摘要
目的:分析益肾荣筋汤辅助胫骨高位截骨治疗内翻型膝骨关节炎的疗效及对患者关节液内细胞因子表达水平的影响。方法:选取90例内翻型膝骨关节炎患者作为观察资料,全部患者均接受胫骨高位截骨术治疗,对照组术后给予常规治疗,观察组术后应用益肾荣筋汤治疗;术后3个月评估两组临床疗效,同时观察术前、术后两组患者临床指标、患膝关节液内细胞因子表达水平的变化情况;随访6个月,观察术前、术后两组患者步态分析指标的变化情况。结果:观察组优良率为97.78%,对照组优良率为91.11%,观察组临床疗效整体水平优于对照组(P<0.05)。术后两组内翻角度、VAS、Lequesne、WOMCA均较术前改善,组内比较差异具有统计学意义;术后观察组VAS、Lequesne、WOMCA均优于对照组,组间比较,差异具有统计学意义。术后两组患者关节液中IL-1、IL-6、IL-17、TNF-α均较术前降低,组内比较差异具有统计学意义;术后观察组各因子均优于对照组,组间比较,差异具有统计学意义。术后随访6个月时两组患者步长、步速、步频、双支撑相均较术前改善,组内比较差异具有统计学意义;术后6个月观察组各项步态指标均优于对照组,组间比较差异具有统计学意义。结论:胫骨高位截骨治疗内翻型膝骨关节炎疗效确切,以益肾荣筋汤辅助治疗后可进一步改善患膝功能、缓解症状,并可有效降低关节液中炎性因子的表达水平,有效控制炎性反应,促进患者术后恢复。
Objective:To analyse the effect of Yishen Rongjin decoction combined with high tibial osteotomy in the treatment of knee osteoarthritis and the expression level of cytokines in articular fluid.Methods:A total of 90 patients with knee osteoarthritis were included.All patients were treated with high tibial osteotomy.The control group received routine therapy after operation,and the observation group was treated with Yishen Rongjin decoction after operation.After 3 months of treatment,the clinical efficacy of the 2 groups was evaluated,meanwhile the clinical indexes and the expression levels of the cytokines in the knee joint were observed before and after operation.After 6 months of treatment,the changes of gait analysis indicators were observed before and after surgery.Results:The excellent and good rate was 97.78%in the observation group,and was 91.11%in the control group.The overall clinical efficacy of the observation group was better than that of the control group(P<0.05).The angle,VAS,Lequesne and WOMCA were significantly improved after 3 months of treatment in the 2 groups(all P<0.05),and the observation group was better than the control group(P<0.05).The level of IL-1,IL-6,IL-17 and TNF-αwere lower after 3 months of treatment in the 2 groups(all P<0.05),and the observation group was better than the control group(P<0.05).The stride length,stride speed,stride frequency and double support phase of the 2 groups were significantly improved after 6 months of treatment(all P<0.05),and the observation group was was better than the control group(P<0.05).Conclusion:Yishen Rongjin decoction combined with high tibial osteotomy is effective in the treatment of knee osteoarthritis.It can improve knee function,relieve symptoms,reduce the expression level of inflammatory factors in joint fluid,control the inflammatory response and promote patients recovered.
作者
关春辉
周占锋
李沛
GUAN Chunhui;ZHOU Zhanfeng;LI Pei(Department of Orthopaedics, The Medical Group of Zhengzhou First People's Hospital(Zhengzhou 450000))
出处
《陕西中医》
2019年第5期616-619,共4页
Shaanxi Journal of Traditional Chinese Medicine
基金
河南省科技攻关项目(123102310440)
