目的 观察关节镜下半月板成形术配合活血利水汤内服治疗退行性半月板损伤的临床疗效。方法 将60例退行性半月板损伤患者随机分成对照组和观察组各30例。两组均行关节镜下半月板修整成形术，观察组术后予以活血利水汤中药内服，对照组术后口服塞来昔布胶囊。两组均连续服用14 d，术后随访6个月。观察和比较两组患者治疗前、术后2周、术后6个月西安大略和麦克马斯特大学骨关节炎指数（Western Ontario McMaster University osteoarthritis index，WOMAC）评分、Lequesne MG评分、关节疼痛视觉模拟量表（visual analogue scale，VAS）评分、Lysholm评分、日本矫形外科学会（Japanese Orthopaedic Association，JOA）评分、关节活动度。结果 两组患者治疗后WOMAC评分、VAS评分、Lysholm评分、JOA评分、Lequesne MG评分及关节活动度均较治疗前显著改善，差异有统计学意义（P＜0.05）；术后2周和术后6个月，观察组患者WOMAC评分、VAS评分、Lysholm评分、JOA评分、Lequesne MG评分均较对照组显著改善（P＜0.05）；膝关节活动度在术后2周观察组优于对照组（P＜0.05），术后6个月随访时两组患者膝关节活动的差异无统计学意义（P＞0.05）。结论 半月板成形术是治疗退行性半月板损伤的有效方法，活血利水汤可改善术后膝关节肿痛，促进膝关节术后功能的恢复。
Objective To investigate the clinical effect of arthroscopic meniscus plasty combined with oral administration of Huoxue Lishui Decoction in the treatment of degenerative meniscus injury. Methods A total of 60 patients with degenerative meniscus injury were randomly divided into observation group and control group, with 30 patients in each group. All patients underwent arthroscopic meniscus plasty, and after surgery, the patients in the observation group were given oral administration of Huoxue Lishui Decoction, and those in the control group were given oral administration of celecoxib capsules. The course of treatment was 14 days for both groups. The patients were followed up for 6 months after surgery, and the two groups were compared in terms of Western Ontario McMaster University Osteoarthritis Index (WOMAC) score, Lequesne MG score, Visual Analogue Scale (VAS) score of joint pain, Lysholm score, Japanese Orthopaedic Association (JOA) score, and joint range of motion before treatment and at 2 weeks and 6 months after surgery. Results Both groups had significant improvements in WOMAC score, VAS score, Lysholm score, JOA score, Lequesne MG score, and joint range of motion after treatment (P<0.05). Compared with the control group at 2 weeks and 6 months after surgery, the observation group had significant improvements in WOMAC score, VAS score, Lysholm score, JOA score, and Lequesne MG score (P<0.05). At 2 weeks after surgery, the observation group had significantly better joint range of motion than the control group (P<0.05), while there was no significant difference in joint range of motion between the two groups at 6 months after surgery (P>0.05). Conclusion Meniscus plasty is an effective method for the treatment of degenerative meniscus injury, and Huoxue Lishui Decoction can significantly improve knee joint swelling and pain and promote the recovery of knee joint function after surgery.
王 正,刘安平,梁文武,王 峰,周正新,张建华.半月板成形术配合中药内服治疗退行性半月板损伤近期疗效观察[J].安徽中医药大学学报,2020,39(5):8-11复制