康复治疗联合玻璃酸钠关节腔注射治疗运动性膝关节损伤的临床疗效评价  

Clinical effect of rehabmtation combined with intra-articular injection of sodium hyaluronate for exercise induced knee osteoarthritis

作　　者：徐瑞泽 张杭州[2] 郭大伟 潘俊南 焦军[1] XU Rui-ze;ZHANG Hang-zhou;GUO Da-wei;PAN Jun-nan;JIAO Jun(Department of Sports Medicine,Shenyang Orthopaedics Hospital,Shenyang,Liangning 121000,China;Department of Or thopaedics,First Affiliated Hospital of China Medical University)

机构地区：[1]沈阳市骨科医院运动医学科,辽宁沈阳121000 [2]中国医科大学附属第一医院骨科,辽宁沈阳110010

出　　处：《海南医学院学报》2018年第19期1737-1741,共5页Journal of Hainan Medical University

基　　金：国家自然科学基金青年项目(81501857)~~

摘　　要：目的:探讨在康复治疗的基础上给予关节腔内注射玻璃酸钠治疗运动性膝关节损伤的患者关节功能、关节周围肌肉功能、膝关节炎性因子的影响,并评价临床疗效。方法:收集2013年8月～2017年10月运动性膝关节损伤患者120例,按照入组先后顺序分为对照组和干预组,每组均为60例。对照组患者给予常规康复治疗,干预组患者在对照组的基础上给予关节腔内注射玻璃酸钠,连续治疗4w。治疗后采用膝关节功能评分量表评估膝关节功能(行走能力、上下楼能力、屈膝下蹲能力3方面);评估膝关节屈伸肌群肌力;在等速向心肌力测试条件下(角速度为60°/S、180°/S)测定膝关节的峰力矩、做功量比值;检测关节液中炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]浓度,并评估临床疗效。结果:治疗后干预组临床疗效高于对照组,但差异无统计学意义(P>0.05);治疗后两组患者的膝关节功能评分均有所升高,差异有统计学意义(P<0.05),且干预组膝关节功能评分高于对照组,差异有统计学意义(P<0.05);治疗后两组患者屈伸肌群肌力均有所升高,差异有统计学意义(P<0.05),且干预组高于对照组,差异有统计学意义(P<0.05);治疗后两组患者膝关节的峰力矩、股四头肌向心峰值力矩比值均高于治疗前,差异有统计学意义(P<0.05),且干预组高于对照组,差异有统计学意义(P<0.05);治疗后两组患者IL-6、TNF-α、CRP均低于治疗前,差异有统计学意义(P<0.05),且对照组低于对照组,差异有统计学意义(P<0.05)。结论:在康复治疗的基础上给予关节腔内注射玻璃酸钠能通过改善膝关节周围肌肉的肌力水平与其生物力学功能与关节腔内炎性反应而改善运动性膝关节损伤患者的关节功能。Objective： To evaluate the clinical effects of rehabmtation combined with intra articular injection of sodium hyaluronate for exercise induced knee osteoarthritis, and to detect changes in biomechanics of knee joint, and inflammatory fac tors in the articular cavity after treatment.. Methods： A total of 120 patients with exercise induced knee osteoarthritis admitted to our hospital during August 2013 and 10 2017 were selected and randomly divided into control group （n=60） and intervene group （n=60）. The patients in the control group were given conventional rehabmtation treatment, while the intervene group were given intra articular injection of sodium hyaluronate based on the conventional treatment given to the control group. Both groups were treated for 4 consecutive weeks. Then, the function of knee joint （walking ability, climb up and down the floor a bility~ and squating ability） were evaluated; isokinetic muscle strength test was conducted; the ratio of muscle peak torque to work load of femoral knee joints under the condition of isokinetic centripetal force test was also carried out （determination of the angular velocity were 60°/S、180°/S）. Inflammatory factors including Interleukin 6 （IL- 6）, tumor necrosis factor α （TNF-α） , C reactive protein （CRP） in the joint fluid were detected. Results： After the treatmentm clinical effect in intervene group was superior to that in control group, but the difference was not significant（P〉0.05）. After the treatment~ the function score of knee joint in the two groups were significant higher than that before treatment （P〈0.05） , and the score of function of knee joint in the intervene group were significant higher than control group （P〈0.05）; the muscle strength of the flexor and extensor muscle group was increased after treatment in both groups showing significant difference （P〈0.05）, and the increase in the intervene group were significant obious than control group （P〈0.05）. After the treatment, the

关 键 词：康复治疗 玻璃酸钠 运动性膝关节损伤 肌力 关节功能 炎性因子 临床疗效 

分 类 号：R873[医药卫生—运动医学]