| Objective(1)To evaluate the clinical efficacy of knee arthroscopic debridement combined with traditional Chinese medicine(Xiaoyu san,? ? ?)in the treatment of early and middle stage KOA patients,Discuss to investigate the correlation between IL-1,CTXII and knee joint degeneration in patients with early and middle stage KOA.(2)To clarify the clinical effect,function characteristics and advantage of external application of traditional Chinese medicine(Xiaoyu san)in treating early and middle stage KOA,To explore the clinical,reasonable,safe and effective treatment of early and middle stage KOA.Method All Patients were hospitalized in the First Affiliated Hospital of Anhui University of traditional Chinese medicine,The method is clinical observation,According to the inclusion criteria and exclusion criteria,A total of 40 cases were selected,Randomly divided into experimental group 20 cases and control group 20 cases,In addition to arthroscopic debridement,the experimental group was treated with traditional Chinese medicine,once a day and for three weeks.The control group received arthroscopic debridement and related treatment.The experimental group and the control group should extract the joint fluid according to the principle of aseptic operation before the application of antibiotics,VAS score and Lequesne index of knee joint were recorded,After 3 months of follow-up,the indexes of joint fluid were recorded and the VAS score was recorded and the Lequesne index was evaluated.Result(1)VAS Pain score After 1 weeks of treatment,the experimental group VAS Pain score(3.30±0.45)was significantly reduced compared with before treatment(P<0.05);Compared with before treatment,after 4 weeks of treatment,the experimental group VAS Pain score(2.84±0.84)was significantly reduced(P<0.01),the control group VAS Pain score(4.82±0.43)decreased(P<0.05);The experimental group after 1 weeks of treatment VAS Pain score(3.30±0.45)and after 4 weeks of treatment,the VAS Pain score(2.84±0.84)the difference was statistically significant(P<0.05);group VAS Pain score test after 3 months of follow-up(2.0±0.78)was significantly reduced than before treatment(P<0.01),the control group VAS Pain score(3.6±1.45)less than before treatment(P<0.05).That arthroscopic debridement combined Xiaoyu san external treatment can significantly reduce the Pain of Patients with KOA,the longer the course,the symptoms are obviously improved,and has a long-term effect.(2)Lequesne index After 1 weeks of treatment,the test group Lequesne index(8.61±3.05)than before treatment(11.48±0.49)decreased,the difference was statistically significant(P<0.01);The experimental group after 4 weeks of treatment,the Lequesne index(3.23±1.92)before and after treatment(11.48±0.49)was significantly lower(P<0.01);the experimental group after 1 weeks of treatment,the Lequesne index(8.61±3.05)after 4weeks of treatment and(3.23±1.92),the difference was statistically significant(P<0.05);The control group after 1 weeks of treatment,the Lequesne index(10.88±2.65)and 4 weeks(8.68±2.17),the difference was statistically significant(P<0.05);After 3 months of follow-up,the experimental group Lequesne index(2.7±0.38)and treatment group(5.6±0.36)compared with that before treatment,there was statistically significant(P<0.01).By arthroscopic debridement combined Xiaoyu san external treatment can improve KOA Patients with osteoarthritis of the strict activity,improve the life quality of Patients,and long-term effect is significant.(3)The concentration of IL-1 in knee joint fluid After 1 weeks of treatment,the concentration of IL-1 in knee joint fluid in the test group(772.35±92.38)and control group(824.87±72.87)was significantly reduced (P<0.01).Compared with before treatment,the concentration of IL-1 in knee joint fluid after 4 weeks of treatment in the test group(390.71±168.12)and control group(432.42±156.72)was significantly reduced(P<0.01);test after 1 weeks of treatment(772.35±92.38)after 4 weeks of treatment with IL-1 in knee joint fluid concentration(390.71±168.12)comparison,the difference was statistically significant(P<0.01);Compared with before treatment,the concentration of IL-1 in knee joint fluid test group after 3 months of follow-up(290.72±220.02)the difference was statistically significant(P<0.01).That arthroscopic debridement combined Xiaoyu san external treatment of KOA clinical symptoms were improved,and has long-term curative effect,long-term efficacy of test group than in the control group has certain advantages.(4)The concentration of CTX-II in knee joint fluid After 1 weeks of treatment,CTX-II concentration of knee joint fluid in test group(287.15±21.32)than before treatment(388.65±20.93)was significantly reduced(P<0.05);Compared with before treatment,after 4 weeks after treatment,CTX-II concentration of knee joint fluid in test group(218.72±35.24)was significantly reduced(P<0.01);experimental group CTX-II concentration after knee joint fluid in 1weeks(287.15±21.32)after 4 weeks of treatment and(218.72±35.24)difference statistical significance(P<0.05);CTX-II concentration group in knee joint fluid test after 3 months of follow-up(164.72±30.02)was significantly reduced than before treatment(P<0.01).The experimental group after arthroscopic debridement combined Xiaoyusan external treatment can significantly improve the clinical symptoms of Patients with KOA,and the long-term curative effect is obvious,but the long-term effect is not obvious in the control group.Conclusion(1)Arthroscopic debridement for early and mid stage KOA;(2)Arthroscopic debridement combined with traditional Chinese medicine(Xiaoyu san)in the treatment of early,mid-term KOA curative effect is accurate,and is better than the simple arthroscopic debridement;(3)The contents of IL-1,CTX-II in knee joint fluid of Patients with early and middle stage KOA were correlated with knee joint degeneration.Controlled clinical study,In the study,we obtained the clinical curative effect and characteristic of arthroscopic debridement combined with external application of Xiaoyu san in the early and middle stage of KOA,It Provides a reasonable and effective treatment for clinical application. |
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