半导体激光穴位照射联合川芎嗪治疗膝骨关节炎的临床研究  

Clinical study of semiconductor laser irradiation combined with tetramethylpyrazine for knee joint osteoarthritis

作　　者：江帆[1] 许建文[1] 张莉[1] 周增华[2] 袁丽秀[1] 付水生 Fan Jiang;Jian-wen Xu;Li Zhang;Zeng-hua Zhou;Li-xiu Yuan;Shui-sheng Fu(Department of Rehabilitation,the First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530021,China;Department of Pain Management,the Second Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530007,China)

机构地区：[1]广西医科大学第一附属医院康复科,广西南宁530021 [2]广西医科大学第二附属医院疼痛科,广西南宁530007

出　　处：《中国现代医学杂志》2018年第34期48-53,共6页China Journal of Modern Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(No:Z2016304)

摘　　要：目的探讨半导体激光穴位照射联合川芎嗪治疗膝骨关节炎的临床疗效。方法选取符合入组标准的膝骨关节炎患者72例,使用SPSS19.0的随机数字发生器分为3组,分别是半导体激光穴位注射组(A组)、川芎嗪关节内注射组(B组)和半导体激光穴位照射联合川芎嗪关节内注射组(C组),治疗周期为4周。采用Lysholm评分标准和视觉模拟评分量表(VAS)对患者进行膝关节功能和疼痛的评估,并由专业的康复治疗师评估患者治疗后的膝关节活动度(ROM)和疗效缓解情况;采用医院焦虑抑郁量表(HAD)和匹茨堡睡眠质量指数量表(PSQI)评估患者的情绪和睡眠质量;采用股骨头前后位和侧位X射线测量各患者的影像学角度。结果 3组患者的总有效率分别是83.3%、73.1%和93.1%。所有患者治疗后VAS评分、ROM和膝关节功能评分均较治疗前显著改善。A、B两组治疗后VAS评分、ROM、膝关节功能评分、PSQI、HAD-A和HAD-B评分差异无统计学意义(P>0.05)。与A组和B组比较,C组治疗后的VAS评分、膝关节功能评分、PSQI、HAD-A和HAD-B评分降低,ROM角度增加,差异有统计学意义(P <0.05)。A组和B组影像学检测的各个角度参数差异无统计学意义(P>0.05),C组影像学检测的各个角度参数较A组和B组减小,差异有统计学意义(P<0.05)。3组患者治疗后股骨长度、局部肿胀疼痛、照射部位损伤和过敏反应发生率差异无统计学意义(P>0.05)。结论半导体激光穴位照射联合川芎嗪关节内注射能有效改善膝骨关节炎患者的疼痛,促进膝关节功能的恢复,提高患者睡眠质量和情绪。Objective To explore the clinical effect of semiconductor laser irradiation combined with intraarticular injection of tetramethylpyrazine in the patients with knee joint osteoarthritis.Methods A total of 72 patients with knee joint osteoarthritis meeting the inclusion criteria were randomly divided into three groups using a random number generator of SPSS 19.0:a semiconductor laser irradiation group(group A),a tetramethylpyrazine intraarticular injection group(group B)and a combination group(group C).The period of treatment in each group was 4 weeks.The function and pain of the knee joints after treatment were assessed by Lysholm score and Visual Analogue Scale(VAS)respectively.Then,the range of motion(ROM)of the knee joints and remission after treatment were evaluated by professional rehabilitation therapists,and Hospital Anxiety and Depression Scale(HAD)and Pittsburgh Sleep Quality Index(PSQI)were performed to evaluate the emotion and sleep quality of included patients.All radiographic measurements were obtained from true long-standing anteroposterior and femoral lateral radiographs.Results The total effective rate of the three groups were 83.3%,73.1%and 93.1%respectively.The VAS score,ROM and functional score of the knee joints in all the patients after treatment were significantly improved in comparison with the baseline condition.The VAS score,ROM,functional score of the knee joints,PSQI,HAD-A and HAD-B scores were not significantly different between the groups A and B(P>0.05).Compared with the groups A and B,the VAS score,functional score of the knee joints,PSQI,HAD-A and HAD-B scores were significantly decreased while ROM was increased in the group C(P<0.05).The measured parameters by radiographs were not significantly different between the groups A and B(P>0.05),but these parameters in the group C were decreased compared to those in the groups A and B(P<0.05).The femoral length and incidence of local swelling and pain,damage of irradiation site and anaphylactic reaction were not significantly different am

关 键 词：骨关节炎 膝 激光 半导体 激光疗法 川芎嗪/中草药 

分 类 号：R684.3[医药卫生—骨科学] R441.1[医药卫生—外科学]