目的 探討牛痘疫苗致炎兔皮提取物聯(lián)合玻璃酸鈉治療創(chuàng)傷性踝關(guān)節(jié)炎的臨床療效。方法 將2015年11月—2020年12月長(zhǎng)沙市第四醫(yī)院收治的76例創(chuàng)傷性踝關(guān)節(jié)炎患者作為研究對(duì)象，將患者按照治療方法分為對(duì)照組和觀察組，每組各38例。對(duì)照組關(guān)節(jié)腔內(nèi)注射玻璃酸鈉注射液，1次/周，20 mg/次，連續(xù)治療5周。觀察組在對(duì)照組治療的基礎(chǔ)上關(guān)節(jié)腔內(nèi)注射牛痘疫苗致炎兔皮提取物，3 mL/次，1次/周，連續(xù)治療5周。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的視覺模擬評(píng)分法（VAS）評(píng)分、美國矯形外科足踝協(xié)會(huì)評(píng)分標(biāo)準(zhǔn)（AOFAS）評(píng)分，白細(xì)胞介素（IL）-17、C反應(yīng)蛋白（CRP）和IL-8水平，以及患肢的背伸活動(dòng)度和跖屈活動(dòng)度。結(jié)果 治療后，觀察組的總有效率為94.74%，明顯高于對(duì)照組的78.95%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的VAS評(píng)分顯著降低，AOFAS評(píng)分顯著升高（P<0.05）；治療后，觀察組的VAS評(píng)分比對(duì)照組低，AOFAS評(píng)分比對(duì)照組高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療后的IL-17、CRP、IL-8水平顯著降低（P<0.05）；觀察組的IL-17、CRP、IL-8水平顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療后的背伸活動(dòng)度、跖屈活動(dòng)度顯著升高（P<0.05）；治療后，觀察組的背伸活動(dòng)度、跖屈活動(dòng)度比對(duì)照組高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 牛痘疫苗致炎兔皮提取物聯(lián)合玻璃酸鈉治療創(chuàng)傷性踝關(guān)節(jié)炎的療效確切，能減輕患者疼痛，控制病情發(fā)展，提高關(guān)節(jié)活動(dòng)度，降低炎癥因子的水平，具有良好臨床運(yùn)用價(jià)值。

Objective To investigate the clinical efficacy of extracts from rabbit skin inflamed by vaccinia virus combined with sodium hyaluronate in treatment of traumatic ankle arthritis. Methods A total of 76 patients with traumatic ankle arthritis admitted to the Fourth Hospital of Changsha from November 2015 to December 2020 were selected as the research subjects, and the patients were divided into control group and observation group according to treatment methods, with 38 patients in each group. Patient in the control group were injected with Sodium Hyaluronate Injection into the joint cavity once a week, 20 mg/time, for 5 consecutive weeks. Patient in the observation group were injected with Extracts from Rabbit Skin Inflamed by Vaccinia Virus for Injection on the basis of control group, 3 mL/time, once a week, for 5 consecutive weeks. Clinical efficacy of two groups were observed, and VAS score, AOFAS score, IL-17, CRP, and IL-8 levels, and dorsal-extension and plantar flexion activity of affected limbs before and after treatment were compared between two groups. Results After treatment, the total effective rate of the observation group was 94.74%, which was significantly higher than 78.95% of the control group, and the difference was statistically significant (P < 0.05). After treatment, VAS score in two groups was significantly decreased, while AOFAS score was significantly increased (P < 0.05). After treatment, the VAS score of the observation group was lower than that of the control group, and the AOFAS score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). After treatment, the levels of IL-17, CRP, and IL-8 in two groups were significantly decreased (P < 0.05). The levels of IL-17, CRP, and IL-8 in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). After treatment, the dorsal extension activity and plantarflexion activity of two groups were significantly increased (P < 0.05). After treatment, the dorsal extension activity and plantarflexion activity of the observation group were higher than those of the control group, and the difference was statistically significant (P < 0.05). Conclusion Rabbit skin inflamed by vaccinia virus combined with sodium hyaluronate has definite efficacy in treatment of traumatic ankle arthritis, which can alleviate the pain of patients, control the development of the disease, improve the range of motion of the joint, and reduce the level of inflammatory factors, and has good clinical application value.

R971