| Objective: To observe the short-term efficacy of Baiyao plaster combined with arthroscopic debridement in the treatment of damp-heat accumulation type knee gouty arthritis,and to explore the mechanism of Baiyao plaster,in order to provide a new,effective and safe method for clinical treatment of knee gouty arthritis.treatment method.Methods: A total of 50 patients with knee GA who met the inclusion criteria were selected,and all 50 patients were in accordance with the TCM syndrome type of damp-heat accumulation.And with the approval of the hospital ethics committee,50 patients were sequentially numbered in the order of admission(1,2,3...49,50).According to the principle of 1:1,a random number table was used to select 25 numbers as the treatment group,and the remaining 25 patients were selected as the treatment group.A control group.Among the patients,the longest course of disease was 12 years,the shortest was 2 years,the youngest was 27 years old,and the oldest was 65 years old.Both groups of patients underwent joint debridement,and routine treatments such as ice compress,infection prevention,uric acid lowering,and rehabilitation functional exercise guidance were given after operation.Intervention measures for patients in the treatment group: the patients started to apply Baiyao ointment externally on the first day after operation,and applied it to the upper edge of the patella or the popliteal fossa,avoiding the operation port,once a day,the ointment application time did not exceed 12 hours,and the course of treatment was 2 weeks.Control group patients: No other intervention measures except general routine treatment.The research methods of inter-group comparison and intra-group comparison were used to compare and observe the VAS score,knee joint circumference,knee joint Lysholm score,and serum interleukin-1β(IL-1β)concentration before and after treatment in the two groups.All data were processed by SPSS 20.0analysis software for statistical analysis.Results: A total of 50 eligible cases were collected and included,of which 6 patients were excluded due to different reasons,and 44 cases were actually completed.The observation data of the two groups of patients are as follows:(1)General information: The gender,age and course of disease of the two groups of patients were statistically processed,and the variance analysis P>0.05,there was no statistical significance;(2)VAS score: The data were tested by repeated measures design data analysis of variance,comparison between groups,and comparison within groups.Analysis of variance showed that there were statistically significant differences among different groups,treatment time and group*time interaction(P<0.05).The comparison between the two groups of patients showed that the variance analysis P>0.05 before the operation and the first day after the operation had no statistical significance,but the difference was statistically significant on the 7th and 15 th day after the operation(P<0.05),indicating that The treatment group was able to exert the analgesic effect of Baiyao ointment,and it was better than the control group in alleviating knee pain.(3)Knee joint circumference: The data processing and comparison methods were the same as the VAS score.The variance analysis showed that the differences between different groups,treatment time periods and group*time interaction were statistically significant(P<0.05).For comparison between the two groups,the preoperative and postoperative day 1 analysis of variance P>0.05,the difference was not statistically significant,while the 7th day and the 15 th day were statistically significant(P<0.05),It shows that compared with the control group,the treatment group can give full play to the blood-activating and swelling-reducing effect of Baiyao ointment,and better improve the knee joint swelling;(4)Lysholm score of knee joint: The data processing and comparison methods were the same as the VAS score,and the interaction analysis of variance of different groups,treatment time,and group*time was P<0.05,and the differences were statistically significant.The comparison between the two groups of patients showed that the variance analysis P>0.05 before the operation and on the 7th day after the operation,the difference was not statistically significant,but the variance analysis P<0.05 on the 28 th day after the operation,the difference was statistically significant.It was concluded that Baiyao ointment combined with joint debridement group can better improve the knee joint function of patients with GA and improve the quality of life of patients;(5)Serum IL-1β concentration: the data processing and comparison methods were the same as the VAS score,and the interaction analysis of variance for different groups,treatment time periods,and group*time was P<0.05,and the differences were statistically significant.For comparison between the two groups,the preoperative variance analysis P>0.05,the difference was not statistically significant,the variance analysis P<0.05 on the 7th day and the15 th day after the operation,the difference between the two postoperative time periods was statistically significant,indicating that On the 7th and 15 th days of postoperative treatment,Baiyao ointment combined with arthroscopic debridement can play a more anti-inflammatory effect,and more significantly reduce the concentration of IL-1β and other inflammasomes in serum;(6)Clinical total effective rate: The data adopts non-parametric rank sum test.The total effective rates of the treatment group after 1 week of treatment and 4weeks of treatment are 81.82% and 90.91%,respectively,and the total effective rates of the control group after 1 week of treatment and 4 weeks of treatment are respectively 77.27%,81.82%.After 1 week of treatment and 4weeks of treatment,P>0.05 by variance analysis,the difference was not statistically significant.It can be understood that Baiyao ointment combined with joint debridement and simple joint debridement are effective in the treatment of knee GA,but comparing the total clinical effective rate and various statistical data,it is not difficult to draw the short-term results of Baiyao ointment combined with joint debridement in the treatment of knee GA patients.The curative effect,to a certain extent,is better than the conclusion of simple joint debridement.Conclusion: This clinical study shows that Baiyao ointment combined with arthroscopic debridement has significant short-term curative effect in the treatment of damp-heat accumulation of knee GA,can effectively relieve clinical symptoms,relieve joint swelling and pain,improve joint function,and reduce the level of arthritic indicators,etc.. |
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