关键词:

关节镜, 中药封包, 膝痛风性关节炎, 疗效

Abstract:

Objective　To observe the early efficacy of arthroscopic debridement combined with traditional Chinese medicine packages in the treatment of patients with knee gouty arthritis. Methods　Ninety patients with knee gouty arthritis who were treated in Liwan District Orthopedic and Traumatology Hospital from May 2020 to June 2022 were selected for the randomized controlled trial, with a total of 90 knees. The patients were divided into a conservative treatment group, a minimally invasive treatment group, and a combined treatment group by the random number table method, with 30 cases in each group. The conservative treatment group were (42.93±3.28) years old, with a disease course of (9.72±3.74) months. The minimally invasive treatment group were (43.03±3.64) years old, with a disease course of (10.01±3.83) months. The combined treatment group were (43.58±5.60) years old, with a disease course of (9.86±3.95) months. The conservative treatment group externally applied self-made Chinese medicine packages, once a day. The minimally invasive treatment group took minimally invasive debridement under arthroscope. The combined treatment group were treated with arthroscopic debridement and postoperative Chinese medicine packages. All the three groups were treated with the same anti-inflammatory and analgesic drugs. The scores of Visual Analogue Scale (VAS) and Lysholm joint function of knee joint (Lysholm) and laboratory indicators (white blood cell, blood uric acid, erythrocyte sedimentation rate, and C-reactive protein) before and 1, 2, and 4 weeks after the treatment, and recurrence rates within six months were observed. The repeated measurement analysis of variance and non-parameter test were applied. Results　There were statistical differences in the scores of VAS and Lysholm and laboratory indicators in the three groups between before and 1 week after the treatment (all P<0.05); there were no statistical differences in the scores of VAS and Lysholm and laboratory indicators 1 week after the treatment between the 3 groups (all P>0.05). Two weeks after the treatment, the scores of VAS and Lysholm in the combined treatment group were 2.00 (1.00) and (81.67±6.35); the scores in the minimally invasive treatment group were 2.00 (1.00) and (80.37±5.58); the scores in the conservative treatment group were 3.00 (1.25) and (77.23±6.10); there were statistical differences between the combined treatment group and the minimally invasive treatment group on one hand and the conservative treatment group on the other hand (all P<0.05), and no between the combined treatment group and the minimally invasive treatment group (both P>0.05). Four weeks after the treatment, the scores of VAS and Lysholm in the combined treatment group were 1.00 (1.25) and (87.03±5.26); the scores in the conservative treatment group were 2.00 (1.00) and (80.70±5.80); the scores in the minimally invasive treatment group were 1.50 (1.00) and (82.33±5.36); there were statistical differences between the combined treatment group on one hand and the minimally invasive treatment group and the conservative treatment group on the other hand (all P<0.05), and no between the conservative treatment group and the minimally invasive treatment group (both P>0.05). All the patients in the 3 groups were followed up half year; no case recurred in the combined treatment group; 1 case recurred in the minimally invasive treatment group; 3 cases recurred in the conservative treatment group. Conclusions　Arthroscopic debridement and traditional Chinese medicine packages for patients with knee gouty arthritis both are effective. The combination of the two has better early effect, and can reduce the recurrence of gout, delay the disease progression, so it is worthy of clinical application.

Key words:

Arthroscope, Traditional Chinese medicine packages, Knee gouty arthritis, Efficacy