【摘要】：目的:對(duì)比研究關(guān)節(jié)鏡術(shù)后口服塞來(lái)昔布與中藥熏洗治療對(duì)創(chuàng)傷性髕骨脫位的臨床療效。方法:將2014年10月-2016年10月共收集的46例病例納入本研究,按照等比例原則,隨機(jī)分為兩組,觀察組23例,對(duì)照組23例。觀察過(guò)程中部分病例脫落,經(jīng)過(guò)篩查,最終總計(jì)共40例臨床病例,其中觀察組20例,采用關(guān)節(jié)鏡術(shù)后中藥熏洗治療;對(duì)照組20例,采用關(guān)節(jié)鏡術(shù)后口服塞來(lái)昔布治療。通過(guò)在治療周期2周、4周、8周對(duì)兩組患者患膝各項(xiàng)功能恢復(fù)的療效觀察,來(lái)評(píng)價(jià)關(guān)節(jié)鏡術(shù)后中藥熏洗療法對(duì)創(chuàng)傷性髕骨脫位的臨床療效。結(jié)果:1.兩組患者治療后的總療效對(duì)比治療后8周,觀察組療效等級(jí)優(yōu)5例,良7例,可7例,差1例,總有效率95%;對(duì)照組療效等級(jí)優(yōu)2例,良4例,可12例,差2例,總有效率90%。2.兩組患者治療早期療效對(duì)比治療后2周,兩組患者在患膝疼痛、腫脹等方面(P0.05)有顯著差異性,具有統(tǒng)計(jì)學(xué)意義。但在患膝其他功能如下蹲、交鎖、爬樓梯等方面(P0.05),兩種治療方法無(wú)明顯差異。3.兩組患者治療中期療效對(duì)比治療后4周,兩組患者在患膝疼痛、腫脹、爬樓梯等方面(P0.05)有顯著差異性,具有統(tǒng)計(jì)學(xué)意義。但在患膝其他功能如下蹲、交鎖、穩(wěn)定性等方面(P0.05),兩種治療方法無(wú)明顯差異。4.兩組患者治療前后療效對(duì)比治療前后8周,同一實(shí)驗(yàn)組前后患者患膝疼痛及跛行、疼痛、腫脹、爬樓梯等功能表現(xiàn)(P0.01)方面有著極顯著差異性。治療后8周,兩組患者之間相比患膝在跛行、疼痛、腫脹、爬樓梯等方面(P0.05)有顯著差異性,具有統(tǒng)計(jì)學(xué)意義。但在患膝其他功能如下蹲、交鎖等方面(P0.05),兩種治療方法無(wú)明顯差異。5.兩組患者治療前后安全性指標(biāo)對(duì)比觀察組和對(duì)照組患者在血常規(guī)、肝腎功能等常用指標(biāo)治療前后相比(P0.05),無(wú)顯著性差異。結(jié)論:1.兩組實(shí)驗(yàn)所采用的治療方法對(duì)創(chuàng)傷性髕骨脫位術(shù)后功能恢復(fù)方面都具有較好治療效果,但觀察組治療效果優(yōu)于對(duì)照組。2.治療早期,在患膝疼痛改善方面,對(duì)照組要優(yōu)于觀察組;在患膝腫脹方面,觀察組要優(yōu)于對(duì)照組。在治療中期,觀察組在疼痛、腫脹、爬樓梯等三個(gè)方面的治療效果均優(yōu)于對(duì)照組。而在治療后期,觀察組總體治療效果要明顯高于對(duì)照組,尤其在跛行、疼痛、腫脹、爬樓梯等方面,觀察組治療方法明顯占優(yōu)。3.治療前后,兩組患者血常規(guī)、肝腎功能等方面未出現(xiàn)明顯異常改變。4.綜上所述,關(guān)節(jié)鏡術(shù)后聯(lián)合中藥熏洗療法在治療創(chuàng)傷性髕骨脫位關(guān)節(jié)鏡術(shù)腫痛、促進(jìn)功能恢復(fù)方面有著積極地臨床價(jià)值,且安全性較高,可以在臨床治療中推廣應(yīng)用。
[Abstract]:Objective: to compare the clinical efficacy of oral celecoxib and fumigation with Chinese medicine in the treatment of traumatic patellar dislocation. Methods: 46 cases collected from October 2014 to October 2016 were included in this study. According to the principle of equal proportion, they were randomly divided into two groups: the observation group (n = 23) and the control group (n = 23). During the course of observation, some of the cases fell off, and after screening, a total of 40 clinical cases were selected, of which 20 cases in the observation group were treated with fumigation and washing with Chinese medicine after arthroscopic operation, and 20 cases in the control group were treated with oral celecoxib after arthroscopy. In order to evaluate the clinical effect of fumigation and washing therapy on traumatic dislocation of patella after arthroscopy, the curative effect was observed on the recovery of knee function in the two groups during the treatment period of 2 weeks, 4 weeks and 8 weeks. Results: 1. The total curative effect of the two groups was compared 8 weeks after treatment. In the observation group, the curative effect was excellent in 5 cases, good in 7 cases, fair in 7 cases, poor in 1 case, and the total effective rate was 95%. In the control group, the curative effect was excellent in 2 cases, good in 4 cases, fair in 12 cases and poor in 2 cases. The total effective rate was 90%. 2. Two weeks after treatment, the two groups had significant difference in knee pain and swelling (P0.05). However, other functions of the affected knee are as follows: squatting, locking, climbing stairs and so on (P0.05), there is no significant difference between the two treatment methods. 3. There were significant differences in knee pain swelling and stair climbing between the two groups after 4 weeks of treatment (P0.05). However, other functions of the affected knee are as follows: squatting, locking, stability and so on (P0.05), there is no significant difference between the two treatment methods. 4. Two groups of patients before and after treatment were compared before and after treatment before and after 8 weeks, the same experimental group before and after the patients suffered from knee pain and claudication, pain, swelling, climbing stairs and other functional performance (P0.01) has a very significant difference. At 8 weeks after treatment, there were significant differences between the two groups in claudication, pain, swelling, stair climbing and so on (P0.05). However, other functions of the affected knee are as follows: squatting, locking and so on (P0.05), there is no significant difference between the two treatment methods. 5. 5. Two groups of patients before and after treatment safety index comparison observation group and control group in blood routine liver and kidney function and other commonly used indicators before and after treatment compared (P0.05) there was no significant difference. Conclusion: 1. The treatment methods used in the two groups had a good effect on the functional recovery of traumatic patellar dislocation after operation, but the therapeutic effect of the observation group was better than that of the control group. 2. In the early stage of treatment, the control group was superior to the observation group in improving the pain of the affected knee, and the observation group was superior to the control group in terms of swelling of the affected knee. In the middle stage of treatment, the treatment effect of the observation group was better than that of the control group in pain, swelling and climbing stairs. In the later stage of treatment, the overall therapeutic effect of the observation group was significantly higher than that of the control group, especially in the aspects of claudication, pain, swelling, climbing stairs, etc. The treatment method of the observation group was obviously superior to that of the control group. Before and after treatment, there were no obvious abnormal changes in blood routine, liver and kidney function between the two groups. 4. 4. To sum up, arthroscopy combined with fumigation therapy has positive clinical value in the treatment of swelling and pain of traumatic patellar dislocation and promoting functional recovery, and it is safe and can be popularized and applied in clinical treatment.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R274.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳良庚;;塞來(lái)昔布對(duì)四肢骨折急診手術(shù)患者的鎮(zhèn)痛作用分析[J];北方藥學(xué);2017年02期

2 郝建橋;劉潔;楊延濤;趙洪波;趙愛(ài)民;王同山;王合圍;李建強(qiáng);申云龍;王非;孫冉;武敏;王俊穎;;Lysholm評(píng)分系統(tǒng)評(píng)價(jià)髕股關(guān)節(jié)的應(yīng)用研究[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2016年12期

3 韓小平;丁路;黃濤;張華;;關(guān)節(jié)鏡輔助治療創(chuàng)傷性髕骨脫位療效及患者滿(mǎn)意度觀察[J];現(xiàn)代儀器與醫(yī)療;2016年04期

4 趙建寧;陳爍;;髕骨脫位的規(guī)范化治療方案[J];中國(guó)骨傷;2015年07期

5 蔡卓亞;周自桂;李萍;秦勇;;伸筋草化學(xué)成分及藥理作用研究進(jìn)展[J];中草藥;2015年02期

6 李偉;趙育紅;武長(zhǎng)江;劉光宇;劉濤;郭曉東;;鹽酸氨基葡萄糖聯(lián)合塞來(lái)昔布對(duì)膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床療效觀察[J];現(xiàn)代生物醫(yī)學(xué)進(jìn)展;2015年02期

7 梁學(xué)振;王少山;魏姍姍;;膝關(guān)節(jié)鏡術(shù)后并發(fā)癥的分析[J];實(shí)用中西醫(yī)結(jié)合臨床;2014年07期

8 杜航;孫佳明;郭曉慶;張輝;;地龍的化學(xué)成分及藥理作用[J];吉林中醫(yī)藥;2014年07期

9 蘇守文;史德海;李智勇;盧華定;王昆;;保守和手術(shù)治療急性髕骨脫位的Meta分析[J];中山大學(xué)學(xué)報(bào)(醫(yī)學(xué)科學(xué)版);2014年04期

10 劉維統(tǒng);楊景帆;;關(guān)節(jié)鏡在創(chuàng)傷性髕骨脫位診治中的臨床價(jià)值探討[J];昆明醫(yī)科大學(xué)學(xué)報(bào);2014年05期

相關(guān)碩士學(xué)位論文 前1條

1 唐祝;初次髕骨脫位診治進(jìn)展[D];重慶醫(yī)科大學(xué);2014年

，

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