体外冲击波联合玻璃酸钠治疗膝骨性关节炎的临床疗效  

Clinical Study of Extracorporeal Shock Wave Combined with Sodium Hyaluronate in the Treatment of Knee Osteoarthritis

作　　者：史涛[1] 黄佑庆 何晓峰 宁亚 臧诗旷 陈艳[1] 王丹[1] 梁跃伟 SHI Tao;HUANG Youqing;HE Xiaofeng;NING Ya;ZANG Shikuang;CHEN Yan;WANG Dan;LIANG Yuewei(Dept,of Pain,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院疼痛科,云南昆明650101

出　　处：《昆明医科大学学报》2022年第3期80-85,共6页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金资助项目(2022J0240);昆明医科大学研究生创新基金资助项目(2021S234)。

摘　　要：目的观察体外放射式冲击波联合关节腔注射玻璃酸钠治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的临床疗效。方法将62例KOA患者随机分为观察组与对照组,每组各31例,其中观察组男13例,女18例;平均年龄(62.35±9.70)岁,病程(3.06±1.49)a。对照组男16例,女15例;平均年龄(60.87±1.56)岁,病程(2.74±1.53)a。观察组患者先给予体外放射式冲击波治疗(extracorporeal shockwave therapy,ESWT),治疗后2d再常规行关节腔内注射玻璃酸钠(intra-articular injections of hyaluronic acid,HA)治疗。对照组患者单纯给予HA治疗。2组患者均每周治疗1次,连续治疗5周。治疗前、治疗结束后1周及治疗结束后3个月分别对2组患者进行疼痛视觉模拟评分(visual analogue scale,VAS)和骨关节炎指数(Western Ontario and McMaster University osteoarthritis index,WOMAC)评分,以评价2组患者的疗效有无差异性;按KOA患者KellgrenLawrence分级(Ⅱ、Ⅲ级)将其分为观察组Ⅱ级、对照组Ⅱ级,观察组Ⅲ级、对照组Ⅲ级分别进行治疗前后VAS评分和WOMAC评分比较。结果观察组与治疗组2组患者的VAS评分和WOMAC评分在治疗后1周及3月均较治疗前降低(P<0.05),观察组在治疗后1周及治疗后3月时的VAS评分和WOMAC评分均低于对照组(P<0.05)。观察组在治疗后3月较治疗后1周时的WOMAC评分进一步降低(P<0.05),Kellgren-LawrenceⅡ、Ⅲ级患者中观察组和对照组治疗后均较治疗前评分降低(P<0.05),Ⅱ级组治疗后1周后观察组VAS降低,但差异无统计学意义,WOMAC评分降低(P<0.05),Ⅱ级组治疗后3月观察组的VAS及WOMAC评分均较对照组降低(P<0.05),Kellgren-LawrenceⅢ级患者中治疗1周及3月后VAS及WOMAC评分均较对照组降低(P<0.05)。结论ESWT联合HA较单纯行HA治疗KOA疗效更显著,可明显减轻关节疼痛,改善膝关节活动功能。Objective To observe the clinical efficacy of external radiative shock wave combined with sodium hyaluronate injection in the treatment of knee osteoarthritis(KOA).Methods Sixty-two patients with KOA be divided into observation group and control group randomly,with 31 cases in each group.The observation group included 13 males and 18 females,the mean age was(62.35±9.70)years old,and the course of disease was(3.06±1.49)years.There were 16 males and 15 females in the control group,the mean age was(60.87±1.56)years old,and the course of disease was(2.74±1.53)years.The Extracorporeal Shockwave therapy(ESWT)was given firstly,then the Intra-articular injection of hyaluronic acid(HA)was injected 2 days later in the observation group.The control group was treated with HA only 1 week.Both of the groups were treated once a week for 5 weeks.The Visual Analogue Scale(VAS)and Western Ontario and Mc Master University Osteoarthritis Index(WOMAC)were used to evaluate the difference in efficacy between the two groups,at the time of before the treatment,1 week after the treatment and 3 months after that.KOA patients were divided into observation groupⅡand control groupⅡaccording to Kellgren-Lawrence grading(Ⅱ,Ⅲ).VAS score and WOMAC score of observation groupⅢand control groupⅢwere compared before and after treatment,respectively.Results The VAS score and WOMAC score in both group were significantly lower than those before at the time of 1 week and 3 months after treatment(P<0.05),while 1 week after treatment and 3 months after treatment the VAS and WOMAC scores in the observation group were lower than those in the control group(P<0.05).The WOMAC score of the observation group was further decreased after 3 months than 1 week after treatment(P<0.05).In kellgren-Lawrence classⅡandⅢpatients,the scores of observation group and control group decreased after treatment compared with before treatment(P<0.05),VAS of observation group decreased 1 week after treatment in classⅡgroup,but the difference was not statistical

关 键 词：体外冲击波 玻璃酸钠 膝关节骨性关节炎 

分 类 号：R684.3[医药卫生—骨科学]