目的 观察关节镜下清理术联合中药熏洗治疗痛风性膝关节炎的临床疗效。方法 收集2013年7月—2016年7月期间收治于我院骨科的痛风性膝关节炎患者,根据纳入及排除标准,获得44例患者,共44个膝关节。根据术后是否采用中药熏洗治疗,将其分为治疗组25例及对照组19例。观察内容:术后1周及术后3月的WBC、BUA、ESR、CRP、膝关节疼痛VAS、Lysholm关节功能评分;2组患者术后6月、12月随访时的膝关节疼痛VAS、Lysholm关节功能评分。结果 ①2组患者术前与术后1周的膝关节疼痛VAS、 Lysholm关节功能评分组内比较差异有统计学意义(P＜0.05),术后1周的膝关节疼痛VAS、 Lysholm关节功能评分组间比较差异无统计学意义(P＞0.05)。②2组患者术前与术后3月随访的WBC、BUA、ESR、CRP组内比较差异有统计学意义(P＜0.05),术后3月随访的WBC、BUA、ESR、CRP组间比较差异无统计学意义(P＞0.05)。③2组患者术后3月、6月、12月随访的膝关节疼痛VAS、Lysholm关节功能评分组间比较,差异有统计学意义(P＜0.05)。结论 关节镜下清理术结合中药治疗痛风性膝关节炎能有效减轻患者膝关节疼痛,值得临床使用。

Objective Retrospective evaluation of the curative effect of the arthroscopic debridement combined with Chinese medicine fumes in the treatment of the gouty arthritis of knee joint.Methods We analyzed 44 patients (from July 2013 to July 2016 in the orthopaedic department of the Sichuan Second T.C.M.Hospital)with gouty arthritis of knee joint. The all 44 patients were divided into treatment group and control group according to postoperative management that whether or not to apply Chinese medicine fumes.The treatment group,25 patients, were all treated by arthroscopic debridement combined with Chinese medicine fumes,and the control group,19 patients, were all treated by arthroscopic debridement only.The observation targets were as follows: VAS、Lysholm、WBC、BUA、ESR、CRP of postoperative after 1 week, 3 months,and VAS、Lysholm. postoperative VAS、Lysholm after 6months、12months.Results Compared the preoperative contents with postoperative contents after1 week,there was statistically significant difference in VAS、Lysholm of both groups(P＜0.05).There was no statistically significant difference in VAS、Lysholm in postoperative 1 week between two groups (P＞0.05). Compared the preoperative contents with postoperative contents after 3 month,there was statistically significant difference in WBC、BUA、ESR、CRP of both groups(P＜0.05).There was no statistically significant difference in WBC、BUA、ESR、CRP of postoperative 3 months between two groups(P＞0.05). There was statistically significant difference in VAS、Lysholm of postoperative 3 months and 6 months between two groups(P＜0.05).Conclusion Arthroscopic debridement combined with Chinese medicine fumes may improve the quality of life in the treatment of gouty arthritis of knee joint,and it is worthy of wide clinical application.

目的 探讨中药熏洗与膝关节自我锻炼管理对改善老年骨性膝关节炎功能康复效果。方法 选择90例在本院就诊的老年骨性关节炎患者,按数字表法分为观察组和对照组各45例,对照组采用膝关节康复护理知识教育、膝部中药熏洗与揉搓按摩等治疗,观察组在此治疗护理上加强对患者进行膝关节功能训炼和自我活动行为管理;随访6周,评价两组患者膝关节肿胀、疼痛、训练依从性、膝关节功能。结果 膝关节疼痛缓解、肿胀消退观察组优于对照组;膝关节功能康复效果观察组优于对照组,活动训练依从性观察组高于对照组。结论 应用中药熏洗与加强患者膝关节自我活动训炼管理,可缓解膝关节疼痛、减轻膝关节肿胀,改善患者膝关节功能,提高患者自我功能训练的依从性和生活质量。

Objective To explore the effect of traditional Chinese medicine fumigation and knee joint exercise management on the rehabilitation of senile osteoarthritis of the knee. Methods 90 cases in our hospital for treatment of senile osteoarthritis were randomly divided into observation group and control group with 45 cases in each group, the control group used the knee joint rehabilitation nursing knowledge education, herbal fumigation and massage knee treatment; the observation group on the treatment and nursingwith strengthening the function of knee joint training and self behavior management for the patients; 6 weeks of follow-up, we have evaluation of two groups of patients with knee joint swelling, pain, and knee joint function training compliance. Results The knee joint pain, swelling, knee joint function rehabilitation effect in the observation group were better than that of control group; training compliance in the observation group was better than that of control group. Conclusion The application of herbal fumigation and strengthen the self training of patients with knee joint activity management, may relieve the pain of knee joint, swelling and improve knee function. Theirtraining compliance and quality of life have been increased.

目的 研究中药熏洗、中药离子导入加CPM综合疗法对膝关节功能障碍患者的作用效果。方法 从2014年4月—2016年4月,于我院共有78例膝关节功能障碍病患就诊。以数字法随机分成观察组(39例)和对照组(39例)。观察组给予中药熏洗以及中药离子导入再加以CPM综合疗法进行护理,对照组仅给予CPM综合疗法护理。观察两组患者护理后膝关节疼痛程度以及活动范围。结果 观察组患者膝关节功能优者占比51.28%,总有良率为84.62%,均高于对照组的25.64%,51.28%;观察组患者膝关节活动范围优者占比51.28%,总优良率为89.74%,均高于对照组的28.21%,66.67%;观察组患者WOMAC评分中膝关节疼痛以及膝关节僵硬和膝关节功能得分均低于对照组,WOMAC总分也低于对照组,差异均有统计学意义(P均＜0.05)。结论 中药熏洗、中药离子导入加CPM综合疗法能显著改善患者膝关节功能,增加活动度数,减轻疼痛等级,值得临床推广使用。

Objective To study the effect of traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM combined therapy on patients with knee joint dysfunction. Methods From April 2014 to April 2016, in our hospital there were a total of 78 cases of knee joint dysfunction disease patient treatment. With digital method they were randomly divided into observation group (39 cases) and control group (39 cases). The observation group was treated with Chinese herbal fumigation and washing and Chinese medicine iontophoresis and CPM combined therapy nursing, control group only received CPM combined therapy nursing. Observation of nursing care of the patients in the two groups were knee pain and range of motion. Results The observation group of patients with knee joint function was accounted for than 51.28%. The total yield was 84.62%. They were significantly higher than those in the control group of 25.64%, 51.28%; Observation group of patients with knee joint range of motion was accounted for than 51.28%. The total excellent and good rate was 89.74%, were significantly higher than those in the control group of 28.21%, 66.67%; Observation group, WOMAC score of knee pain and knee stiffness and knee joint function score were significantly lower than those of the control group. WOMAC score was significantly lower than that of the control group. The differences were statistically significant (P<0.05). Conclusion Traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM therapy could significantly improve the patient's knee function, increase the degree of activity, reduce the pain level. It is worth to have clinical application.

目的 对比观察海桐皮汤熏洗应用于膝骨性关节炎关节镜清理术后的临床疗效。方法 于2012年1月—2014年1月,从我院骨科住院患者中选取因膝骨性关节炎行关节镜清理术病例60例,随机分为两组,对照组术后给予常规康复治疗措施,治疗组在常规康复治疗的基础上于术后2周拆线后配合海桐皮汤熏洗治疗,治疗周期4周。对比两组患者治疗前后的WOMAC评分,分析其疗效差异。结果 两组患者WOMAC评分术后2周比较无差异P＞0.5;治疗4周后,两组患者较术后2周有所降低(P＜0.5),但治疗组疗效优于对照组(P＜0.5)。结论 海桐皮汤熏洗疗法可改善膝骨性关节炎关节镜清理术后膝关节功能,操作简便,成本低廉,无副作用,值得临床推广应用。

       目的   研究海艾汤加减熏洗联合梅花针叩刺治疗斑秃的疗效，为治疗斑秃提供依据。方法   选择2022年7月—2023年7月大理州中医医院收治的87例斑秃患者。根据患者就诊前后顺序分成对照组42例与观察组45例，前组采取海艾汤加减熏洗治疗，后组采用海艾汤加减熏洗联合梅花针叩刺治疗。比较两组临床疗效、治疗前后毛囊内因子转录表达、毛发相关指标、生活质量的影响。结果   观察组治疗有效率为95.55%（43/45），对照组治疗有效率为76.19%（32/42）；与对照组治疗有效率相比，观察组治疗有效率更高（P＜0.05）。与同组治疗前毛囊中维生素受体、胰岛素样生长因子I受体、增糖皮激素受体水平相比，两组治疗后更高（P＜0.05）；与对照组治疗后毛囊中维生素受体、胰岛素样生长因子I受体、增糖皮激素受体水平相比，观察组更高（P＜0.05）。与同组治疗前毛发密度、毛囊密度、斑秃面积相比，两组治疗后更优（P＜0.05）；与对照组治疗后毛发密度、毛囊密度、斑秃面积相比，观察组更优（P＜0.05）。与同组治疗前皮肤生活质量量表指数（DLQI）评分相比，两组治疗后更低（P＜0.05）；与对照组治疗后DLQI评分相比，观察组更低（P＜0.05）。两组不良反应发生率比较无差异（P＞0.05）。结论   海艾汤加减熏洗联合梅花针叩刺能够提高斑秃患者的临床疗效，其能够调节患者毛囊内因子转录表达，改善毛发密度、毛囊密度，缩小斑秃面积，不良反应较低，有助于预后质量的提升。