目的 观察腰痛1号方治疗椎间盘源性腰痛的疗效.方法 随机选择2020年1月—2022年2月在福建中医药大学附属漳州市中医院骨一病区治疗的60例椎间盘源性腰痛患者为研究对象,通过随机数表法分为对照组和观察组,每组30例.对照组予以常规镇痛、腰椎牵引及功能锻炼治疗,观察组在对照组治疗基础上给予腰痛1号方熏洗.比较治疗后两组腰部疼痛视觉模拟评分(Visual Analogue Scale,VAS)、腰椎功能障碍指数(Oswestry Disability Index,ODI)、下腰痛评分法(Low Back Outcome Scone,LBOS)及磁共振椎间盘退变Pfirrmann分级.结果 治疗1个月,观察组的腰痛VAS评分(1.17±1.12)分、ODI(8.87±1.98)分低于对照组的(2.07±1.31)分、(14.60±1.69)分,LBOS(51.97±4.44)分高于对照组(46.93±5.86)分,差异有统计学意义(t= 2.862、12.059、-3.751,P<0.05).治疗后,观察组椎间盘退变Pfirrmann分级与对照组比较,差异有统计学意义(P<0.05).结论 腰痛1号方能有效降低椎间盘源性腰痛的疼痛评分及减轻腰椎间盘的退变程度,改善腰椎功能状态,促进患者康复.

目的:观察下肢洗伤方在全膝关节置换术后患肢康复中的疗效.方法:将30例行全膝关节置换术的患者随机分为治疗组和对照组,每组15例.对照组采用常规康复训练加热水熏洗,治疗组在常规康复训练的基础上应用下肢洗伤方熏洗治疗.2组均以4周为1个疗程.观察2组治疗前后膝关节肿胀程度、视觉模拟评分法(VAS)评分、关节活动度、膝关节HSS评分.结果:术后2周,2组膝关节肿胀程度、VAS评分、关节活动度较治疗前均有改善(P<0.05).术后4周,2组VAS评分、关节活动度、膝关节HSS评分较治疗前均有改善(P<0.05);且治疗组膝关节肿胀程度、VAS评分、关节活动度、膝关节HSS评分均优于对照组(P<0.05).结论:下肢洗伤方对提高全膝关节置换术后患肢功能效果明显,值得应用推广.

Objective To investigate the effect of Jiegndan on the postoperative recovery after anterior cruciate ligament reconstruction by autologous tendon and the expression of TNF-α,IL-1β,and MMP-2 during the tendon-bone healing.Methods 60 patients with anterior cruciate ligament reconstruction in our hospital from June 2014 to May 2016 were selected.They were randomly divided into observation group and control group,30 cases in each group.Within 2 weeks,the two groups of patients underwent routine knee rehabilitation exercise and oral Xiaozhong Huoxue herb.The observation group began to use Jiegudan from the third week after operation,and took the drug for 8 weeks with 1 week of interval in the middle.Results The Lysholm scores in the observation group before operation,3 months after operation,and 6 months after operation were (38.37±1.10),(85.01±2.34),(93.37±1.30),and those in the control group were (38.90±1.27),(81.10±2.89),(93.87±1.57),the difference was statistically significant at 3 months after operation (P＜0.05).The content of IL-1β in the synovial fluid in the observation group before operation,1 month after operation,and 3 months after operation were (142.67±16.96)pg/nl,(99.81±17.53) pg/nl,(34.74±6.58) pg/nl,and those in the control group were (145.55±17.50) pg/nl,(110.24± 18.04) pg/nl,(38.87±7.44) pg/nl,the difference between the two groups was statistically significant at 1 month and 3 months after operation (P＜0.05).The levels of TNF-αt in the synovial fluid in the observation group before operation,1 month after operation,and 3 months after operation were (249.50± 18.7) pg/nl,(122.13± 19.81)pg/nl,(60.42±9.53) pg/nl,and those in the control group were (241.80±21.08) pg/nl,(135.61±17.70) pg/nl,(66.20±12.35) pg/nl,the difference between the two groups was statistically significant at 1 month and 3 months after operation (P＜0.05).The levels of MMP-2 in the synovial fluid in the observation group before operation,1 month after operation,and 3 months after operation were (102.36±12.10) pg/nl,(80.16±9.35) pg/nl,(63.28±13.74) pg/nl,and those in the control group were (98.29±11.13) pg/nl,(91.02±14.97) pg/nl,(67.81±16.36) pg/nl,the difference between the two groups was statistically significant at 1 month after operation (P＜0.05).The content of IL-1β in the blood in the observation group before operation,1 month after operation,and 3 months after operation were (213.46±18.31) pg/nl,(139.61±17.46) pg/nl,(103.88±17.92) pg/nl,and those in the control group were (211.60±15.02) pg/nl,(149.92±15.96) pg/nl,(100.96±13.32) pg/nl,the difference between the two groups was statistically significant at 1 month and 3 months after operation (P＜0.05).The levels of TNF-t in the blood in the observation group before operation,1 month after operation,and 3 months after operation were (352.44±24.70) pg/nl,(240.65±22.26) pg/nl,(131.80±17.27) pg/nl,and those in the control group were (354.18±21.20) pg/nl,(260.02±25.15) pg/nl,(149.63±24.42) pg/nl,the difference between the two groups was statistically significant at 1 month and 3 months after operation (P＜0.05).The levels of MMP-2 in the blood in the observation group before operation,1 month after operation,and 3 months after operation were (180.62± 18.88) pg/nl,(119.82 15.96) pg/nl,(87.90±14.02) pg/nl,and those in the control group were (171.45±19.18) pg/nl,(129.80±20.17) pg/nl,(90.20±14.83) pg/nl,the difference between the two groups was statistically significant at 1 month after operation (P＜0.05).Conclusion Jiegudan can improve the score of knee function after ACL reconstruction in a short period of time,reduce local inflammation,improve the symptoms of knee joint.

2015年1月～2017年12月,我科采用改良肘关节前内侧入路治疗1 1例尺骨冠状突骨折患者,效果良好,报道如下. 1材料与方法 1.1病例资料本组11例,男7例,女4例,年龄24 ～65岁.左侧4例,右侧7例.开放损伤2例,闭合损伤9例.患者受伤至手术时间1.5 ～72 h.

目的 探讨伸直型桡骨远端骨折手法复位后予休息位石膏固定后的临床疗效,并与传统夹板固定进行比较.方法 选择2013年12月-2015年11月120例伸直型桡骨远端骨折患者,随机分为试验组和对照组各60例.试验组采用休息位石膏托外固定,2周后改为夹板外固定;对照组腕关节手法复位后予传统夹板固定在掌屈尺偏位,两组均固定至临床愈合,观察其临床疗效.等级资料比较采用秩和检验,P＜0.05为差异有统计学意义.结果 两组患者影像学疗效(75.00％、16.67％、8.33％、0.00％与58.33％、25.00％、8.33％、8.33％)比较,差异有统计学意义(Z=-2.048,P＜0.05).两组患者Cooney评分(71.67％、20.00％、6.67％、1.67％与53.33％、21.67％、10.67％、8.33％)比较,差异有统计学意义(Z=-2.378,P＜0.05).结论 休息位固定治疗腕关节伸直型桡骨远端骨折较传统夹板掌屈尺偏位固定临床效果更佳.

髌股关节不稳定是临床上的一种常见病.该病的临床治疗方案多为保守治疗或手术治疗.本文对该病的病因,发病机理,临床症状等进行分析并对近年来对于该病的保守治疗方案做一综述.