中药熏洗联合CPM治疗胫骨平台骨折术后膝关节功能障碍临床观察(1)
【摘 要】目的：观察中药熏洗联合CPM治疗胫骨平台骨折术后功能障碍的临床疗效。方法：将54例胫骨平台骨折术后膝关节功能障碍的患者随机分为中药熏洗组、CPM组联合组，每组18例。中药熏洗组采用中药熏洗治疗，CPM组采用CPM机治疗，联合组以中药熏洗联合CPM机功能锻炼进行治疗。疗程均为3周。观察3组优良率及HSS评分。结果：联合组膝关节活动度优良率优于中药熏洗组和CPM组(P < 0.05)，中药熏洗组优于CPM组(P < 0.05)。术后6个月随访时，联合组HSS评分及优良率均显著高于中药熏洗组和CPM组(P < 0.05)，中药熏洗组优于CPM组(P < 0.05)。结论：中药熏洗联合CPM能够较好地治疗胫骨平台骨折术后膝关节功能障碍，松解膝关节周围软组织粘连，改善膝关节功能活动，临床效果较好。
【关键词】 膝关节功能障碍；中药熏洗；CPM；胫骨平台骨折
doi：10.3969/j.issn.2095-4174.2015.10.006
【ABSTRACT】Objective：To observe the clinical effect of Chinese herbal fumigating and washing combined with CPM in the treatment of knee joint dysfunction after operation on fracture of tibial plateau.Methods：54 cases of knee joint dysfunction after operation on fracture of tibial plateau fracture were randomly divided into a Chinese herbal fumigating and washing group (CHFWG)，a CPM group，and a combined group，18 cases in each.The CHFWG was treated by Chinese herbal fumigating and washing，the CPM group by CPM alone and the combined group by Chinese herbal fumigating and washing combined with CPM.The three groups were treated for 3 weeks.Excellence rate and HSS score of the 3 groups were observed.Results：The excellence rate of the knee joint activity of the combined group was superior to those of the CHFWG and CPM group (P < 0.05)，and the excellence rate of the CHFWG was better than that of the CPM group (P < 0.05).During the follow up after 6 months，the HSS score and excellence rate of the combined group were significantly higher than those of the CHFWG and CPM group (P < 0.05)，and the CHFWG was better than the CPM group(P < 0.05).Conclusion：Chinese herbal fumigating and washing combined with CPM can better treat the knee joint dysfunction after operation on fracture of tibial plateau，and improve the soft tissue conglutination and knee joint function，having a better clinical effect.
【Keywords】knee joint dysfunction；Chinese herbal fumigating and washing；CPM；fracture of tibial plateau
胫骨平台骨折约占全身骨折的4.38%[1]，骨折术后由于损伤和长期制动，造成局部血液循环不畅，组织液吸收和回流障碍，不但影响了创伤组织的修复，而且使周围韧带、关节囊等软组织发生变性、粘连和挛缩，膝关节周围肌肉萎缩，最终致膝关节僵硬和功能障碍等后遗症。笔者观察采用中药熏洗联合CPM机功能锻炼治疗胫骨平台骨折术后功能障碍患者，其膝关节功能障碍、关节活动范围均有不同程度改善，现总结报告如下。
1 临床资料
1.1 一般资料 选取2014年1月至2014年6月在河南省洛阳正骨医院膝部损伤科就诊的经手术治疗并术后佩戴支具固定3周后出现膝关节功能障碍的胫骨平台骨折患者54例，按随机数字表法分为中药熏洗组、CPM组、联合组，每组18例。中药熏洗组男11例，女7例；年龄23～61岁，平均(39.40±3.15)岁。CPM组男14例，女4例；年龄24～60岁，平均(36.40±1.34)岁。联合组男13例，女5例；年龄25～63岁，平均(35.30±2.47)岁。
3组患者在性别、年龄等方面比较，差异无统计学意义(P > 0.05)，具有可比性。
1.2 诊断标准 参照2002年国家食品药品监督管理局颁布的《中药新药临床研究指导原则(试行)》中“外伤性骨折的诊断标准”气滞血瘀型制定[2]。, 百拇医药(韩宗昌 李无阴 王战朝 石福明 孟庆阳)
【关键词】 膝关节功能障碍；中药熏洗；CPM；胫骨平台骨折
doi：10.3969/j.issn.2095-4174.2015.10.006
【ABSTRACT】Objective：To observe the clinical effect of Chinese herbal fumigating and washing combined with CPM in the treatment of knee joint dysfunction after operation on fracture of tibial plateau.Methods：54 cases of knee joint dysfunction after operation on fracture of tibial plateau fracture were randomly divided into a Chinese herbal fumigating and washing group (CHFWG)，a CPM group，and a combined group，18 cases in each.The CHFWG was treated by Chinese herbal fumigating and washing，the CPM group by CPM alone and the combined group by Chinese herbal fumigating and washing combined with CPM.The three groups were treated for 3 weeks.Excellence rate and HSS score of the 3 groups were observed.Results：The excellence rate of the knee joint activity of the combined group was superior to those of the CHFWG and CPM group (P < 0.05)，and the excellence rate of the CHFWG was better than that of the CPM group (P < 0.05).During the follow up after 6 months，the HSS score and excellence rate of the combined group were significantly higher than those of the CHFWG and CPM group (P < 0.05)，and the CHFWG was better than the CPM group(P < 0.05).Conclusion：Chinese herbal fumigating and washing combined with CPM can better treat the knee joint dysfunction after operation on fracture of tibial plateau，and improve the soft tissue conglutination and knee joint function，having a better clinical effect.
【Keywords】knee joint dysfunction；Chinese herbal fumigating and washing；CPM；fracture of tibial plateau
胫骨平台骨折约占全身骨折的4.38%[1]，骨折术后由于损伤和长期制动，造成局部血液循环不畅，组织液吸收和回流障碍，不但影响了创伤组织的修复，而且使周围韧带、关节囊等软组织发生变性、粘连和挛缩，膝关节周围肌肉萎缩，最终致膝关节僵硬和功能障碍等后遗症。笔者观察采用中药熏洗联合CPM机功能锻炼治疗胫骨平台骨折术后功能障碍患者，其膝关节功能障碍、关节活动范围均有不同程度改善，现总结报告如下。
1 临床资料
1.1 一般资料 选取2014年1月至2014年6月在河南省洛阳正骨医院膝部损伤科就诊的经手术治疗并术后佩戴支具固定3周后出现膝关节功能障碍的胫骨平台骨折患者54例，按随机数字表法分为中药熏洗组、CPM组、联合组，每组18例。中药熏洗组男11例，女7例；年龄23～61岁，平均(39.40±3.15)岁。CPM组男14例，女4例；年龄24～60岁，平均(36.40±1.34)岁。联合组男13例，女5例；年龄25～63岁，平均(35.30±2.47)岁。
3组患者在性别、年龄等方面比较，差异无统计学意义(P > 0.05)，具有可比性。
1.2 诊断标准 参照2002年国家食品药品监督管理局颁布的《中药新药临床研究指导原则(试行)》中“外伤性骨折的诊断标准”气滞血瘀型制定[2]。, 百拇医药(韩宗昌 李无阴 王战朝 石福明 孟庆阳)