阎秀 冯岚

【摘 要】目的：观察中药封包对膝关节镜术后残留疼痛及白细胞介素-1β（IL-1β）的影响。方法：将膝关节镜术后残留疼痛患者60例随机分为治疗组和对照组，每组30例。对照组在膝关节镜术后给予对症处理及CPM机锻炼，治疗组在对照组治疗基础上配合中药封包。观察2组术后膝关节疼痛视觉模拟评分法（VAS）评分，检测关节液IL-1β表达水平。结果：治疗组患者在术后第2，3，7，14天时，膝关节疼痛VAS评分得到缓解，较治疗前有改善（P < 0.05），且较同时间点对照组改善（P < 0.05）。治疗组术后第14天关节液IL-1β明显下降（P < 0.05），且较对照组下降明显（P < 0.05）。结论：中药封包可有效缓解膝关节镜术后残留疼痛，降低关节液IL-1β表达。

【关键词】 中药封包；膝关节镜手术；疼痛；白细胞介素-1β

Effect of Chinese Medicine Package Therapy on Residual Pain and Interleukin-1β after Arthroscopic Knee Surgery

YAN Xiu，FENG Lan

【ABSTRACT】Objective：To observe the effect of Chinese medicine package therapy on residual pain and interleukin-1β（IL-1β）after arthroscopic knee surgery.Methods：Sixty patients with residual pain after arthroscopic knee surgery were randomly divided into a treatment group and a control group，30 cases in each group.The control group was given symptomatic treatment and CPM exercise after arthroscopic knee surgery，while the treatment group was treated with Chinese medicine package therapy based on the treatment for the control group.Visual analogue score（VAS）of knee joint pain was observed and the expression of IL-1β in joint fluid was detected.Results：Respectively 2，3，7，14 days after operation，the VAS score of knee pain in the treatment group was relieved，which was better than that before treatment（P < 0.05），and was better than that in the control group at the same time（P < 0.05）.The level of IL-1β in the synovial fluid of the treatment group was significantly lower than that of the control group on the 14 th day after operation（P < 0.05）.Conclusion：Chinese medicine package therapy can effectively relieve residual pain after arthroscopic knee surgery and reduce the expression of IL-1β in synovial fluid.

【Keywords】 Chinese medicine package therapy；arthroscopic knee surgery；pain；interleukin-1β

隨着微创外科理念的发展和技术的成熟，膝关节镜手术在骨伤科领域中运用逐渐增多，特别是膝骨关节炎、膝关节半月板损伤等，具有创伤小、恢复快等优势。然而，因膝关节镜术中需要对关节腔灌洗生理盐水，术后常出现关节肿胀、残留疼痛等症状，影响了患者术后的康复[1-3]。笔者针对膝关节镜术后残留疼痛运用中药封包进行治疗，观察疼痛缓解情况及关节液白细胞介素-1β（IL-1β）表达情况，现总结报告如下。

1 临床资料

1.1 一般资料 选取2016年1月至2017年10月在湖南省中医药研究院附属医院骨伤科就诊的膝关节镜术后残留疼痛患者60例，随机分为治疗组和对照组，每组30例。治疗组男13例，女17例；年龄41～65岁，平均（56.90±3.21）岁；术前疾病诊断：膝骨关节炎10例，半月板损伤14例，膝关节内游离体6例。手术方式：关节清理术10例，

半月板修整14例，游离体摘除6例。手术时间30～90 min，平均（64.72±10.43）min。对照组男12例，女18例；年龄40～65岁，平均（57.24±

3.56）岁；术前疾病诊断：膝骨关节炎11例，半月板损伤13例，膝关节内游离体6例。……