体外冲击波联合透明质酸治疗膝关节骨关节炎的疗效观察  

Clinical observation of extracorporeal shock wave combined with hyaluronic acid in the treatment of knee osteoarthritis

作　　者：史长安 刘丽[1] 王建伟[1] SHI Chang-an;LIU Li;WANG Jian-wei(Department of Orthopedics,Yan’an People’s Hospital,Yan’an,Shaanxi,716000,China)

机构地区：[1]延安市人民医院骨科,陕西716000

出　　处：《中国骨与关节杂志》2020年第8期632-635,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨体外冲击波联合透明质酸治疗膝关节骨关节炎 (knee osteoarthritis,KOA) 的疗效和安全性。方法本研究于 2018 年 1~12 月间前瞻性纳入 80 例 KOA 患者,通过随机数表法将患者分为联合组 (40 例) 和对照组 (40 例),其中联合组患者每周接受一次体外冲击波治疗 (共 8 周) 和膝关节腔内透明质酸注射 (共 5 周),对照组患者仅每周接受一次膝关节腔内透明质酸注射 (共 5 周)。主要观察指标为 8 周后膝关节疼痛视觉模拟评分 (visual analog scale,VAS) 的改变,而次要观察指标为西安大略和麦克马斯特大学 (Western Ontario and McMaster Universities Arthritis Index,WOMAC) 骨关节炎指数和膝关节损伤和骨关节炎评分 (knee injury and osteoarthritis outcome score,KOOS) 的改变。结果经 8 周治疗后,联合组的 VAS 评分[(1.9±0.5) vs.(3.2±1.1),P<0.001]和 WOMAC 总分[(19.2±6.5) vs.(25.3±7.3),P<0.001]显著低于对照组;联合组的 KOOS 评分中的疼痛[(74.2±17.1) vs.(65.9±16.2),P<0.05]、日常活动[(69.1±12.4) vs.(63.2±9.6),P<0.05]、症状[(67.8±11.4) vs.(62.4±12.3),P<0.05]、运动和娱乐功能[(56.4±8.2) vs.(49.2±9.0),P<0.001]、生活质量[(69.3±14.5) vs.(60.2±12.1),P<0.01]等各项均显著高于对照组。两组患者在治疗周期内的均未发生严重不良反应。结论体外冲击波联合透明质酸治疗 KOA 的临床疗效优于单用透明质酸治疗。Objective To evaluate the efficacy and safety of extracorporeal shock wave(EPSW)combined with hyaluronic acid(HA)in the treatment of knee osteoarthritis(KOA).Methods Eighty patients with KOA were prospectively enrolled between January 2018 and December 2018.All were divided into the combination group(n=40)and control group(n=40)by random number table.The combination group received EPSW(total 8 weeks)combined with intra-cavity HA injection(total 5 weeks)in the knee joint once a week,and the control group received intra-cavity HA injection only once a week(total 5 weeks).Changes of visual analogue scale(VAS)were presented as a main outcome measure,while Western Ontario and McMaster Universities Arthritis Index(WOMAC)and knee injury and osteoarthritis outcome score(KOOS)as the second.Results VAS scores[(1.9±0.5)vs.(3.2±1.1),P<0.001]and WOMAC total scores[(19.2±6.5)vs.(25.3±7.3),P<0.001]of the combination group were significantly lower than that of the control group 8 weeks after the treatment.The KOOS pain[(74.2±17.1)vs.(65.9±16.2),P<0.05],daily activities[(69.1±12.4)vs.(63.2±9.6),P<0.05],symptoms[(67.8±11.4)vs.(62.4±12.3),P<0.05],sports and entertainment functions[(56.4±8.2)vs.(49.2±9.0),P<0.001],and quality of life[(69.3±14.5)vs.(60.2±12.1),P<0.01]of the combination group were significantly higher than those of the control group.No serious adverse reactions occurred in either group.Conclusions The clinical efficacy of EPSW combined with HA is better than that of HA alone in the treatment of KOA.

关 键 词：骨关节炎 膝 体外冲击波疗法 透明质酸 疼痛 

分 类 号：R684.3[医药卫生—骨科学]