Clinical Observation Of Zhuangjin Yangxue Decoction Combined With Platelet-rich Plasma In The Treatment Of Meniscus Injury After Arthroscopy

Objective:In this paper,by observing the clinical efficacy of Zhuangjin Yangxue Decoction combined with platelet-rich plasma in the treatment of meniscus injury after arthroscopic suture repair,to explore the effectiveness and feasibility of Chinese medicine combined with PRP in the treatment of meniscus injury.Methods:Seventy-one patients with meniscus injury were selected from November 2021 to November 2022,who were diagnosed with meniscus injury and underwent arthroscopic meniscus suture repair in the Department of Sports Medicine,Jiangxi Provincial Hospital of TCM,and met the inclusion criteria.The enrolled patients were randomly divided into control group(group A: arthroscopic meniscus suture repair)24 patients,PRP group(group B: arthroscopic meniscus suture repair +PRP injection)24 patients,and combined treatment group(group C: arthroscopic meniscus suture repair +PRP injection + Chinese medicine Zhuangjin Yangxue Decoction)23patients.Group A: After operation,20% mannitol,ice water mixture external application swelling,rehabilitation training and other basic treatment;Group B: PRP was injected into the joint cavity after operation at the same time as basic treatment.Group C: On the basis of group B,oral administration of Zhuangjin Yangxue Decoction for 4 weeks began from the first day after surgery.The knee swelling data of the three groups were collected before operation,the first day after operation and before treatment,1 week and 2 weeks after operation.The VAS and Lysholm score of the affected knee were collected before operation,1 month and 3 months after operation,and the MRI results before operation and 3 months after operation were collected.The data obtained from the study were statistically analyzed by SPSS26.0 software to evaluate and compare the clinical efficacy of the three treatment methods.Results:(1)There were no significant differences in preoperative general data,VAS score,Lysholm score and degree of joint swelling among the three groups(P > 0.05),indicating comparability.(2)In terms of the degree of postoperative knee swelling: before and after treatment in each group,the swelling of 2cm above the patellar base of the affected knee showed a gradual decline from the first day after surgery to the first week and the second week after surgery,and the difference at different time nodes was statistically significant(P <0.05).Comparison among the three groups of treatment methods: at the 1week postoperative node,the swelling degree of the affected limb in the three groups was different,and the difference between the combination group and the control group,the combination group and the PRP group was significant(P < 0.05),but there was no significant difference between the PRP group and the control group(P = 0.203).Two weeks after surgery,the swelling values of affected limbs between the combined group and PRP group,and between the combined group and control group were statistically significant(P < 0.001),but there was no significant difference between PRP group and control group(P = 0.133).(3)In terms of pain score(VAS): The pain score of affected limb in each group at 1 month and 3 months after surgery was lower than that before surgery,with statistical significance(P < 0.05).Comparison among different treatments: At 1 month after surgery,there was no significant difference in pain between the control group and the PRP group(P = 0.056),nor between the PRP group and the combined treatment group(P = 0.613),while there was a significant and significant difference between the control group and the combined treatment group(P = 0.016).At 3 months after surgery,there were significant differences in pain among the three groups(P < 0.001).(4)In terms of Lysholm of affected knee joint: the functional scores of patients in each group before surgery,1 month after surgery and 3months after surgery showed an increasing trend,and there were significant differences among different nodes(P < 0.05).Comparison of patients among different groups: At 1 month after surgery,there was no significant difference in joint function between control group and PRP group and PRP group and combination group(P > 0.05).However,there was significant difference between the control group and the combination group(P = 0.009).At 3 months after operation,Lysholm scores were significantly different between control group and PRP group,control group and combined treatment group,and PRP group and combined treatment group(P < 0.001).(5)MRI meniscus healing rate 3 months after surgery: The overall healing rate was 62.50% in the control group,79.17% in the PRP group and 82.61%in the combination group.It was found that there were significant differences in meniscus healing rate among the three groups(P = 0.018).The healing rate between control group and PRP group and between control group and combination group was significantly different(P < 0.05),but there was no statistical significance between PRP group and combination group(P = 0.906).Conclusion:(1)After meniscus injury,arthroscopic meniscus suture repair,suture repair +PRP injection and meniscus suture repair + Zhuangjin Yangxue decoction +PRP injection are effective.(2)The combined treatment group containing Zhuangjin Yangxue Decoction is not only superior to the other two groups in improving the clinical symptoms of the affected knee and joint function,but also has accurate,safe and reliable effect,which is worth popularizing and applying.(3)The combination group containing Zhuangjin Yangxue Decoction and PRP group were superior to the control group in promoting injury healing and recovery by meniscus suture.(4)Meniscus suture is less effective than the other two methods in improving symptoms,restoring joint function and healing injury.