桃红四物汤加味内服合二妙散加味外敷配合血流限制性运动对前交叉韧带重建术后患者康复的影响  

Effect of Taohong Siwu Decoction and Ermiao Powder for internal and external application combined with blood flow restriction training on postoperative rehabilitation of knee joint function of anterior cruciate ligament reconstruction

作　　者：李举杰 茶晓锋[1] 李彬[1] LI Jujie;CHA Xiaofeng;LI Bin(Third Department of Orthopedics,Luzhou TCM Hospital,Luzhou,Sichuan 646000)

机构地区：[1]四川省泸州市中医医院骨伤三科,四川泸州646000

出　　处：《河北中医》2023年第10期1675-1679,1684,共6页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察桃红四物汤加味口服联合二妙散加味外敷配合血流限制性运动对前交叉韧带重建术后患者康复的影响。方法选取2020年1月至2022年1月收治的78例前交叉韧带重建术后患者,按照随机数字表法分为2组,对照组39例予血流限制性运动治疗,治疗组39例在对照组基础上加用桃红四物汤加味口服联合二妙散加味外敷治疗。2组均治疗3个月后统计疗效,比较2组治疗前后中医证候(包括疼痛、僵硬、肿胀、屈伸不利、关节酸涩沉着及舌脉)评分、膝关节Lysholm评分量表评分、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数评分、膝关节活动度(屈曲受限和伸膝受限)及实验室指标[包括血清白细胞介素1β(IL-1β)、转化生长因子β(TGF-β)及基质金属蛋白酶-2(MMP-2)]水平变化情况。结果治疗组总有效率92.31%(36/39),对照组总有效率71.79%(28/39),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医证候疼痛、僵硬、肿胀、屈伸不利、关节酸涩沉着及舌脉评分降低(P<0.05),且治疗组治疗后中医证候疼痛、僵硬、肿胀、屈伸不利、关节酸涩沉着及舌脉评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后膝关节Lysholm评分均升高(P<0.05),WOMAC评分均降低(P<0.05),且治疗组治疗后膝关节Lysholm评分高于对照组(P<0.05),WOMAC评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后膝关节活动度屈曲受限及伸膝受限水平均减小(P<0.05),且治疗组治疗后膝关节活动度屈曲受限及伸膝受限水平小于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清IL-1β及MMP-2水平均降低(P<0.05),TGF-β水平均升高(P<0.05),且治疗组治疗后血清IL-1β及MMP-2水平均低于对照组(P<0.05),TGF-β水平高于对照组(P<0.05)。结论桃红四物汤加味口服联合二妙散加味外敷配合血流限制性运动治疗前交叉韧带重建术后临床疗效确切,Objective To explore the effect of Taohong Siwu Decoction and Ermiao Powder for oral administration and external application combined with blood flow restriction training on the postoperative rehabilitation of knee joint function of anterior cruciate ligament(ACL)reconstruction.Methods Totally 78 patients with ACL reconstruction who were admitted to the hospital from January 2020 to January 2022 were selected and randomly divided into the treatment group(n=39)and the control group(n=39).All patients were given blood flow restriction training,the patients of the treatment group was additionally given Taohong Siwu Decoction and Ermiao Powder for oral administration and external application.The treatment was performed for three months,and the curative effect was counted.The scores of traditional Chinese medicine(TCM)syndromes including pain,stiffness,swelling,unfavorable flexion and extension,joint acerbity and tongue and pulse,Lysholm Knee Scoring,and Western Ontario and McMaster University Osteoarthritis Index(WOMAC),as well as knee joint activity(flexion limitation and extension limitation)and laboratory indexes including serum interleukin-1β(IL-1β),transforming growth factor-β(TGF-β),and matrix metalloproteinase-2(MMP-2)were compared between the two groups before and after treatment.Results After treatment,The total effective rate in the treatment group was significantly higher than that in the control group(92.31%[36/39]vs 71.79%[28/39],P<0.05).The TCM syndrome scores of the two groups significantly decreased treatment than those before treatment(P<0.05),and the decrease was more pronounced in the treatment group(P<0.05).Significantly elevated knee Lysholm scores,and decreased WOMAC scores were detected in the both groups(both P<0.05),and there were significant differences in Lysholm scores and WOMAC scores between the treatment group and the control group(both P<0.05).The knee joint activity(flexion limitation and extension limitation)in the both groups reduced after treatment(P<0.05),and which was better

关 键 词：前交叉韧带 膝关节 术后康复 中西医结合疗法 

分 类 号：R289.6[医药卫生—方剂学]