关节克痹丸联合关节镜微创术治疗寒湿痹阻型膝骨关节炎临床研究  

Clinical Study on Guanjie Kebi Pills Combined with Arthroscopic Minimally Invasive Surgery for Knee Osteoarthritis of Cold-Damp Obstruction Type

作　　者：赵玉果[1] 叶向阳[1] 程省[1] ZHAO Yuguo;YE Xiangyang;CHENG Sheng(Dapartment of Orthopedics Ward 1,Nanyang Central Hospital,Nanyang Henan,473000,China)

机构地区：[1]南阳市中心医院骨科一病区,河南南阳473000

出　　处：《新中医》2024年第9期115-119,共5页New Chinese Medicine

基　　金：河南省中医药科学研究专项课题(2023ZY2187);河南省医学科技攻关省部共建重大项目(SBGJ202103108);南阳市科技攻关计划项目(KJGG171);河南省科技计划项目(182102310466)。

摘　　要：目的:观察关节克痹丸联合关节镜微创术治疗寒湿痹阻型膝骨关节炎的临床疗效。方法:选取2021年9月—2023年7月在南阳市中心医院骨科接受治疗的128例寒湿痹阻型膝骨关节炎患者作为研究对象,采用随机数字表法将患者分为观察组、对照组各64例。2组均给予关节镜微创术治疗,对照组术后给予甲氨蝶呤片治疗,观察组术后给予关节克痹丸治疗。比较2组临床疗效及治疗前后美国特种外科医院膝关节评分系统(HSS)、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)、中医证候评分、微循环功能指标[血细胞平均运动速度(AVBC)、运动血细胞浓度(CMBC)、微血管血流灌注量(MBP)、经皮氧分压(Tcp O2)]、血清炎症因子[白细胞介素-6 (IL-6)、C-反应蛋白(CRP)]水平。结果:治疗后,观察组总有效率90.62%,对照组总有效率75.00%,2组比较,差异有统计学意义(P<0.05)。2组治疗后HSS、WHOQOL-BREF评分及AVBC、CMBC、MBP、Tcp O2均较治疗前升高(P<0.05),且观察组治疗后HSS、WHOQOL-BREF评分及微循环功能指标高于对照组(P<0.05)。2组治疗后中医证候评分及血清IL-6、CRP水平均较治疗前降低(P<0.05),且观察组治疗后中医证候评分及血清炎症因子水平均低于对照组(P<0.05)。结论:关节克痹丸联合关节镜微创术治疗寒湿痹阻型膝骨关节炎疗效确切,能够改善患者关节功能及微循环,减轻炎症反应。Objective:To observe the clinical effect on Guanjie Kebi Pills combined with arthroscopic minimally invasive surgery on knee osteoarthritis of cold-damp obstruction type.Methods:A total of 128 patients with knee osteoarthritis of cold-damp obstruction type who received treatment in the orthopedics department of Nanyang Central Hospital from September 2021 to July 2023 were selected as the research subjects.The patients were randomly divided into the observation group and the control group according to the random number table method,with 64 cases in each group.Both groups were treated with arthroscopic minimally invasive surgery,the control group was treated with Methotrexate Tablets after operation,and the observation group was treated with Guanjie Kebi Pills after operation.The scores of Hospital for Special Surgery(HSS),World Health Organization Quality of Life-BREF(WHOQOL-BREF),traditional Chinese medicine (TCM) syndromes,microcirculation function indicators [average velocity bloodcell (AVBC), concentration of moving blood cells(CMBC), microvascular blood perfusion (MBP),transcutaneous oxygen pressure (Tcp O2)],and levels of inflammatory factors in serum [interleukin-6 (IL-6)and C-reactive protein(CRP)] before and after treatment, as well as the clinical effects were comparedbetween the two groups. Results:After treatment,the total effective rate was 90.62% in the observationgroup, and 75.00% in the control group, the difference being significant (P<0.05). After treatment, thescores of HSS and WHOQOL-BREF, and the levels of AVBC, CMBC, MBP, and Tcp O2 in the twogroups were increased when compared with those before treatment (P<0.05),and the scores of HSS andWHOQOL-BREF,and microcirculation function indicators in the observation group were higher than thosein the control group (P<0.05). After treatment, the TCM syndrome scores and levels of IL-6 and CRP inserum in the two groups were decreased when compared with those before treatment (P<0.05),and theTCM syndrome score and levels of inflammatory factors in seru

关 键 词：膝骨关节炎 寒湿痹阻型 关节功能 关节克痹丸 关节镜微创术 微循环 炎症因子 

分 类 号：R684.3[医药卫生—骨科学]