关节镜术后联合中药熏洗治疗创伤性髌骨脱位的疗效观察

发布时间：2018-12-09 16:51

【摘要】：目的:对比研究关节镜术后口服塞来昔布与中药熏洗治疗对创伤性髌骨脱位的临床疗效。方法:将2014年10月-2016年10月共收集的46例病例纳入本研究,按照等比例原则,随机分为两组,观察组23例,对照组23例。观察过程中部分病例脱落,经过筛查,最终总计共40例临床病例,其中观察组20例,采用关节镜术后中药熏洗治疗;对照组20例,采用关节镜术后口服塞来昔布治疗。通过在治疗周期2周、4周、8周对两组患者患膝各项功能恢复的疗效观察,来评价关节镜术后中药熏洗疗法对创伤性髌骨脱位的临床疗效。结果:1.两组患者治疗后的总疗效对比治疗后8周,观察组疗效等级优5例,良7例,可7例,差1例,总有效率95%;对照组疗效等级优2例,良4例,可12例,差2例,总有效率90%。2.两组患者治疗早期疗效对比治疗后2周,两组患者在患膝疼痛、肿胀等方面(P0.05)有显著差异性,具有统计学意义。但在患膝其他功能如下蹲、交锁、爬楼梯等方面(P0.05),两种治疗方法无明显差异。3.两组患者治疗中期疗效对比治疗后4周,两组患者在患膝疼痛、肿胀、爬楼梯等方面(P0.05)有显著差异性,具有统计学意义。但在患膝其他功能如下蹲、交锁、稳定性等方面(P0.05),两种治疗方法无明显差异。4.两组患者治疗前后疗效对比治疗前后8周,同一实验组前后患者患膝疼痛及跛行、疼痛、肿胀、爬楼梯等功能表现(P0.01)方面有着极显著差异性。治疗后8周,两组患者之间相比患膝在跛行、疼痛、肿胀、爬楼梯等方面(P0.05)有显著差异性,具有统计学意义。但在患膝其他功能如下蹲、交锁等方面(P0.05),两种治疗方法无明显差异。5.两组患者治疗前后安全性指标对比观察组和对照组患者在血常规、肝肾功能等常用指标治疗前后相比(P0.05),无显著性差异。结论:1.两组实验所采用的治疗方法对创伤性髌骨脱位术后功能恢复方面都具有较好治疗效果,但观察组治疗效果优于对照组。2.治疗早期,在患膝疼痛改善方面,对照组要优于观察组;在患膝肿胀方面,观察组要优于对照组。在治疗中期,观察组在疼痛、肿胀、爬楼梯等三个方面的治疗效果均优于对照组。而在治疗后期,观察组总体治疗效果要明显高于对照组,尤其在跛行、疼痛、肿胀、爬楼梯等方面,观察组治疗方法明显占优。3.治疗前后,两组患者血常规、肝肾功能等方面未出现明显异常改变。4.综上所述,关节镜术后联合中药熏洗疗法在治疗创伤性髌骨脱位关节镜术肿痛、促进功能恢复方面有着积极地临床价值,且安全性较高,可以在临床治疗中推广应用。
[Abstract]:Objective: to compare the clinical efficacy of oral celecoxib and fumigation with Chinese medicine in the treatment of traumatic patellar dislocation. Methods: 46 cases collected from October 2014 to October 2016 were included in this study. According to the principle of equal proportion, they were randomly divided into two groups: the observation group (n = 23) and the control group (n = 23). During the course of observation, some of the cases fell off, and after screening, a total of 40 clinical cases were selected, of which 20 cases in the observation group were treated with fumigation and washing with Chinese medicine after arthroscopic operation, and 20 cases in the control group were treated with oral celecoxib after arthroscopy. In order to evaluate the clinical effect of fumigation and washing therapy on traumatic dislocation of patella after arthroscopy, the curative effect was observed on the recovery of knee function in the two groups during the treatment period of 2 weeks, 4 weeks and 8 weeks. Results: 1. The total curative effect of the two groups was compared 8 weeks after treatment. In the observation group, the curative effect was excellent in 5 cases, good in 7 cases, fair in 7 cases, poor in 1 case, and the total effective rate was 95%. In the control group, the curative effect was excellent in 2 cases, good in 4 cases, fair in 12 cases and poor in 2 cases. The total effective rate was 90%. 2. Two weeks after treatment, the two groups had significant difference in knee pain and swelling (P0.05). However, other functions of the affected knee are as follows: squatting, locking, climbing stairs and so on (P0.05), there is no significant difference between the two treatment methods. 3. There were significant differences in knee pain swelling and stair climbing between the two groups after 4 weeks of treatment (P0.05). However, other functions of the affected knee are as follows: squatting, locking, stability and so on (P0.05), there is no significant difference between the two treatment methods. 4. Two groups of patients before and after treatment were compared before and after treatment before and after 8 weeks, the same experimental group before and after the patients suffered from knee pain and claudication, pain, swelling, climbing stairs and other functional performance (P0.01) has a very significant difference. At 8 weeks after treatment, there were significant differences between the two groups in claudication, pain, swelling, stair climbing and so on (P0.05). However, other functions of the affected knee are as follows: squatting, locking and so on (P0.05), there is no significant difference between the two treatment methods. 5. 5. Two groups of patients before and after treatment safety index comparison observation group and control group in blood routine liver and kidney function and other commonly used indicators before and after treatment compared (P0.05) there was no significant difference. Conclusion: 1. The treatment methods used in the two groups had a good effect on the functional recovery of traumatic patellar dislocation after operation, but the therapeutic effect of the observation group was better than that of the control group. 2. In the early stage of treatment, the control group was superior to the observation group in improving the pain of the affected knee, and the observation group was superior to the control group in terms of swelling of the affected knee. In the middle stage of treatment, the treatment effect of the observation group was better than that of the control group in pain, swelling and climbing stairs. In the later stage of treatment, the overall therapeutic effect of the observation group was significantly higher than that of the control group, especially in the aspects of claudication, pain, swelling, climbing stairs, etc. The treatment method of the observation group was obviously superior to that of the control group. Before and after treatment, there were no obvious abnormal changes in blood routine, liver and kidney function between the two groups. 4. 4. To sum up, arthroscopy combined with fumigation therapy has positive clinical value in the treatment of swelling and pain of traumatic patellar dislocation and promoting functional recovery, and it is safe and can be popularized and applied in clinical treatment.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9

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