| ObjectivesThis research is conception through clinical trials, research on knee osteoarthritis pathological changes under arthroscopy (cartilage injury, synovial hyperplasia, meniscus injury, free body formation, osteophyte formation) and of the reinforcement, the correlation of serum CTX-Ⅱand COMP level, one is to explore the knee osteoarthritis pathological changes under arthroscopy and the intrinsic relationship of the reinforcement, discusses each type of knee osteoarthritis by reinforcement points pathological changes of the structure under the arthroscope, reinforcement parting in the clinical research to provide the objective basis;The second is to explore the knee osteoarthritis pathological changes of the structure under arthroscope and the correlation of serum CTX-Ⅱand COMP level, discusses the two kinds of cytokines in the development of knee osteoarthritis, and explore two kinds of cell factors of knee osteoarthritis pathological assessment the reliability of the structure. At the same time, the application of combined postoperative use of arthroscopic surgery by reinforcement treatment (with reinforcement technique, acupuncture focal elimination method) for rehabilitation, to explore the synergistic treatment of the arthroscopic combined by reinforcement treatment effect.MethodsSelecting standard 120 cases of patients with knee osteoarthritis, according to the national Chinese medicine management department 《22 major 95 kinds of traditional Chinese medicine diagnosis and treatment plan》 of the disease of knee (knee osteoarthritis)in the diagnosis and treatment plan, and according to the Chinese academy of sciences issued 《the Jingjin Meridian Syndrome Type disease diagnostic criteria》 for clinical cases data collection and the reinforcement dialectical analysis, in order to find out the knee osteoarthritis by reinforcement distribution regularity of clinical syndrome differentiation. First of all, in patients with preoperative application of ELISA method to detect the serum CTX-Ⅱand COMP level;Second,arthroscopic surgery, through the observation and record in patients with knee osteoarthritis pathological changes under arthroscopy, counting under arthroscopy pathological changes in the different reinforced parting distribution of pathological changes of the every tissue and the correlation among of the reinforcement, discusses the pathological changes under arthroscopy in the role of knee osteoarthritis by muscle differentiation;Finally, choose 103 cases of patients with knee osteoarthritis, after classics of tendon, postoperative use of the reinforcement treatment method (the reinforcement technique, acupuncture focal) rehabilitation therapy, and through the WOMAC score standards before and after the treatment, the serum levels of cytokines CTX-Ⅱcontrast and COMP level, explore the arthroscopic combined by reinforcement treatment of synergy therapy effect.ResultIn the second part of the clinical study, knee osteoarthritis of change under arthroscopy and the reinforcement of statistics analysis,the tip of the muscle and joint the microscopic changes(cartilage injury, synovial hyperplasia, meniscus injury, osteophyte formation, joint loose bodies, etc) about (P<0.05), in addition, the reinforcement parting with change under arthroscopy using LSD multiple ratio test results show:among the reinforcement parting, change under the arthroscope (cartilage injury, synovial hyperplasia, meniscus injury, osteophyte formation, joint loose bodies and other lesions) lesions, classification on statistically significant also show changes related to the reinforcement parting under arthroscopy.The results confirmed that the knee osteoarthritis cartilage damage under arthroscopy and synovial membrane lesion and serum CTX-Ⅱand COMP level has close correlation, and other microscopic histological (meniscus, joint loose bodies, and osteophyte formation) and CTX-Ⅱand COMP level correlation has no statistical significance.By arthroscopic surgery in combination with the muscle therapy to treat 103 cases of patients with knee osteoarthritis, including the treatment group (by reinforcement treatment) and control and control group 1 postoperative health education guidance function of exercise (simple) and group 2 (oral celecoxib capsules).Through the WOMAC scores before and after the treatment (the degree of pain, joint rigidity, degree of activity) and the levels of serum CTX-Ⅱ and COMP inspection by reinforcement treatment effectiveness and the arthroscopic combined by reinforcement treatment of synergy therapy effect.The result shows the overall curative effect between three groups by the rank and inspection, the treatment group and control group was statistically difference (P<0.05), prompt treatment of knee osteoarthritis treatment group curative effect is superior to the control group 1,2;WOMAC scores of three groups of patients after treatment in each scored significantly lower earlier, compared with before treatment differences were statistically significant (P<0.05), score the curative effect of treatment group were superior to control group 1,2, compare the differences between groups were statistically significant (P<0.05), the treatment group curative effect is better;Of three groups of patients after treatment serum CTX-II, COMP content were significantly reduced earlier, compared with before treatment differences were statistically significant (P<0.05), and compare the differences between groups was statistically significant (P<0.05), the treatment group curative effect is better.Conclusion1. This research shows that, under arthroscopy can intuitively reflect the knee osteoarthritis patients with pathological changes of the articular cavity structure. By observing the injury of articular cartilage, synovial hyperplasia, meniscus injury, osteophyte, loose bodies, such as change, can evaluate the severity of knee osteoarthritis.2.Discusses microscopically various pathological changes and the correlation between of the reinforcement. The study found that among syndrome types in articular cartilage injury, synovial hyperplasia, meniscus injury, osteophyte, joint loose bodies such as statistically significant lesions extent. With the degree of knee osteoarthritis by muscle lesions, aggravating the degree of change under arthroscopy.As the reinforcement card type from the simple to the complex transformation, pathological changes under arthroscopy also changes.3. Knee osteoarthritis as degenerative joint disease, we should not only focus on degradation of bone and cartilage aging and degeneration of knee joint cavity structure also is a key factor in the pathogenesis of knee osteoarthritis.X-rays on joint space narrow and osteophyte formation shows the disease characteristics of knee osteoarthritis, but not exactly shows intra-articular other bony structure change, so the reinforcement in knee osteoarthritis of syndrome differentiation of TCM syndrome differentiation is particularly important.4. In this study, according to the results of patients with knee osteoarthritis joint cavity tissue pathological changes and correlated with serum CTX-Ⅱ,COMP level.The level of serum CTX-Ⅱand COMP can response to a certain extent the severity of knee osteoarthritis cartilage, synovial pathological changes, but with the meniscus injury, osteophytes and joint loose bodies formed, change has no obvious correlation.5. Arthroscopic surgery using the reinforcement treatment method (the reinforcement technique, acupuncture focal) rehabilitation treatment, compared before and after treatment respectively WOMAC score and cytokines CTX-Ⅱand observation indexes such as COMP level, according to the results of using approved by muscle therapy to treat the postoperative tendon parting knee osteoarthritis has a good curative effect, the muscle therapy treatment group curative effect is better than that of oral celecoxib group. The arthroscopic combined with reinforcement therapy for knee osteoarthritis can have synergistic treatment effect. |
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