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Objective:To investigate the clinical efficacy of Simiaosan combined with arthroscopic radiofrequency ablation in the treatment of acute traumatic knee synovitis and its effects on inflammatory markers and knee joint function. Method:A total of 92 patients with acute traumatic knee synovitis who were treated in our hospital from February 2017 to November 2018 were randomly divided into observation group and control group, with 46 cases in each group. The patients in observation group were treated with Simiaosan combined with arthroscopic radiofrequency ablation, while the patients in control group were treated radiofrequency ablation combined with Gubi tablet, synovitis granule and imrecoxib tablets. The efficacy in the two groups was observed one month after operation. The degree of pain and the swelling of knee joint were evaluated before and one month after operation, and the function of knee joint was evaluated by lysholm knee score system (LKSS) before and one month after operation. And at the same time, the knee joint activity was measured, erythrocyte sedimentation rate (ESR) was analyzed by Wechsler's method, and hypersensitivity C-reactive protein (hs-CRP) was detected by immunoturbidimetry. The adverse reactions and complications of the two groups were observed. Result:Compared with control group after treatment, the total effective rate in observation group was significantly higher than that in control group, with statistically significant differences (P<0.05). The visual analogue scale (VAS) scores of knee pain in both groups after treatment were significantly lower than those before treatment (P<0.05), while the joint swelling scores were significantly higher (P<0.05). After treatment, the VAS score of knee pain in observation group was significantly lower than that of control group at the same time (P<0.05), while the joint swelling score was significantly higher (P<0.05). After treatment, the LKSS score and the range of motion of the affected knee joints in both groups were significantly increased compared with those before treatment (P<0.05), but with more significant improvement in observation group (P<0.05). The levels of ESR in peripheral blood and hs-CRP in serum of the two groups were significantly lower than those before treatment (P<0.05), especially in observation group (P<0.05). No obvious side effects were observed in observation group during the treatment with Simiaosan. There was no significant difference in the incidence of complications between the two groups. Conclusion:The treatment of Simiaosan combined with radiofrequency ablation under arthroscope has a significant efficacy in the treatment of acute traumatic gonarthromeningitis. The knee joint function of the patients was significantly improved, and the mechanism may be related to the inhibition of inflammatory reaction in vivo.
RESUMO
Objective::To observe the clinical efficacy of flavored Sanxitang combined with celecoxib in treating gonarthromeningitis caused by dampness and cold. Method::Totally 120 case were randomly divided into the control group and the treatment group, with 60 cases in each group. The control group was given celecoxib, and the treatment group was treated with flavored sanxitang combined with celecoxib for 30 d. The visual analogue scale (VAS), American knee association knee function scale (AKS), arthritis impact scale (AIMS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were observed before and after treatment. The circumferential diameter, articular cavity effusion and synovial hyperplasia thickness were measured. The serum tumor necrosis factor-α(TNF-α), matrix metalloproteinase (MMP)-3, serum interleukin-1 (IL-1) and erythrocyte sedimentation rate (ESR) were detected. The effective rate and adverse reactions were observed in two groups. Result::The total effective rate in treatment group was 94.8% (55/58), which was higher than 80.7% (46/57) in control group (P<0.05). Compared with before treatment, VAS, AIMS, WOMAC, knee circumference, articular cavity effusion and synovial hyperplasia thickness were significantly reduced in two groups (P<0.05), while the AKS score was significantly increased (P<0.05). Compared with after treatment, VAS, AIMS, WOMAC, knee circumference, articular cavity effusion and synovial hyperplasia thickness were significantly reduced in observation group (P<0.05), whereas the AKS score was significantly increased (P<0.05). TNF-α, MMP-3, IL-1 and ESR in two groups were significantly lower than those group before treatment (P<0.05). After treatment, TNF-α, MMP-3, IL-1 and ESR levels in observation group were significantly reduced compared with those in control group (P<0.05). The incidence rate of adverse reactions in treatment group was 5.89% (4/58), which was lower than 22.81% (13/57) in control group (P<0.05). Conclusion::Flavored Sanxitang combined with celecoxib could alleviate the clinical symptoms of gonarthromeningitis caused by dampness and cold, with a low incidence of adverse reactions.
RESUMO
OBJECTIVE@#To observe the effect of heat sensitive moxibustion based on the articular injection for knee joint synovitis.@*METHODS@#Sixty-seven patients with knee joint synovitis were randomly assigned into an observation group (34 cases) and a control group (33 cases). Articular injection of triamcinolone was used in the control group for 2 courses, 2 times as a course, once 5 days. Based on the treatment in the control group, heat sensitive moxibustion was used in the observation group for 2 courses, 2 weeks as a course, 5 times a week. The acupoints were Yanglingquan (GB 34), Yinlingquan (SP 9), Liangqiu (ST 34), Xuehai (SP 10), Heding (EX-LE 2) or the pain point, subcutaneous nodules around the patella. American Knee Society (AKS) score was measured before and after treatment and one month after treatment. At the same time, the knee joint synovium thickness was measured by MRI; the knee joint effusion was observed by ultrasound; the serum interleukin-1 (IL-1) and matrix metalloproteinase-3 (MMP-3) were measured.@*RESULTS@#After treatment, the AKS scores increased in the two groups (both <0.05); after treatment and at follow-up, the AKS scores in the observation group were higher than those in the control group (both <0.05); at follow-up, the AKS score in the control group was lower than that after treatment (<0.05). After treatment, the synovium thickness, effusion, IL-1 and MMP-3 were lower than those before treatment in the two groups (all <0.05); after treatment and at follow-up, the four indexes in the observation group were lower than those in the control group (all <0.05); at follow-up, the four indexes in the control group increased than those after treatment (all <0.05).@*CONCLUSION@#Heat sensitive moxibustion combined with medicine articular injection can improve synovium inflammatory reaction and the absorption of effusion in the articular cavity,with long-time effect, which are better than simple medicine articular injection.