赤木洗剂熏洗联合PRP关节腔注射治疗中老年膝骨性关节炎的临床观察

发布时间：2018-01-03 16:38

本文关键词：赤木洗剂熏洗联合PRP关节腔注射治疗中老年膝骨性关节炎的临床观察　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察赤木洗剂熏洗联合PRP关节腔注射对膝骨性关节炎的临床疗效,探讨二者的协同作用,探索治疗KOA的新方法。收集2016年1月至2016年8月山东文登整骨医院就诊骨关节科的65例膝骨性关节炎患者,采用前瞻性临床对照对65例膝骨性关节炎病例进行研究。根据病例选择标准分为赤木洗剂熏洗联合PRP关节腔注射组(实验组33例)和PRP关节腔注射组(对照组32例)。干预方法:实验组与对照组均予两个疗程共10次PRP关节腔注射治疗,两个疗程间隔1个月。每个疗程5针,1针/3天。实验组分别在两个PRP注射疗程结束后第3天起予赤木洗剂患膝关节熏洗,连续3周。对照组不予赤木洗剂熏洗。观察实验组和对照组两组患者膝关节疼痛程度及关节功能变化,以VAS疼痛评分及WOMAC膝关节功能评分对两组患者膝关节疼痛程度及关节功能进行评分并记录,抽取关节液测定IL-1、TNF-α含量并记录。研究观察点设置在治疗前、两个疗程治疗结束后的三个月以及六个月。结果:①对两组患者的一般情况、膝关节的疼痛程度和功能评分及IL-1、TNF-α含量进行统计分析无显著差异,有可比性;②两个疗程治疗结束后三个月及六个月,实验组与对照组的VAS疼痛评分及WOMAC关节功能评分均较治疗前减少,关节液中IL-1、TNF-α含量均减少,差异有统计学意义(P0.05),说明两组治疗都有效果;③两个疗程治疗结束后三个月及六个月,实验组与对照组比较,实验组VAS疼痛评分及WOMAC关节功能评分均较对照组减少,组间差异有统计学意义(P0.05),说明实验组的疗效好于对照组;④两个疗程治疗结束后三个月,两组患者IL-1、TNF-α含量比较,组间无统计学差异,治疗结束后六个月,实验组患者IL-1、TNF-α含量比对照组低,差异有统计学意义(P0.05),说明实验组相对对照组疗效更稳定。结论:实验组治疗KOA的疗效优于对照组,在疗程结束后三个月及六个月实验组患者症状及关节功能较对照组显现出更大的改善,实验组在疗程结束六个月时IL-1、TNF-α含量比对照组低。证实了赤木洗剂熏洗联合PRP关节腔注射治疗膝骨性关节炎的协同作用,二者结合能在早期更大的改善临床症状、膝关节功能,而且作用持久,不良反应发生率低,操作简单,适合临床开展。
[Abstract]:Objective: to observe the clinical effect of Chimu lotion combined with PRP injection in the treatment of knee osteoarthritis and to explore the synergistic effect of the two. From January 2016 to August 2016, 65 patients with knee osteoarthritis in Department of Orthopaedics and Arthritis, Shandong Wenden whole Bone Hospital, were collected. A prospective clinical control study of 65 cases of knee osteoarthritis was carried out. According to the criteria of case selection, the patients were divided into two groups (33 cases in the experimental group) treated by fumigation with Chimu lotion and PRP intraarticular injection (n = 33). Intervention method: both experimental group and control group were treated with PRP injection for 10 times. The interval between the two courses was one month. The experimental group was given fumigation of the knee joint with Chimu lotion from the third day after the end of the two PRP injection courses. For 3 weeks, the patients in the control group were not fumigated with Chimu lotion. The degree of knee joint pain and the function of the joint were observed in the experimental group and the control group. VAS pain score and WOMAC knee joint function score were used to score and record the degree of knee joint pain and joint function in both groups. IL-1 was measured in articular fluid. The observation point was set before treatment, three months after two courses of treatment and six months after treatment. There was no significant difference in pain degree and function score and IL-1TNF- 伪 content in knee joint. 2Three months and six months after the two courses of treatment, the VAS pain score and WOMAC joint function score of the experimental group and the control group were lower than those of the control group. IL-1 in the articular fluid was decreased. The content of TNF- 伪 decreased, and the difference was statistically significant (P 0.05). 3Three months and six months after two courses of treatment, the VAS pain score and WOMAC joint function score in the experimental group were lower than those in the control group. The difference between the two groups was statistically significant (P 0.05), which indicated that the effect of the experimental group was better than that of the control group. 4 three months after the two courses of treatment, the two groups of patients with IL-1TNF- 伪 content comparison, there is no statistical difference between the group, six months after the end of treatment, patients in the experimental group IL-1. The content of TNF- 伪 was lower than that of the control group, and the difference was statistically significant (P 0.05), which indicated that the curative effect of the experimental group was more stable than that of the control group. Conclusion: the therapeutic effect of the experimental group is better than that of the control group. The symptoms and joint function of the patients in the experimental group showed greater improvement than that in the control group three and six months after the end of the course of treatment, and IL-1 was found in the experimental group at the end of the treatment period of six months. The content of TNF- 伪 was lower than that of the control group, which confirmed the synergistic effect of Chimu lotion combined with PRP injection in the treatment of knee osteoarthritis. The combination of TNF- 伪 and TNF- 伪 could improve the clinical symptoms and function of knee joint in the early stage. And the effect is long, the adverse reaction rate is low, the operation is simple, suitable for clinical development.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R684.3

【参考文献】