84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]倪力剛,胡勁濤.關(guān)節(jié)鏡清理術(shù)聯(lián)合中藥薰蒸與單純關(guān)節(jié)鏡清理術(shù)治療 早期膝骨關(guān)節(jié)炎的對比研究[J].中醫(yī)正骨,2015,27(12):41-45.
　NI Ligang,HU Jintao.A retrospective trial of arthroscopic debridement integrated and nonintegrated with Chinese herbal steaming for treatment of early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):41-45.
點(diǎn)擊復(fù)制

關(guān)節(jié)鏡清理術(shù)聯(lián)合中藥薰蒸與單純關(guān)節(jié)鏡清理術(shù)治療 早期膝骨關(guān)節(jié)炎的對比研究()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年12期
頁碼:
41-45
欄目:
臨床研究
出版日期:
2015-12-30

文章信息/Info

Title:
A retrospective trial of arthroscopic debridement integrated and nonintegrated with Chinese herbal steaming for treatment of early knee osteoarthritis
作者:
倪力剛1; 胡勁濤2
1.浙江省杭州市余杭區(qū)第五人民醫(yī)院,浙江 杭州 311100;
2.浙江省紹興市柯橋區(qū)中醫(yī)醫(yī)院,浙江 紹興 312030
Author(s):
NI Ligang1; HU Jintao2
1.The Fifth People's Hospital of Yuhang district in Hangzhou City,Hangzhou 311100,Zhejiang,China
2.Keqiao Hospital of Traditional Chinese Medicine in Shaoxing City,Shaoxing 312030,Zhejiang,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  關(guān)節(jié)鏡檢查;  薰洗;  治療; 臨床研究性
Keywords:
osteoarthritis; knee;  arthroscopy;  steaming washing therapy;  therapies; investigational
摘要:
目的:比較關(guān)節(jié)鏡清理術(shù)聯(lián)合中藥薰蒸與單純關(guān)節(jié)鏡清理術(shù)治療早期膝骨關(guān)節(jié)炎的臨床療效。方法:回顧性分析64例早期膝骨關(guān)節(jié)炎患者的病例資料,其中采用單純關(guān)節(jié)鏡清理術(shù)治療35例,采用關(guān)節(jié)鏡清理術(shù)聯(lián)合中藥薰蒸治療29例。男26例,女38例。年齡53～67歲,中位數(shù)59歲。按照骨關(guān)節(jié)炎Kellgren-Lawrence影像學(xué)分級,Ⅰ級22例、Ⅱ級42例。分別比較術(shù)前、術(shù)后6個月及術(shù)后12個月時2組患者的膝關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分、健康調(diào)查簡表(36-item short form health survey,SF-36)評分及Lysholm膝關(guān)節(jié)評分。結(jié)果:手術(shù)前后不同時間點(diǎn)膝關(guān)節(jié)疼痛VAS評分比較,差異有統(tǒng)計學(xué)意義,存在時間效應(yīng)(F=1032.375,P=0.000); 2組患者膝關(guān)節(jié)疼痛VAS評分比較,組間差異有統(tǒng)計學(xué)意義,存在分組效應(yīng)(F=6.772,P=0.012); 術(shù)前2組患者膝關(guān)節(jié)疼痛VAS評分比較,差異無統(tǒng)計學(xué)意義[(8.2±0.8)分,(8.3±0.7)分,t=0.354,P=0.554]; 術(shù)后6個月和術(shù)后12個月,關(guān)節(jié)鏡清理術(shù)聯(lián)合中藥薰蒸組的膝關(guān)節(jié)疼痛VAS評分均低于單純關(guān)節(jié)鏡清理術(shù)組[(1.2±1.0)分,(1.9±1.0)分,t=7.512,P=0.008;(2.0±1.0)分,(2.6±1.0)分,t=4.326,P=0.042]; 時間因素和分組因素存在交互效應(yīng)(F=3.567,P=0.031)。手術(shù)前后不同時間點(diǎn)SF-36評分比較,差異有統(tǒng)計學(xué)意義,存在時間效應(yīng)(F=2501.188,P=0.000); 2組患者SF-36評分比較,組間差異有統(tǒng)計學(xué)意義,存在分組效應(yīng)(F=40.308,P=0.000); 術(shù)前2組患者SF-36評分比較,差異無統(tǒng)計學(xué)意義[(55.5±3.6)分,(56.0±3.7)分,t=0.363,P=0.549]; 術(shù)后6個月和術(shù)后12個月,關(guān)節(jié)鏡清理術(shù)聯(lián)合中藥薰蒸組的SF-36評分均高于單純關(guān)節(jié)鏡清理術(shù)組[(91.7±3.0)分,(87.9±2.9)分,t=25.938,P=0.000;(88.8±2.6)分,(83.7±3.2)分,t=55.254,P=0.000]; 時間因素和分組因素存在交互效應(yīng)(F=9.868,P=0.000)。手術(shù)前后不同時間點(diǎn)Lysholm膝關(guān)節(jié)評分比較,差異有統(tǒng)計學(xué)意義,存在時間效應(yīng)(F=1980.728,P=0.000); 2組患者Lysholm膝關(guān)節(jié)評分比較,組間差異有統(tǒng)計學(xué)意義,存在分組效應(yīng)(F=39.257,P=0.000); 術(shù)前2組患者Lysholm膝關(guān)節(jié)評分比較,差異無統(tǒng)計學(xué)意義[(52.3±3.8)分,(52.3±3.7)分,t=0.004,P=0.950]; 術(shù)后6個月和術(shù)后12個月,關(guān)節(jié)鏡清理術(shù)聯(lián)合中藥薰蒸組的Lysholm膝關(guān)節(jié)評分均高于單純關(guān)節(jié)鏡清理術(shù)組[(90.5±2.8)分,(87.0±3.2)分,t=20.987,P=0.000;(88.5±3.1)分,(82.8±4.3)分,t=35.725,P=0.000]; 時間因素和分組因素存在交互效應(yīng)(F=9.744,P=0.000)。結(jié)論:關(guān)節(jié)鏡清理術(shù)聯(lián)合中藥薰蒸治療早期KOA,能夠緩解或消除膝關(guān)節(jié)疼痛,改善膝關(guān)節(jié)功能,提高患者生活質(zhì)量,其療效優(yōu)于單純關(guān)節(jié)鏡清理術(shù),值得臨床推廣應(yīng)用。
Abstract:
Objective:To compare the clinical curative effects of combination therapy of arthroscopic debridement and Chinese herbal steaming versus monotherapy of arthroscopic debridement in the treatment of early knee osteoarthritis(KOA).Methods:The medical records of 64 patients with early KOA were analyzed retrospectively.Thirty-five patients were treated with monotherapy of arthroscopic debridement(monotherapy group)while the others were treated with combination therapy of arthroscopic debridement and Chinese herbal steaming(combination therapy group).The patients consisted of 26 males and 38 females,and ranged in age from 53 to 67 years(Median=59 yrs).According to Kellgren-Lawrence imaging classification,the KOA belonged to typesⅠ(22)andⅡ(42).The visual analogue scale (VAS)scores,36-item short form health survey(SF-36)scores and Lysholm knee scores were compared between the 2 groups before the surgery and at 6 and 12 months after the surgery respectively.Results:There was statistical difference in the knee pain VAS scores between different time points,in other words,there was time effect(F=1032.375,P=0.000).There was statistical difference in the knee pain VAS scores between the two groups,in other words,there was group effect(F=6.772,P=0.012).There was no statistical difference in preoperative knee pain VAS scores between the 2 groups(8.2+/-0.8 vs 8.3+/-0.7 points,t=0.354,P=0.554).The knee pain VAS scores were lower in combination therapy group compared to monotherapy group at 6 and 12 months after the surgery(1.2+/-1.0 vs 1.9+/-1.0 points,t=7.512,P=0.008; 2.0+/-1.0 vs 2.6+/-1.0 points,t=4.326,P=0.042).There was interaction between time factor and group factor(F=3.567,P=0.031).There was statistical difference in the SF-36 scores between different time points,in other words,there was time effect(F=2501.188,P=0.000).There was statistical difference in the SF-36 scores between the two groups,in other words,there was group effect(F=40.308,P=0.000).There was no statistical difference in preoperative SF-36 scores between the 2 groups(55.5+/-3.6 vs 56.0+/-3.7 points,t=0.363,P=0.549).The SF-36 scores were higher in combination therapy group compared to monotherapy group at 6 and 12 months after the surgery(91.7+/-3.0 vs 87.9+/-2.9 points,t=25.938,P=0.000; 88.8±2.6 vs 83.7±3.2 points,t=55.254,P=0.000).There was interaction between time factor and group factor(F=9.868,P=0.000).There was statistical difference in the Lysholm knee scores between different time points,in other words,there was time effect(F=1980.728,P=0.000).There was statistical difference in the Lysholm knee scores between the two groups,in other words,there was group effect(F=39.257,P=0.000).There was no statistical difference in preoperative Lysholm knee scores between the 2 groups(52.3+/-3.8 vs 52.3+/-3.7 points,t=0.004,P=0.950).The Lysholm knee scores were higher in combination therapy group compared to monotherapy group at 6 and 12 months after the surgery(90.5+/-2.8 vs 87.0+/-3.2 points,t=20.987,P=0.000; 88.5+/-3.1 vs 82.8+/-4.3 points,t=35.725,P=0.000).There was interaction between time factor and group factor(F=9.744,P=0.000).Conclusion:The combination therapy of arthroscopic debridement and Chinese herbal steaming can relieve or eliminate the knee pain and improve the knee function and the quality of live of patients with early KOA,and it surpasses the monotherapy of arthroscopic debridement in curative effect,so it is worthy of popularizing in clinic.

參考文獻(xiàn)/References:

[1] Ibarra CJ,Cabrales M,Crisótomo JF,et al.Resultados obtenidos obtenidos con la limpieza articular de rodilla en pacientes con osteoarthritis[J].Acta Ortop Mex,2009,23(2):85-89.
[2] Kellgren JH,Lawrence JS.Radiological assesment of osteoarthritis[J].Ann Rheum Dis,1957,16(4):494-502.
[3] 中華醫(yī)學(xué)會骨科學(xué)分會.骨關(guān)節(jié)炎診治指南(2007年版)[J].中國矯形外科雜志,2014,27(3):287-288.
[4] 蔣協(xié)遠(yuǎn),王大偉.骨科臨床療效評價標(biāo)準(zhǔn)[M].北京:人民衛(wèi)生出版社,2005:123-124.
[5] Ware JE,Gandek B.Overview of the SF-36 health survey and the international quality of Life assessment(IQOLA)project[J].J Clin Epidemiol,1998,51(11):903-912.
[6] Lysholm J,Gillquist J.Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale[J].Am J Sports Med,1982,10(3):150-154.
[7] Bohnsack M,LipkaW,Rǜhmann O,et al.The value of knee arthroscopy in patients with severe radiological osteoarthritis[J].Arch Orthop Trauma Surg,2002,122(8):451-453.
[8] Swank AM,Kachelman JB,Bibeau W,et al.Prehabilitation before total knee arthroplasty increases strength and function in older adults with severe osteoarthritis[J].J Strength Cond Res,2011,25(2):318-325.
[9] Pisters MF,Veenhof C,Schellevis FG,et al.Long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee:a randomized controlled trial comparing two different physical therapy interventions[J].Osteoarthritis and Cartilage,2010,18(8):1019-1026.
[10] Bernard J,Lemon M,Patterson MH.Arthroscopic washout of the knee -a 5-year survival analysis[J].Knee,2004,11(3):233-235.
[11] Figueroa D,Calvo R,Villalon IE,et al.Clinical outcomes after arthroscopic treatment of knee osteoarthritis[J].Knee,2013,20(6):591-594.
[12] Dearing J,Nutton RW.Evidence based factors influencing outcome of arthroscopy in osteoarthritis of the knee[J].Knee,2008,15(3):159-163.
[13] 蔣堯傳,蔣就喜,唐志宏,等.膝骨性關(guān)節(jié)炎的關(guān)節(jié)鏡手術(shù)治療[J].中國骨與關(guān)節(jié)損傷雜志,2010,25(3):259-260.
[14] 馮歡歡,王培民,范競,等.膝骨關(guān)節(jié)炎X線表現(xiàn)與膝關(guān)節(jié)疼痛程度的相關(guān)性分析[J].中醫(yī)正骨,2013,25(6):29-30.
[15] 譚福柱,張樂鑫,任樹軍.針刺配合口服骨力膠囊治療膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2015,27(1):20-22, 26.
[16] 佘明明.中藥外洗結(jié)合功能鍛煉治療骨性關(guān)節(jié)炎80例[J].長春中醫(yī)藥大學(xué)學(xué)報,2009,25(1):102-103.
[17] 黃崇博.中藥外洗外敷治療膝骨性關(guān)節(jié)炎60例臨床觀察[J].中藥材,2009,32(4):651-652.
[18] 蒙劍德,夏賢生,趙小泉,等.功能鍛煉聯(lián)合中藥薰蒸在膝關(guān)節(jié)半月板損傷關(guān)節(jié)鏡下成形術(shù)后康復(fù)治療中的應(yīng)用[J].中醫(yī)正骨,2015,27(6):37-38.

相似文獻(xiàn)/References:

[1]樊慶陽,任凱晶.定制3D打印切模輔助全膝關(guān)節(jié)置換術(shù)治療 膝骨關(guān)節(jié)炎合并股骨干骨折畸形愈合[J].中醫(yī)正骨,2015,27(11):37.
[2]劉曉雅,孫永強(qiáng),劉國杰.主動快速康復(fù)鍛煉對全膝關(guān)節(jié)置換術(shù)后關(guān)節(jié)活動度的影響[J].中醫(yī)正骨,2015,27(09):73.
[3]鄭春松,葉蕻芝,李西海,等.透骨消痛膠囊中補(bǔ)腎柔肝藥和活血祛風(fēng)藥治療 骨關(guān)節(jié)炎作用方式的計算機(jī)模擬比較[J].中醫(yī)正骨,2015,27(07):6.
　ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Comparison of the mode of action of Bushen Rougan(補(bǔ)腎柔肝)drugs versus Huoxue Qufeng(活血祛風(fēng))drugs contained in Tougu Xiaotong Jiaonang(透骨消痛膠囊)for the treatment of osteoarthritis:A computer simulation study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):6.
[4]宋兵華,孫俊英,倪增良,等.全膝關(guān)節(jié)置換術(shù)前CT測量股骨后髁角的臨床意義[J].中醫(yī)正骨,2015,27(07):38.
[5]鄭春松,葉蕻芝,李西海,等.獨(dú)活寄生湯含藥血清對白細(xì)胞介素1β誘導(dǎo)的 退變關(guān)節(jié)軟骨細(xì)胞中基質(zhì)金屬蛋白酶 和環(huán)氧化酶2表達(dá)的影響[J].中醫(yī)正骨,2015,27(12):1.
　ZHENG Chunsong,YE Hongzhi,LI Xihai,et al.Impact of Duhuo Jisheng Tang(獨(dú)活寄生湯)medicated serum on expression of matrix metalloproteinase and cyclooxygenase 2 in degenerative articular chondrocytes induced by interleukin-1 beta[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):1.
[6]王金良,孫京濤,李玲,等.骨水泥聯(lián)合螺釘修復(fù)全膝關(guān)節(jié)置換術(shù)中 脛骨平臺內(nèi)側(cè)骨缺損[J].中醫(yī)正骨,2015,27(12):55.
[7]馮榮,王平,李炳奇,等.鈹針刺絡(luò)拔罐結(jié)合中藥口服治療膝骨關(guān)節(jié)炎合并 原發(fā)性血小板增多癥1例[J].中醫(yī)正骨,2015,27(12):73.
[8]蔡云仙.圍手術(shù)期耳穴按壓聯(lián)合平衡針療法 在全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛中的應(yīng)用[J].中醫(yī)正骨,2015,27(06):41.
[9]張榮,王健.人工全膝關(guān)節(jié)置換術(shù)的圍手術(shù)期心理護(hù)理[J].中醫(yī)正骨,2015,27(05):77.
[10]喻長純,楊明路,王戰(zhàn)朝.不同手術(shù)方式治療脛骨平臺骨折畸形愈合的體會[J].中醫(yī)正骨,2015,27(03):37.
[11]孟維娜,明立功,王新德,等.關(guān)節(jié)鏡下清理聯(lián)合腓骨近1/3段截骨治療膝骨關(guān)節(jié)炎[J].中醫(yī)正骨,2015,27(11):40.
[12]明立功,孟維娜,王新德,等.腓骨近端截骨治療內(nèi)側(cè)間室膝骨關(guān)節(jié)炎的近期療效觀察[J].中醫(yī)正骨,2015,27(10):25.
[13]張杰,王人彥,張玉柱.膝骨關(guān)節(jié)炎的治療進(jìn)展[J].中醫(yī)正骨,2015,27(10):68.
[14]梁朝,蔡靜怡,閆立,等.針刀療法改善膝骨關(guān)節(jié)炎早期疼痛癥狀的療效評價[J].中醫(yī)正骨,2015,27(09):9.
　LIANG Zhao,CAI Jingyi,YAN Li,et al.Evaluation of the curative effect of needle-knife therapy for relieving knee pain in patients with early knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):9.
[15]王建武,黨建軍,李強(qiáng),等.四聯(lián)療法治療膝骨關(guān)節(jié)炎[J].中醫(yī)正骨,2015,27(08):44.
[16]劉紅娟,郭會利,郭樹農(nóng).云克聯(lián)合中藥治療膝骨關(guān)節(jié)炎的護(hù)理[J].中醫(yī)正骨,2015,27(08):75.
[17]陳衛(wèi)衡.探索建立系統(tǒng)的膝骨關(guān)節(jié)炎中醫(yī)臨床科研范式 和理論體系[J].中醫(yī)正骨,2015,27(07):1.
[18]帥波,沈霖,楊艷萍,等.加味青娥丸治療膝骨關(guān)節(jié)炎的作用機(jī)制研究[J].中醫(yī)正骨,2015,27(07):15.
　SHUAI Bo,SHEN Lin,YANG Yanping,et al.Study on the mechanism of action of Jiawei Qing'e Wan(加味青娥丸)for the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):15.
[19]梅其杰,袁長深,段戡,等.壯藥骨痹方燙熨聯(lián)合運(yùn)動療法治療膝骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2015,27(07):27.
　MEI Qijie,YUAN Changshen,DUAN Kan,et al.Clinical study of the curative effect of hot compressing and rubbing with packet of Gubi Fang(骨痹方)combined with exercise therapy in the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):27.
[20]王丹輝,張燕,劉麗娟,等.重組人Ⅱ型腫瘤壞死因子受體-抗體融合蛋白 關(guān)節(jié)腔注射聯(lián)合中藥薰洗治療膝骨關(guān)節(jié)炎的臨床研究[J].中醫(yī)正骨,2015,27(07):31.
　WANG Danhui,ZHANG Yan,LIU Lijuan,et al.Clinical study on intra-articular injection of TypeⅡrecombinant human tumor necrosis factor receptor-Fc fusion protein combined with Chinese herbal steaming and washing therapy for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):31.

備注/Memo

備注/Memo:
2015-10-07收稿 2015-11-18修回
通訊作者:倪力剛 E-mail:[email protected]
更新日期/Last Update: 2015-12-30