辨证施护配合康复训练对双膝骨性关节炎患者血清炎症因子水平的影响
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摘要
【目的】评价辨证施护配合康复训练对双膝骨性关节炎(KOA)血清炎症因子水平与关节功能的影响。【方法】将60例双膝KOA患者随机分为观察组和对照组各30例。治疗期间2例脱落,1例退出,最终纳入病例对照组29例、观察组28例。对照组在中医治疗基础上给予常规护理,观察组在对照组常规护理基础上给予辨证施护(分风寒湿痹、风湿热痹、瘀血闭阻、肝肾亏虚4型)配合康复训练,评价2组患者的临床疗效及护理干预前后膝关节功能、血清炎症因子的变化情况。【结果】(1)观察组的总有效率为89.3%,优于对照组的72.4%,差异有统计学意义(P<0.05)。(2)护理干预后,2组Lysholm评分均较护理干预前显著提高(P<0.05),且观察组的提高作用优于对照组(P<0.05)。(3)护理干预后,2组白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均较护理干预前显著下降(P<0.05),且观察组的下降作用优于对照组(P<0.05)。【结论】辨证施护配合康复训练干预治疗双膝KOA患者,临床疗效确切,可显著改善患者的膝关节功能,调控患者的血清炎症因子水平。
Objective To investigate the effect of dialectical nursing combined with rehabilitation training on the levels of serum inflammatory cytokines and joint function of patients with bilateral knee osteoarthritis(KOA). Methods A total of 60 cases of bilateral KOA patients were randomized into observation group and control group,30 case in each group. During the treatment,2 cases of observation group were dropped out and one case of the control group quitted,and therefore,the number of the final cases of the observation group and control group was 28, 29 respectively. The control group was given routine nursing and Chinese medicine therapy, and the observation group was given dialectical nursing care combined with rehabilitation training on the basis of the treatment for the control group. The dialectical nursing was performed for the four syndromes of wind-cold-damp arthralgia,wind-damp-heat arthralgia,blood-stasis blockage,and liver-kidney insufficiency.The therapeutic effect was evaluated after treatment, and the changes in knee joint function and serum inflammatory cytokines before and after treatment were observed. Results(1)The total effective rate of the observation group was 89.3%, superior to 72.4% in the control group(P <0.05).(2)After treatment, Lysholm scores of both groups were increased(P <0.05 compared with those before treatment), and the increase of the observation group was superior to that of the control group(P <0.05).(3)After treatment, serum levels of interleukin 1(IL-1),interleukin 6(IL-6),and tumor necrosis factor alpha(TNF-α)were declined in the two groups(P<0.05 compared with those before treatment),and the decrease of the observation group was superior to that of the control group(P <0.05). Conclusion Dialectical nursing combined with rehabilitation training is effective for the treatment of bilateral KOA,and the combined therapy has certain effect on improving knee joint function and regulating the levels of serum inflammatory cytokines.
Objective To investigate the effect of dialectical nursing combined with rehabilitation training on the levels of serum inflammatory cytokines and joint function of patients with bilateral knee osteoarthritis(KOA). Methods A total of 60 cases of bilateral KOA patients were randomized into observation group and control group,30 case in each group. During the treatment,2 cases of observation group were dropped out and one case of the control group quitted,and therefore,the number of the final cases of the observation group and control group was 28, 29 respectively. The control group was given routine nursing and Chinese medicine therapy, and the observation group was given dialectical nursing care combined with rehabilitation training on the basis of the treatment for the control group. The dialectical nursing was performed for the four syndromes of wind-cold-damp arthralgia,wind-damp-heat arthralgia,blood-stasis blockage,and liver-kidney insufficiency.The therapeutic effect was evaluated after treatment, and the changes in knee joint function and serum inflammatory cytokines before and after treatment were observed. Results(1)The total effective rate of the observation group was 89.3%, superior to 72.4% in the control group(P <0.05).(2)After treatment, Lysholm scores of both groups were increased(P <0.05 compared with those before treatment), and the increase of the observation group was superior to that of the control group(P <0.05).(3)After treatment, serum levels of interleukin 1(IL-1),interleukin 6(IL-6),and tumor necrosis factor alpha(TNF-α)were declined in the two groups(P<0.05 compared with those before treatment),and the decrease of the observation group was superior to that of the control group(P <0.05). Conclusion Dialectical nursing combined with rehabilitation training is effective for the treatment of bilateral KOA,and the combined therapy has certain effect on improving knee joint function and regulating the levels of serum inflammatory cytokines.
引文
[1]陈水晶.中医熏洗联合中医护理在膝骨性关节炎65例中的应用[J].中国民族民间医药,2014,22(24):129.
[2]田润,王丹,沈旭慧.双膝晚期骨性关节炎患者手术治疗与康复护理进展[J].湖州师范学院学报,2015,36(4):86.
[3]吕红姣.老年膝关节骨性关节炎患者TKA术后不同护理方式效果观察[J].河北医科大学学报,2012,52(6):717.
[4]沈菊艳.1例双膝骨性关节炎伴糖尿病患者行双侧全膝关节置换术的护理[J].护理实践与研究,2013,23(9):118.
[5]鞠传兰.综合疗法治疗膝骨性关节炎的疗效观察及护理[J].中华全科医学,2011,8(7):1156.
[6]黄姝变,乔欣军,安海库.护理干预配合中药外洗治疗膝关节骨关节炎疗效观察[J].河北北方学院学报(自然科学版),2012,27(4):66.
[7]荀淑英,王玲玲,徐玫玫,等.中西医结合微创技术治疗膝关节骨性关节炎88例的规范化护理[J].河南中医,2012,36(10):1413.
[8]张旺琼,钟志年,周首邦.中药熏洗和中医护理配合治疗膝骨性关节炎的临床研究[J].中医临床研究,2012,3(24):106.
[9]郭红军,张宇静.循证护理在中老年膝骨关节炎患者护理中的应用[J].河南科技大学学报(医学版),2007,24(2):158.
[10]刘蕾,李海波,杨丽莎,等.中药热奄包治疗膝关节退行性骨关节炎的循证护理[J].贵阳中医学院学报,2013,34(2):216.
[2]田润,王丹,沈旭慧.双膝晚期骨性关节炎患者手术治疗与康复护理进展[J].湖州师范学院学报,2015,36(4):86.
[3]吕红姣.老年膝关节骨性关节炎患者TKA术后不同护理方式效果观察[J].河北医科大学学报,2012,52(6):717.
[4]沈菊艳.1例双膝骨性关节炎伴糖尿病患者行双侧全膝关节置换术的护理[J].护理实践与研究,2013,23(9):118.
[5]鞠传兰.综合疗法治疗膝骨性关节炎的疗效观察及护理[J].中华全科医学,2011,8(7):1156.
[6]黄姝变,乔欣军,安海库.护理干预配合中药外洗治疗膝关节骨关节炎疗效观察[J].河北北方学院学报(自然科学版),2012,27(4):66.
[7]荀淑英,王玲玲,徐玫玫,等.中西医结合微创技术治疗膝关节骨性关节炎88例的规范化护理[J].河南中医,2012,36(10):1413.
[8]张旺琼,钟志年,周首邦.中药熏洗和中医护理配合治疗膝骨性关节炎的临床研究[J].中医临床研究,2012,3(24):106.
[9]郭红军,张宇静.循证护理在中老年膝骨关节炎患者护理中的应用[J].河南科技大学学报(医学版),2007,24(2):158.
[10]刘蕾,李海波,杨丽莎,等.中药热奄包治疗膝关节退行性骨关节炎的循证护理[J].贵阳中医学院学报,2013,34(2):216.