负重监测下扶拐减重联合股四头肌锻炼治疗轻中度膝骨关节炎的临床研究  

Crutch-assisted weight relief under the guidance of weight-bearing monitor combined with quadriceps exercises for treatment of mild-to-moderate knee osteoarthritis: a clinical study

作　　者：秦伟凯[1] 陈彦飞[1] 张宽[1] 赵勇[1] QIN Weikai;CHEN Yanfei;ZHANG Kuan;ZHAO Yong(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《中医正骨》2018年第11期13-16,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：北京中医药科技发展资金项目(JJ2016-67);中国中医科学院望京医院院级科研课题(WJYY2016-PY-011)

摘　　要：目的:观察负重监测下扶拐减重联合股四头肌锻炼治疗轻中度膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:将符合要求的60例KOA患者随机分为2组,每组30例。联合治疗组采用负重监测仪监测下扶拐减重联合股四头肌锻炼治疗,股四头肌锻炼组单纯采用股四头肌锻炼治疗。分别于治疗前和治疗2周后评定患者的膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、Lysholm膝关节评分、美国特种外科医院(The Hospital for Special Surgery,HSS)膝关节评分,并于治疗2周后采用《中药新药临床研究指导原则(试行)》中KOA的疾病疗效判定标准评定总体疗效。结果:至观察结束时,联合治疗组1例脱落、股四头肌锻炼组2例脱落。治疗前2组患者的疼痛VAS评分比较,差异无统计学意义(t=0. 631,P=0. 531);治疗2周后,2组患者的疼痛VAS评分均较治疗前降低[(4. 97±1. 02)分,(1. 90±0. 77)分,t=12. 943,P=0. 000;(4. 79±1. 13)分,(2. 75±1. 53)分,t=5. 655,P=0. 000],联合治疗组的评分低于股四头肌锻炼组(t=-2. 644,P=0. 012)。治疗前2组患者的Lysholm评分比较,差异无统计学意义(t=-2. 817,P=0. 077);治疗2周后,2组患者的Lysholm评分均较治疗前增高[(59. 45±14. 06)分,(77. 86±13. 27)分,t=-5. 129,P=0. 000;(69. 14±11. 77)分,(80. 64±12. 73)分,t=-3. 059,P=0. 001]; 2组治疗2周后的评分比较,差异无统计学意义(t=-0. 807,P=0. 423)。治疗前2组患者的HSS评分比较,差异无统计学意义(t=-1. 558,P=0. 125);治疗2周后,2组患者的HSS评分均较治疗前增高[(78. 76±7. 68)分,(86. 65±8. 61)分,t=-3. 685,P=0. 001;(82. 04±8. 19)分,(86. 89±9. 24)分,t=-2. 081,P=0. 042]; 2组治疗2周后的评分比较,差异无统计学意义(t=-0. 100,P=0. 920)。治疗2周后,2组患者的总体疗效比较,差异无统计学意义(u=1. 592,P=0. 328)。结论:负重监测下扶拐减重联合股四头肌锻炼可有效缓解轻中度KOA患者的疼痛症状、改善膝关节功能,在缓解�Objective：To observe the clinical curative effects of crutch-assisted weight relief under the guidance of weight-bearing monitor combined with quadrieeps exercises for treatment of mild-to-nloderate knee osteoarthritis（KOA）. Methods：Sixty patients with KOA were enrolled in the study and were randomly divided into combination treatment group and quadrieeps exercise group, 30 eases in each group. The patients in combination treatment group were treated with crutch-assisted weight relief under the guidance of weight-bearing monitor,while the others in quadrieeps exercise group were treated with monotherapy of quadrieeps exercises. The knee pain visual analogue scale （VAS）scores, Lysholm knee joint scores and Hospital for Special Surgery-（HSS） knee scores were evaluated before treatment and after 2-week treatment respectively, and the total curative effects were evaluated after 2-week treatment according to the therapeutic effect evalua- tion standard of KOA which was extracted from Guiding prbtoiples of clinical research on new Chbwse medicbw （try out）. Results：One pa- tient in combination treatment group and 2 patients in quadrieeps exercise group dropped out of the trial by the end of observation period. There was no statistical difference in knee pain VAS scores between the 2 groups before the treatment（ t = 0. 631 ,P = 0. 531 ）. The knee pain VAS scores decreased after 2-week treatment compared to pretreatment in the 2 groups （4.97 ＋/-1.02 vs 1.90 ＋/-0.77 points, t = 12. 943,P = 0.000 ;4.79 ＋/- 1.13 vs 2.75 ＋/- 1.53 points, t = 5. 655, P = 0. 000） , and were lower in combination treatment group com- pared to quadrieeps exercise group（t = -2. 644,P = 0. 012）. There was no statistical difference in Lysholm scores between the 2 groups before the treatment（t = -2. 817, P = 0. 077 ）. The Lyshohn scores increased after 2-week treatment compared to pretreatment in the 2 groups（59.45 ＋/- 14.06 vs 77.86 ＋/- 13.27 points, t = -5. 129,P = 0. 000;69.14 ＋/- 11.77 vs 80.64

关 键 词：骨关节炎 膝 负重 股四头肌 运动疗法 临床试验 

分 类 号：R684.3[医药卫生—骨科学]