加味桂枝芍药知母汤对急性创伤性膝关节滑膜炎患者炎性因子和膝关节症状分级量化的影响  

Effect of Modified Guizhi Shaoyao Zhimu Decoction on Inflammatory Factors and Knee Joint Symptom Grading Quantification in Patients with Acute Traumatic Synovitis of the Knee

作　　者：赵玉石[1] 李守艳 高晶[1] 蔡晓辉[1] Zhao Yushi;Li Shouyan;Gao Jing;Cai Xiaohui(Jiading District Chinese Medicine Hospital,Shanghai 201800,China)

机构地区：[1]上海市嘉定区中医医院,上海201800

出　　处：《中国中医急症》2024年第10期1766-1769,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家卫生健康委员会“十四五”规划重点课题(YYWS3989);上海市嘉定区区科委课题(JDKW-2022-0020)。

摘　　要：目的 观察加味桂枝芍药知母汤口服配合关节穿刺抽液倍他米松、利多卡因关节腔注射对急性创伤性膝关节滑膜炎患者的炎性因子和膝关节肿痛症状改善情况。方法 选70例急性创伤性膝关节滑膜炎患者随机分为两组,治疗组口服加味桂枝芍药知母汤,并配合关节穿刺抽液倍他米松、利多卡因关节腔注射,对照组仅行关节穿刺抽液倍他米松、利多卡因关节腔注射;比较两组患者膝关节肿痛症状及血清炎性因子改善情况。结果 治疗组总有效率为91.43%,高于对照组的74.29%(P <0.05);治疗后两组患者Lysholm膝关节评分及症状分级量化(疼痛、肿胀、活动度、压痛和功能)评分均较治疗前增高(P <0.05),且治疗组高于对照组(P <0.05);两组患者血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均较治疗前下降,但治疗组下降更明显(P <0.05)。结论 加味桂枝芍药知母汤口服,并配合关节穿刺抽吸积液并行倍他米松、利多卡因关节腔注射治疗急性创伤性膝关节滑膜炎可明显减轻膝关节肿痛、改善关节功能,并降低血清中IL-1、IL-6和TNF-α的水平;疗效优于单纯的关节穿刺抽吸积液并行倍他米松、利多卡因关节腔注射。Objective:To observe the effect of oral administration of modified Guizhi Shaoyao Zhimu Decoction combined with intra-articular injection of betamethasone and lidocaine after arthrocentesis on inflammatory factors and improvement of swelling and pain symptoms in patients with acute traumatic synovitis of the knee.Methods:70 patients with acute traumatic synovitis of the knee were randomly divided into two groups.The treatment group received modified Guizhi Shaoyao Zhimu Decoction orally combined with intra-articular injection of betamethasone and lidocaine after arthrocentesis,while the control group only received the intra-articular injection of betametha-sone and lidocaine after arthrocentesis.The improvement in knee joint swelling and pain symptoms and changes in inflammatory factors in the blood were compared between the two groups.Results:The overall effective rate in the treatment group was 91.43%,and 74.29%in the control group,indicating that the treatment group had better efficacy(P<0.05).After treatment,the Lysholm knee scores and symptom grading quantification scores(pain,swelling,range of motion,tenderness,and function)in both groups were higher than before treatment(P<0.05),and the treatment group had higher scores than the control group(P<0.05).The serum levels of IL-1,IL-6,and TNF-αin both groups decreased compared with before treatment,and the decrease was more significant in the treatment group(P<0.05).Conclusion:Oral administration of modified Guizhi Shaoyao Zhimu Decoction com-bined with intra-articular injection of betamethasone and lidocaine after arthrocentesis for acute traumatic synovi-tis of the knee significantly reduces knee swelling and pain,improves joint function,and lowers the levels of IL-1,IL-6,and TNF-αin the serum,which is more effective than intra-articular injection of betamethasone and lido-caine alone after arthrocentesis.

关 键 词：急性创伤性膝关节滑膜炎 炎症因子 膝关节症状分级量化 加味桂枝芍药知母汤 关节穿刺 

分 类 号：R686.7[医药卫生—骨科学]