低强度脉冲超声可缓解膝骨关节炎疼痛与修复关节软骨损伤  

Low-intensity pulsed ultrasound can alleviate knee osteoarthritis pain and promote articular cartilage repair

作　　者：罗显文 李明星[1] Luo Xianwen;Li Mingxing(Department of Ultrasound,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Ultrasound,Zigong Third People’s Hospital,Zigong 643000,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院超声科,四川省泸州市646000 [2]自贡市第三人民医院超声科,四川省自贡市643000

出　　处：《中国组织工程研究》2019年第3期348-353,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:大量研究证实低频脉冲超声治疗能有效缓解膝关节骨关节炎患者的关节肿胀与炎症。但同时探讨低强度脉冲超声波治疗对骨关节炎疼痛与关节软骨损伤修复作用的临床研究鲜有报道。目的:探讨低强度脉冲超声波对膝骨关节炎疼痛与关节软骨损伤的治疗作用及疗效评价。方法:将120例膝骨关节炎患者随机分为对照组、超声治疗组和联合治疗组,对照组患者接受双氯芬酸钠缓释片常规治疗,超声治疗组接受低强度脉冲超声波治疗,联合治疗组接受双氯芬酸钠缓释片联合低强度脉冲超声波治疗。治疗后1和3个月观察疼痛目测类比评分、Lequesne指数、Lysholm评分、Noyes关节软骨缺损评分、临床疗效和不良反应发生情况。结果与结论:①治疗后1和3个月,超声治疗组和联合治疗组疼痛目测类比评分及Lequesne指数显著低于对照组,末次随访总有效率显著高于对照组(P <0.01,P <0.05);②治疗后1和3个月,超声治疗组和联合治疗组Lysholm评分显著高于对照组(P <0.01);③治疗后1和3个月,超声治疗组和联合治疗组Noyes关节评分显著低于对照组(P <0.01);④随访期间,仅对照组有2例发生药物相关性头痛和恶心,其他2组未发生超声波毒性反应和药物不良反应;⑤结果提示,低强度脉冲超声治疗膝关节骨关节炎疗效确切,能有效减轻疼痛并促进关节软骨损伤的修复,且低强度脉冲超声治疗并不影响药物的有效性。BACKGROUND:Low-intensity pulse ultrasound(LIPUS)has been shown to effectively alleviate joint swelling and inflammation in patients with knee osteoarthritis.But its efficacy in the alleviation of osteoarthritis pain and in the repair of articular cartilage is rarely reported.OBJECTIVE:To evaluate the effect of LIPUS on alleviating knee osteoarthritis pain and treating articular cartilage injury.METHODS:Totally 120 patients with knee osteoarthritis were randomly divided into three groups,and treated with diclofenac sodium sustained release tablets(control group),LIPUS(LIPUS group)and their combinations(combination group),respectively.The visual analogue scale,Lequence index,Lysholm score,Noyes score,clinical efficacy and adverse reactions were observed at 1 and 3 months after treatment.RESULTS AND CONCLUSION:At 1 and 3 months after treatment,in the LIPUS and combination groups,the visual analogue scale score and the Lequence index were significantly lower than those in the control group,and the total effective rate was significantly higher than that in the control group(P<0.01,P<0.05).At 1 and 3 months after treatment,the Lysholm scores in the LIPUS and combination groups were significantly higher than those in the control group(P<0.01).The Noyes scores in the LIPUS and combination groups were significantly lower than those in the control group at 1 and 3 months after treatment(P<0.01).Additionally,there were two cases of drug-related headache and nausea in the control group,and no ultrasonic toxicity or drug-related adverse events occurred in the other two groups.These results imply that LIPUS is effective in the treatment of knee osteoarthritis,can effectively relieve pain and promote the repair of articular cartilage injury.It shows no effect on the effectiveness of drugs.

关 键 词：软骨组织工程 低强度脉冲超声波 膝骨关节炎 关节软骨损伤 双氯芬酸钠缓释片 无创 疼痛评分 Noyes关节评分 关节活动度 组织构建 超声疗法 骨关节炎 镇痛 膝关节 组织工程 

分 类 号：R454.3[医药卫生—治疗学]