【摘要】：目的：探討微創(chuàng)針刀鏡治療膝關節(jié)痛風性關節(jié)炎的臨床療效。方法：研究對象選取自2014年6月至2015年12月在廣州中醫(yī)藥大學第一附屬醫(yī)院風濕科病房住院治療的60例膝關節(jié)痛風性關節(jié)炎的患者(均符合診斷標準、納入標準及排除標準),隨機分為兩組,治療組與對照組各30例。其中男性54例,女性6例：年齡26-75歲,平均年齡53.78±12.34歲。對照組口服塞來昔布膠囊、別嘌醇片及碳酸氫鈉片治療,治療組在口服藥物治療基礎上行微創(chuàng)針刀鏡治療,觀察時間為1周。選取治療前、治療后7天時間點上觀察患者VAS評分、膝關節(jié)功能Lysholm評分、血尿酸、C反應蛋白、紅細胞沉降率,對比兩組患者治療前后各項評分、指標的變化,結果采用自身前后對照及組間對照并進行統(tǒng)計學分析結果(SPSS 19.0統(tǒng)計軟件)。成果：根據(jù)VAS評分、Lysholm評分、血尿酸、C反應蛋白、紅細胞沉降率的結果顯示,微創(chuàng)針刀鏡聯(lián)合藥物對比單純藥物治療膝關節(jié)痛風性關節(jié)炎,兩組患者在組內對照、組間對照治療前后VAS評分、C反應蛋白、紅細胞沉降率、Lysholm評分變化差異均有統(tǒng)計學意義(P0.05),組內對照血尿酸在治療前后具有統(tǒng)計學意義(P0.05),組間對照血尿酸在治療前后無統(tǒng)計學意義(P0.05)。術后隨訪結果顯示患者復發(fā)頻率顯示治療組優(yōu)于對照組。結論：微創(chuàng)針刀鏡聯(lián)合藥物和單純藥物治療膝關節(jié)痛風性關節(jié)炎均能緩解患者疼痛、腫脹、改善膝關節(jié)功能及促進急性炎癥指標下降。微創(chuàng)針刀鏡能更快緩解疼痛、促進膝關節(jié)功能改善,有效減低復發(fā)頻率,相比單純藥物治療療效更佳,是一種具有安全、有效、操作簡便、術后功能恢復快等優(yōu)點的治療手段,值得進一步推廣應用。
[Abstract]:Objective: to investigate the clinical effect of minimally invasive needle-knife and endoscope in the treatment of knee joint gouty arthritis. Methods: from June 2014 to December 2015, 60 patients with gouty arthritis of knee joint were treated in the Department of Rheumatology, the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine (all in accordance with diagnostic criteria, inclusion criteria and exclusion criteria). Randomly divided into two groups, treatment group and control group of 30 cases. There were 54 males and 6 females, aged 26 to 75 years, with an average age of 53.78 鹵12.34 years. The control group was treated with celecoxib capsules, allopurinol tablets and sodium bicarbonate tablets. The VAS score, knee function Lysholm score, serum uric acid, C-reactive protein, erythrocyte sedimentation rate were observed before and 7 days after treatment, and the changes of scores and indexes were compared between the two groups before and after treatment. Results the results of statistical analysis were performed with SPSS 19.0 software. Results: according to VAS score, Lysholm score, serum uric acid, C-reactive protein, erythrocyte sedimentation rate, the results showed that the treatment of knee joint gouty arthritis with minimally invasive needle knife and endoscope was more effective than that with drugs alone. There were significant differences in VAS score, C-reactive protein, erythrocyte sedimentation rate and Lysholm score between the two groups before and after treatment (P0.05), while the changes of serum uric acid in the control group were statistically significant before and after treatment (P0.05). There was no significant difference in serum uric acid between groups before and after treatment (P0.05). The results of follow-up showed that the recurrence frequency of the treatment group was better than that of the control group. Conclusion: the combination of minimally invasive needle knife and endoscope and medicine alone can relieve the pain, swelling, improve the function of knee joint and decrease the index of acute inflammation in patients with knee joint gouty arthritis. Minimally invasive needle knife endoscope can relieve pain more quickly, promote knee function improvement, and reduce recurrence rate more effectively. It is a safe, effective, easy to operate and quick functional recovery method compared with drug therapy alone. It is worth further popularizing and applying.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.9

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