摘要
目的 探讨术前预康复结合中药熏浴和定向透药对前交叉韧带重建术后疼痛及膝关节功能的影响,并分析其治疗安全性,旨在为前交叉韧带重建术治疗患者围术期干预提供更安全可靠的临床方案。方法 选取2023年1月至2024年6月期间行前交叉韧带重建术治疗患者78例,根据拟采取的术前术后干预方案,分为研究组(术前预康复+术前、术后中药熏浴和定向透药+术后常规干预,n=27)、中医组(术前、术后中药熏浴和定向透药+术前术后常规干预,n=23)和对照组(术前术后常规干预,n=28)。患者均根据《骨科疾病疗效评价标准》中相关疗效标准进行疗效判定,统计比较三组治疗有效率。收集比较三组术前、术后1、3个月的膝关节疼痛状况、膝关节活动度(knee range of motion,ROM)、膝关节功能和生活质量评价指标。并统计三组并发症发生状况。结果 研究组治疗有效率(92.59%)高于中医组(65.22%)和对照组(60.71%)(P<0.05);中医组和对照组的治疗有效率比较差异无统计学意义(P>0.05)。较之术前,术后1、3个月三组患者的膝关节视觉疼痛模拟评分(VAS)均降低,且研究组最低,其次为中医组,对照组最高(P<0.05)。较之术前,术后1、3个月三组患者的Lysholm评分、ROM、国际膝关节文件编制委员会(International Knee Documentation Committee,IKDC)膝关节分级评分评分和Barthel评分均较术前升高,且研究组更高,其次为中医组,对照组最抵(P<0.05)。治疗期间三组均未见明显并发症,提示治疗具有较好的安全性。结论 术前预康复结合中药熏浴和定向透药可促进前交叉韧带重建术后疼痛缓解、膝关节功能和日常生活能力恢复,且其治疗安全可靠,值得临床应用。
Objective To investigate the combined application value of preoperative pre-rehabilitation,traditional Chinese medicine fumigation bath and targeted drug penetration through the evaluation of postoperative pain and knee joint function rehabilitation after anterior cruciate ligament reconstruction surgery.Methods 78 patients who underwent anterior cruciate ligament reconstruction surgery from January 2023 to June 2024 were selected.According to the preoperative and postoperative intervention plan,the patients were divided into study group(preoperative pre rehabilitation+preoperative and postoperative traditional Chinese medicine fumigation bath and targeted drug penetration+postoperative routine intervention,n=27),traditional Chinese medicine group(preoperative and postoperative traditional Chinese medicine fumigation bath and targeted drug penetration+preoperative and postoperative routine intervention,n=23),and control group(preoperative and postoperative routine intervention,n=51).The patients were evaluated for efficacy according to the relevant efficacy standards in the"Evaluation Criteria for Therapeutic Efficacy of Orthopedic Diseases",and the effective rates of the 3 groups were statistically compared.The knee pain,knee range of motion(ROM),knee function and Barthel score between 3 groups before surgery,1 month and 3 months after surgery were collected and compared.And the incidence of complications in 3 groups were collected and analyzed.Results The therapeutic effective rate of the study group(92.59%)was higher than toseof the was higher than that of the traditional Chinese medicine group(65.22%)and the control group(60.71%)(P<0.05);There was no statistically significant difference in the treatment effectiveness between the traditional Chinese medicine group and the control group(P>0.05).Compared with those of before treatment,The 1 month and 3 months after surgery VAS scores of 3 groups were decreased,with that of the study group was the lowest,followed by the traditional Chinese medicine group,and that of the control group was the highest(P<0.05).Compared with those of before treatment,The 1 month and 3 months after surgery Lysholm Score,ROM,International Knee Documentation Committee(IKDC)Knee Grading Score,and Barthel Score of 3 groups were increased,with those of the study group were the highsest,followed by the traditional Chinese medicine group,and that of the control group was the lowest(P<0.05).There were no significant complications occurred during the treatment period in 3 groups,which meant the treatment safety was good.Conclusion The combined application of preoperative pre-rehabilitation,traditional Chinese medicine fumigation bath and targeted drug penetration can promote pain relief,knee joint function rehabilitation and daily living ability recovery after anterior cruciate ligament reconstruction surgery,and the treatment is safe and reliable,which is worthy of clinical application.
作者
胡文锋
洪钟源
邓怀东
HU Wen-feng;HONG Zhong-yuan;DENG Huai-dong(Orthopedics Department 1,Dongguan Hospital of Traditional Chinese Medicine,Dongguan 523000,Guangdong,China)
出处
《广东医学》
2025年第4期615-621,共7页
Guangdong Medical Journal
基金
2023年度广东省中医药局科研项目(20231365)。
关键词
术前预康复
中药熏浴
定向透药
前交叉韧带重建
疼痛
膝关节功能
preoperative pre-rehabilitation
Chinese herbal fumigation bath
targeted drug penetration
anterior cruciate ligament reconstruction
pain
knee joint function
