遵循软组织外科学理论运用发散式体外冲击波治疗膝骨关节炎的疗效观察  

Efficacy of radial extracorporeal shockwave in the treatment of knee osteoarthritis according to the theory of soft tissue surgery

作　　者：李杨敏 王帅[2] 张爱军[1] 刘荣国[2] Li Yangmin;Wang Shuai;Zhang Aijun;Liu Rongguo(Department of Painology,Sanming First Hospital,Sanming City,Fujian Province 365000,China;Department of Painology,Fujian Provincial Hospital,Clinical Medical College of Fujian Medical University,Fuzhou City,Fujian Province 35000l,China)

机构地区：[1]三明市第一医院疼痛科,福建省三明市365000 [2]福建医科大学省立临床医学院、福建省立医院疼痛科,福州市350001

出　　处：《中华疼痛学杂志》2022年第6期807-813,共7页Chinese Journal Of Painology

基　　金：福建省科技厅引导性项目(2021Y0049)。

摘　　要：目的:探讨依据软组织外科学理论能否提升体外冲击波治疗膝骨关节炎(KOA)患者的疗效。方法:前瞻性纳入2018年11月至2019年11月三明市第一医院疼痛科60例KOA患者,按随机数字表法分为1个部位冲击波组和3个部位冲击波组,每组30例。前者选取膝关节周围压痛点为治疗部位;后者在1个部位冲击波组基础上增加大腿根部、髋外侧压痛点为治疗部位。两组均每周治疗1次,持续4周。分别于治疗前和治疗结束后1周、1个月、3个月和6个月时采用视觉模拟评分(VAS)和西安大略-麦克马斯特大学骨关节炎量表(WOMAC)评估患者疼痛和膝关节功能情况,以健康调查12条简表(SF-12)评估患者生活质量,并记录两组患者治疗相关的不良事件。结果:两组患者治疗前情况比较,差异均无统计学意义( P均>0.05)。在治疗结束后1周、1个月、3个月和6个月随访时,3个部位冲击波组患者VAS评分、WOMAC评分低于1个部位冲击波组( P均<0.05)。3个部位冲击波组SF-12量表中躯体总评得分高于1个部位冲击波组( P均<0.05)。而两组治疗后SF-12量表中心理总评得分差异均无统计学意义( P均>0.05)。治疗期间两组均未见治疗相关的明显不良事件。 结论:1个部位冲击波治疗与3个部位治疗对膝骨关节炎均有疗效,但根据软组织外科学理论增加髋外侧、大腿根部冲击波治疗可以进一步缓解KOA疼痛症状,恢复膝关节功能,提高生活质量。Objective To investigate the'efficacy of radial extracorporeal shockwave treatment guided by the theory of soft tissue surgery for the knee osteoarthritis(KOA)patients.Methods Sixty KOA patients in Sanming First Hospital from November 2018 to November 2019,were enrolled and randomly divided into 1 site group(n=30)and 3 sites group(n=30).The patients received radial extracorporeal shock treatment in one tenderness point around knee joint in the 1 site group,and added the tenderness points at the inner thigh and lateral hip besides in the 3 sites group.The visual analogue scale(VAS)and Western Ontario and McMaster Universities Arthritis Index(WOMAC)were evaluated for the pain and function of KOA in both groups before the treatment and 1 week,1 month,3 months,and 6 months after the treatment.The 12-item short-form health survey(SF-12)was assessed for patients'quality of life.The treatment-related adverse events were recorded in the two groups.Results At 1 week,1 month,3 months,and 6 months after the treatment,the VAS and the WOMAC scores were significantly lower in the 3 sites group than those in the 1 site group(all P<0.05).The scores of PCS in SF-12 were higher in the 3 sites group than those in the 1 site group(all P<0.05).There was no significant difference in the score of MCS between the two groups(all P>0.05).No treatment-related adverse events were observed in both groups.Conclusion Although 1 site radial extracorporeal shock wave treatment is effective for the treatment of knee osteoarthritis,adding treatment sites under the guidance of the theory of soft tissue surgery could further alleviate pain,restore knee joint function and improve quality of life in KOA patients.

关 键 词：骨关节炎 膝 体外冲击波疗法 软组织外科学理论 

分 类 号：R684.3[医药卫生—骨科学]