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[目的]观察辨证分型联合关节镜手术治疗膝关节滑膜炎疗效。[方法]对68例膝关节滑膜炎,关节镜手术,按Jackson标准选择手术入路,充分冲洗并排除关节内积血,探查髌上囊、内外侧间沟、髌股关节及髁间窝;刨刀切除充血水肿、形成血管翳-肥厚滑膜;视滑膜功能,离子刀电凝止血保留部分苍白或轻充血滑膜,生理盐水充分冲洗关节腔,直到引流液清亮,取滑膜病理诊断;术后24~48h拔出引流管,局部冰敷24h,尽早进行股四头肌等长收缩训练、直腿抬高训练、内收肌功能训练及髌骨内推活动。辨证分型,气滞血瘀,活血利湿,桃红四物汤合三妙散;风寒湿阻,健脾利湿,健脾除湿汤;脾肾不足,舒筋壮骨,利湿消肿,自制舒络丸合壮骨片;痰湿结滞,温阳利水兼化痰,五苓散合二陈汤。连续治疗1周为1疗程。观测临床症状、关节疼痛、肿胀程度及数目、功能障碍、Cincinnati评分、浮髌试验、不良反应。治疗1疗程,判定疗效。[结果]痊愈32例,显效18例,有效14例,无效4例,总有效率94.12%。Cincinnati评分明显改善(P<0.05)。[结论]辨证分型联合关节镜手术治疗膝关节滑膜炎,疗效显著,值得推广。
[Objective] To observe the effect of syndrome differentiation combined with arthroscopic operation on knee synovitis. [Method] 68 patients with synovitis of knee joint and arthroscopy were chosen according to the Jackson standard. The hematoma of the joint was fully rinsed out, and the suprapatellar bursa, the medial-lateral gullet, the patellofemoral joint and the intercondylar notch were probed ; Planer resection hyperemia and edema, the formation of vascular 翳 - hypertrophic synovium; as synovial function, ion knife coagulation to keep part of the pale or light congestion of the synovium, saline flush the joint cavity, until the drainage fluid clear, take synovial pathological diagnosis ; 24 to 48h after surgery, the drainage tube was pulled out, local ice 24h, as soon as possible isometric quadriceps contraction training, straight leg raising training, adductor muscle function training and patellar push activities. Syndrome Differentiation, qi stagnation and blood stasis, promoting blood circulation and dampness, Taohong Siwu Decoction combined Miao San; wind and dampness resistance, spleen and dampness, spleen and dampness Decoction; spleen and kidney insufficiency, Shujin Zhuanggu, dampness swelling, Homemade Shuluo Pills and Zhuanggu tablets; Phlegm damp stagnation, yin and yang water and phlegm, Wuling Sanchen two Chen Tang. Continuous treatment for 1 week for a course of treatment. Clinical symptoms, joint pain, degree and number of swelling, dysfunction, Cincinnati score, floating patella test, adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Result] 32 cases were cured, 18 cases were markedly effective, 14 cases were effective and 4 cases were ineffective. The total effective rate was 94.12%. Cincinnati score improved significantly (P <0.05). [Conclusion] Syndrome differentiation combined with arthroscopic treatment of knee joint synovitis has significant curative effect and is worth popularizing.