【摘要】 目的 观察体外冲击波联合滑膜炎颗粒对治疗膝关节镜术后关节功能的临床效果。方法 选取石家庄市中医院骨科2023年1月至2024年1月收治的行单侧膝关节镜手术的KOA患者76例，采用随机数字表法将其分为对照组（38例）和治疗组（38例）。对照组术后第1天起给予滑膜炎颗粒口服，治疗组在对照组基础上加用体外冲击波治疗，两组均治疗14 d。比较两组治疗前后视觉模拟评分法（VAS）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、Lequesne指数评分、膝关节肿胀程度、血清炎症因子指标[白细胞介素（IL）-1β、IL-6、C反应蛋白（CRP）]、膝关节主动活动度及伸膝、屈膝肌群峰力矩（PT）；观察治疗过程中不良反应的发生情况。结果 治疗后，两组VAS评分、WOMAC评分、Lequesne指数评分均低于治疗前，且治疗组低于对照组（P<0.05）。治疗后，两组患膝关节肿胀程度均低于治疗前（P<0.05）；两组患膝关节肿胀程度比较，差异无统计学意义（P>0.05）。治疗后，两组IL-1β、IL-6、CRP水平均低于治疗前（P<0.05）；两组IL-1β、IL-6、CRP水平比较，差异无统计学意义（P>0.05）。治疗后，两组屈膝活动度均高于治疗前，且治疗组高于对照组（P<0.05）；两组伸膝活动度组内及组间比较，差异无统计学意义（P>0.05）。治疗后，两组伸膝、屈膝肌群PT值高于治疗前，且治疗组高于对照组（P<0.05）。两组治疗过程中安全性指标均未出现异常。结论 体外冲击波治疗联合滑膜炎颗粒治疗膝关节镜术后患者可明显缓解疼痛、改善关节功能，其作用可能与抑制患者血清炎症反应、改善膝关节局部肌肉功能有关。更多还原

【Abstract】 Objective To observe the clinical efficacy of extracorporeal shock wave therapy combined with Synovitis Granules on joint function after knee arthroscopy. Methods A total of 76 patients with knee osteoarthritis who underwent unilateral knee arthroscopic surgery were selected from the Department of Orthopedics of Shijiazhuang Traditional Chinese Medicine Hospital from January 2023 to January 2024. They were divided into control group(38 cases) and treatment group(38 cases) by random number table method. The control group was given oral treatment of Synovitis Granules on the first day after surgery, and the treatment group was given extracorporeal shock wave therapy on the basis of control group, both groups were treated for 14 days. Visual analogue scale(VAS) score, Western Ontario and McM aster University osteoarthritis index(WOMAC) score, Lequesne index score, knee swelling degree, serum inflammatory factors [interleukin(IL)-1β, IL-6,C-reactive protein(CRP)], active knee activity, and peaktorque(PT) of knee extension and knee bend muscle were compared between two groups before and after treatment; the occurrence of adverse reactions during treatment was observed. Results After treatment, VAS score, WOMAC score, and Lequesne index score of both groups were lower than before treatment, and treatment group was lower than control group(P<0.05). After treatment, the knee swelling degree in both groups was lower than before treatment(P<0.05); while there was no significant difference in knee swelling degree between two groups(P>0.05). After treatment, the levels of IL-1β, IL-6, and CRP in both groups were lower than before treatment(P<0.05); while there were no significant difference in IL-1β, IL-6, and CRP levels between two groups(P>0.05). After treatment, the knee bend activity of both groups was higher than before treatment, and treatment group was higher than control group(P<0.05);there was no significant difference in knee extension activity between two groups(P>0.05). After treatment, the PT value of knee extension and knee bend muscles in two groups was higher than before treatment, and treatment group was higher than control group(P <0.05). There were no abnormal safety indexes in the two groups during treatment. Conclusion Extracorporeal shock wave therapy combined with Synovitis Granules can significantly relieve pain and improve joint function in patients after knee arthroscopic surgery, which may be related to inhibiting serum inflammatory response and improving local muscle function of knee joint.更多还原