软伤外洗方联合理疗治疗前交叉韧带重建术后膝关节僵硬临床研究

Clinical Study on Ruanshang Waixi Prescription Combined with Physical Therapy in Treating Knee Joint Stiffness After Anterior Cruciate Ligament Reconstruction

摘要:

目的：观察软伤外洗方联合理疗治疗前交叉韧带重建术后膝关节僵硬的临床疗效。方法：选取2022年6月—2024年12月于河南省洛阳正骨医院/河南省骨科医院诊治的155例前交叉韧带重建术后膝关节僵硬患者，采用随机数字表法分为对照组（77例，失访3例，最终纳入74例） 和研究组（78例，失访2例，最终纳入76例）。对照组单纯予以理疗，研究组在对照组基础上予以软伤外洗方外敷。2组均治疗8周。评价2组临床疗效，比较2组膝关节活动度、膝关节功能及疼痛程度，观察药物不良反应发生情况。结果：研究组总有效率为92.11%（70/76），高于对照组77.03%（57/74）（P＜0.05）。治疗后，2组膝关节外旋、内旋、屈伸活动度较治疗前增加（P＜0.05），且研究组膝关节外旋、内旋、屈伸活动度大于对照组（P＜0.05）。治疗1 周、2 周、4周、8周后，2组视觉模拟评分法（VAS） 评分逐渐降低（P＜0.05），且研究组VAS评分低于同期对照组（P＜0.05）。治疗1周、2周、4周、8周后，2组Lysholm、Tegner、国际膝关节文献委员会膝关节主观评价表（IKDC） 评分逐渐升高（P＜0.05）；治疗2周、4周、8周后，研究组Lysholm、Tegner、IKDC评分高于同期对照组（P＜0.05）。2组均未发生皮肤过敏等药物不良反应。结论：软伤外洗方联合理疗治疗前交叉韧带重建术后膝关节僵硬患者疗效显著，可提高膝关节活动度，减轻疼痛，提升膝关节功能，且安全性高。

Abstract:

Abstract： Objective： To observe the clinical effects of Ruanshang Waixi Prescription combined with physical therapy in treating knee joint stiffness after anterior cruciate ligament reconstruction. Methods：A total of 155 patients with knee joint stiffness after anterior cruciate ligament reconstruction admitted to Luoyang Orthopedic-Traumatological Hospital of Henan Province/Henan Provincial Orthopedic Hospital from June 2022 to December 2024 were enrolled and divided into the control group and the study group by the random number table method. The control group contained 77 cases with 3 cases lost to follow-up，and finally 74 cases were included；the study group contained 78 cases with 2 cases lost to follow-up， and finally 76 cases were included. The control group was treated with simple physical therapy，and the study group was given external application of Ruanshang Waixi Prescription on the basis of the control group. Both groups received treatment for 8 weeks. The clinical effects were evaluated， knee range of motion， knee joint function and pain level were compared， and drug-related adverse reactions were observed. Results： The total effective rate was 92.11% （70/76） in the study group，higher than that of 77.03% （57/74） in the control group （P＜ 0.05）. After treatment，the ranges of external rotation，internal rotation，and flexion and extension of knee joint in both groups were increased when compared with those before treatment （P＜0.05）， and the above indicators in the study group were superior to those in the control group （P＜0.05）. At 1， 2， 4， and 8 weeks after treatment， Visual Analogue Scale （VAS） scores in both groups were decreased gradually （P＜0.05），and the scores in the study group were lower than those in the control group at the same time points （P＜0.05）. Lysholm score， Tegner score， and International Knee Documentation Committee （IKDC） subjective knee evaluation scores in both groups were increased gradually at each time point （P＜0.05）；the above scores in the study group were higher than those in the control group at 2， 4， and 8 weeks after treatment （P＜0.05）. No drug-related adverse reactions such as skin allergy occurred in either group. Conclusion：Ruanshang Waixi Prescription combined with physical therapy has a certain curative effect on patients with knee joint stiffness after anterior cruciate ligament reconstruction. It can improve knee range of motion， relieve pain，and enhance knee joint function with high safety.