scores decreased gradually after treatment in two groups(P<0.01).And the treatment group showed lower VAS scores than control group on day 3,day 7 and at the end of treatment,with statistical significance(P<0.05 or P<0.01).At follow-up,there was no significant difference in VAS scores between the two groups(P>0.05).The Lysholm knee function scores were increased gradually after treatment in two groups(P<0.01).There was no significant difference in Lysholm knee function scores between the two groups on day 3 and day 7(P>0.05).The treatment group showed higher Lysholm knee function scores than control group at the end of treatment and fol

关 键 词：髌股外侧高压综合征 关节镜下髌骨外侧支持带松解 髌骨成形术 海桐皮汤 中药熏蒸 

分 类 号：R274.32[医药卫生—中医骨伤科学]