【摘要】 目的:探讨膝关节镜清理术联合中药离子导入治疗膝骨性关节炎的疗效及作用机制。方法:选取在2013年1月至2015年3月收治的60例膝骨性关节炎患者,按照治疗方式将患者随机分成两组,对照组(30例)予以膝关节镜清理术治疗,观察组(30例)予以膝关节镜清理术联合中药离子导入治疗。采用VSA疼痛评分及Lysholm膝关节功能评分标准,评定患者的临床治疗疗效及止痛效果;采用酶联免疫吸附法检测两组患者术前、术后关节液中金属基质蛋白酶-13(MMP-13)及白介素-1(IL-1)、肿瘤坏死因子-ɑ(TNF-ɑ)、转化生长因子-β(TGF-β)表达情况。结果:两组患者在治疗1个月后VSA疼痛评分比较差异无统计学意义(P>0.05),治疗6个月及12个月后观察组患者VSA疼痛评分明显低于对照组,差异有统计学意义(P<0.05);治疗后每个阶段观察组患者Lsholm膝关节功能评分均高于对照组,差异有统计学意义(P<0.05);两组患者治疗前、后MMP-13蛋白表达水平差异无统计学意义(P>0.05);两组患者在治疗前IL-1、TNF-ɑ表达水平比较差异无统计学意义(P>0.05),治疗后两组患者IL-1及TNF-ɑ表达水平均下降,但观察组IL-1及TNF-ɑ下降程度高于对照组,差异有统计学意义(P<0.05),观察组治疗前后组间比较均差异有统计学意义(P<0.05);治疗前TGF-β表达水平比较差异无统计学意义(P>0.05),治疗后两组患者TGF-β表达水平均上升,观察组患者上升程度高于对照组,差异有统计学意义(P<0.05),两组患者组间比较均差异有统计学意义(P<0.05)。结论:膝关节镜清理术联合中药离子导入治疗止痛效果明显优于单用膝关节镜清理术,并且联合治疗能快速调节患者体内炎症因子失衡情况,促进细胞正常增值与分化。更多还原

【Abstract】 Objective:To investigate the effect and mechanism of arthroscopic debridement combined with traditional Chinese medicine iontophoresis in the treatment of knee osteoarthritis.Methods:60cases with knee osteoarthritis in our hospital from January 2013 to March 2015 were randomly divided into control group and observation group,30 cases in each group.The control group was treated with arthroscopic debridement,while the observation group was treated with arthroscopic debridement combined with traditional Chinese medicine iontophoresis.VSA score and Lysholm knee function score were used to evaluate the clinic and analgesic effect.The expression of MMP13,IL-1,TNF-ɑand TGF-βin synovial fluid of two groups were detected before and after surgery.Results:After 1month of treatment,the VSA score of two groups had no significant difference(P>0.05),and the VSA score of the observation group was significantly lower than that of the control group(P<0.05)after treatment for 6months and 12 months.Lsholm knee function score of the observation group was higher than that in the control group at every stage after treatment(P<0.05).There was no difference in theexpression of MMP13 protein between the two groups before and after treatment(P >0.05).There was no difference before treatment in the expression of IL-1and TNF-ɑproteinbetween the two groups(P>0.05);IL-1,TNF-ɑexpression level were decreased after treatment in two groups,but it decreased more in the observation group(P<0.05),and there was difference before and after treatment in two groups(P<0.05).The expression level of TGF-βbetween two groups had no significant difference before treatment(P<0.05),and it increased in the two groups after treatment;the rise of the observation group was higher than that of the control group(P<0.05).Conclusion:Arthroscopic debridement combined with traditional Chinese medicine iontophoresis is better than the single use of arthroscopic debridement,and combined treatment can quickly adjust the patient the imbalance of inflammatory cytokines,promote normal cell proliferation and differentiation.更多还原