综合康复治疗对轻中度膝骨关节炎骨髓水肿的疗效  

The therapeutic effect observation of comprehensive rehabilitation therapy on mild to moderate knee osteoarthritis with bone marrow edema

作　　者：欧阳辉[1] 宋秀豹[1] 王玉苹[1] 朱丽花[2] 史长征[3] 

机构地区：[1]暨南大学附属第一医院康复科,广东广州510630 [2]暨南大学附属第一医院风湿科,广东广州510630 [3]暨南大学附属第一医院影像科,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2015年第2期182-185,共4页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：广东省医学科研基金项目(A2012336)

摘　　要：目的:探讨综合康复治疗对轻中度膝骨关节炎骨髓水肿(BME)的疗效.方法:选择核磁共振(MRI)诊断为BME的膝骨关节炎患者60例,按随机数字表随机分为综合康复治疗组和药物对照组,综合康复治疗组:在药物治疗的同时根据美国运动医学学会(ACSM)指导原则进行规范化的综合康复治疗,采用布洛芬胶囊(0.3 g,一日两次)+氨基葡萄糖(750 mg,一日两次)+综合康复治疗(体外高频热疗+肌力训练),共12周;对照组:布洛芬胶囊(0.3 g,一日两次)+氨基葡萄糖(750 mg,一日两次),共12周.两组患者治疗前及治疗结束后采用视觉模拟评分法(VAS)和西安大略与麦克马斯特大学骨关节炎指数(WOMAC)问卷调查进行疼痛和关节功能评分.BME评估利用MRI技术采用Felson等方法进行评分.结果:综合康复治疗在缓解疼痛和改善功能方面的疗效优于药物组,两组BME评分与治疗前比较均有明显减少,差异有统计学意义(P<0.01);治疗组的BME评分低于对照组,差异有统计学意义(P<0.05),提示两组方法均能有效减少BME,且综合康复疗法优于单纯药物治疗.结论:通过MRI观察,综合康复治疗(体外高频热疗+肌力训练+药物)能够减轻膝骨关节炎的骨髓水肿,具有消炎、消肿、止痛、延缓软骨退变、改善关节功能的作用.Aim：To determine the efficacy of comprehensive rehabilitation therapy for bone marrow e-dema（BME）caused by mild to moderate osteoarthritis of the knee.Methods：Sixty patients were ran-domly divided into the comprehensive rehabilitation treatment group and the control group of drugs ac-cording to the random number table.The comprehensive rehabilitation treatment group took Ibuprofen Capsules （0.3 g,bid）,Glucosamine （750 mg,bid）and comprehensive rehabilitation therapy （In vitro high-frequency hyperthermia and strength training）whichaccording to American college of sports medi-cine （ACSM）’s guidelines while the control group took only Ibuprofen Capsules （0.3 g,bid）,Glu-cosamine （750 mg,bid）for a period of 12 weeks.Both groups used a questionnaire to survey pain and the joint function scores before and after the treatments.For BME evaluation,magnetic resonance ima-ging （MRI）,Felson method and other methods were used.Results：Comprehensive rehabilitation thera-py in relieving pain and improving function is better than the drug therapy.Both groups’BME scores are significantly reduced（P 〈0.01）but the treatment group had less scores （P 〈0.05）which prompt both means can effectively reduce the BME and comprehensive rehabilitation therapy is better than medication.＆nbsp;Conclusion：Comprehensive rehabilitation treatment can alleviateknee osteoarthritis’BME and has anti-phlogistic and acetanilide detumescence effect as well as retarding cartilage degeneration and improving joint functions.

关 键 词：膝关节骨关节炎 骨髓水肿 综合 康复治疗 

分 类 号：R454[医药卫生—治疗学]