| Objective:To observe the short-term clinical efficacy of arthroscopic debridement combined with Taohong Siwu Decoction in the treatment of knee osteoarthritis of qi stagnation and blood stasis type in order to verify the effectiveness of the integrated traditional Chinese and Western medicine therapy,preliminarily elaborate its principle of action and summarize its advantages,so as to provide reference for further improving the method in the future.Methods:Patients with knee osteoarthritis who met the diagnostic criteria and had complete data and were admitted to the orthopedics and traumatology ward of the First Affiliated Hospital of Tianjin University of traditional Chinese medicine from May 2019 to December 2020 were selected.According to whether they used traditional Chinese medicine decoction after operation,they were divided into two groups: arthroscopic debridement combined with addition and subtraction of Taohong Siwu Decoction treatment group(treatment group)and arthroscopic debridement alone(control group).The treatment group began to take 1 dose daily on the 2nd day after surgery,divided into morning and evening,7 days as a course of treatment,two courses of treatment were taken continuously,a total of 14 doses.On postoperative day 2,the treatment group began to take an oral TCM Decoction with 1 dose per day and divided doses early and late,each 7 days,for two consecutive courses.Postoperatively,both groups were given the same symptomatic treatment and performed the same functional exercise under the guidance of the same specialized physician.The clinical data of knee pain condition,swelling condition and functional condition of all patients were summarized and collated,and the patients in both groups were observed for symptom improvement,sign change and functional improvement.Data on VAS pain scores,Lysholm function scores,total joint range of motion and swelling values were collected from the two groups before,at 2 weeks and at 2 months after surgery,and all data were compared using spss25.0。Results:(1)A total of 68 patients were included in the study,15 males and 53 females,aged 60.43± 7.80 years(41-70 years),33 left knees and 35 right knees.The course of disease was 27.31± 31.51 months(3-120 months),35 patients in the treatment group and 33 patients in the control group.There were no significant differences in baseline data of gender,age,body mass index(BMI),course of disease,affected knee,imaging grade(Kellgren-Lawrence grade)between the two groups(P>0.05),which was comparable.(2)VAS score: comparison within the control group: the VAS score decreased more than before surgery at 2 weeks and at 2 months postoperatively(P <0.05,P <0.05,respectively).Within treatment group comparisons: VAS scores decreased more than preoperatively at 2 weeks and 2 months postoperatively(P <0.05,P <0.05,respectively).Comparisons between groups: the two groups were comparable preoperatively,with no statistical difference(P = 0.307).VAS scores decreased more in the treatment group than in the control group at 2 weeks and at 2 months postoperatively(P <0.05;P <0.05,respectively).(3)Lysholm scores: comparison within the control group: both Lysholm scores at 2 weeks and 2 months after surgery improved compared to before surgery(P <0.05,P<0.05,respectively).Within treatment group,Lysholm scores at 2 weeks and 2 months were significantly higher(P <0.05,P <0.05,respectively).Comparison between groups: the preoperative values were comparable between the two groups with no significant difference(P= 0.976).Lysholm scores improved more in the treatment group than in the control group both at 2 weeks and at 2 months postoperatively(P <0.05;P <0.05,respectively).(4)Swelling values:comparison within the control group: the swelling values at 2 weeks and 2 months after surgery were reduced compared with those before surgery(P <0.05;P <0.05,respectively).Within the treatment group,swelling values at 2 weeks and 2 months postoperatively decreased(P <0.05,and P <0.05,respectively).Comparison between groups: the two groups were comparable preoperatively with no statistical difference(P = 0.648).Swelling values decreased more in the treatment group compared with the control group at 2 weeks and at 2 months postoperatively(P <0.05;P <0.05,respectively).(5)Total range of joint motion(TROM): the control group showed improved TROM compared to the preoperative values at 2 weeks and 2 months(P<0.05;P <0.05).Within treatment group comparisons: TROM improved more than before at 2weeks and 2 months postoperatively(P <0.05;P <0.05,respectively).Comparison between groups: the two groups were comparable preoperatively with no significant difference(P=0.297).TROM improved more significantly in the treatment group compared to the control group at 2 weeks and 2 months postoperatively(P<0.05;P<0.05).(6)Efficacy evaluation: the94.29% overall significant efficiency of the treatment group was significantly better than the75.76% overall significant efficiency of the control group,with statistical significance(P=0.031).(7)Subgroup analysis: Patients with different preoperative KL grades showed no statistically significant differences in all observed measures(P=0.548;P=0.123;P=0.906;P=0.972,respectively).At 2 months postoperatively,there were no significant differences in VAS scores between the two groups(P=0.697),Lysholm scores,KL grade II improved more significantly than grade III(P=0.027),and neither swelling values nor TROM were significantly different between the two groups(P=0.906;P=0.509).Conclusion:1.Both arthroscopic debridement combined with Taohong Siwu Decoction and simple arthroscopic debridement had good curative effect on knee osteoarthritis of qi stagnation and blood stasis type in short term.2.Arthroscopic debridement combined with the Taohong Siwu Decoction resulted in better improvement of knee function in patients with KL grade II than in those with grade III.3.Arthroscopic debridement combined with Tao Hong Si Wu Decoction plus and minus treatment resulted in more obvious symptom relief,more complete functional improvement,and a more rapid rehabilitation course in patients with qi stagnation and blood stasis type of knee osteoarthritis,with greater clinical advantages. |
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