手法结合肌力训练治疗膝骨关节炎的临床疗效观察  

Clinical observation on manipulation combined with muscle strength training in treatment of knee osteoarthritis

作　　者：陈莉莉 康辉 蔡洁 吴高贤 CHEN Li-li;KANG Hui;CAI Jie;WU Gao-xian(General Hospital of Central Theater Command,Wuhan 430070)

机构地区：[1]中部战区总医院,湖北武汉430070

出　　处：《湖北中医药大学学报》2023年第4期75-78,共4页Journal of Hubei University of Chinese Medicine

基　　金：湖北省医学青年拔尖人才项目(项目编号:[2019]48);全国名老中医药专家传承工作室建设项目(国中医药人教函[2018]134号)。

摘　　要：目的 观察手法结合肌力训练治疗膝骨关节炎(KOA)的疗效。方法 将在我院就诊的120例KOA患者随机分为观察组与对照组各60例,观察组行手法结合肌力训练治疗,对照组行玻璃酸钠关节内注射治疗。评定两组临床疗效,统计分析两组治疗前和治疗5周后视觉模拟评分(VAS)、西安大略和麦克马斯特大学骨关节炎指数评分(WOMAC)、血清炎性因子肿瘤坏死因子-α(TNF-α)、白细胞介素-1 β(IL-1β )含量和远红外热像图(IRT)。结果 治疗后,观察组总有效率高于对照组( P<0.05);观察组VAS评分、WOMAC评分、血清炎性因子TNF-α、IL-1β 含量均低于对照组( P<0.05);治疗前两组典型病例膝关节IRT均表现不同程度的低温反应,治疗后,膝关节IRT色域均趋暖。结论 手法结合肌力训练能改善KOA患者膝关节的功能活动,减轻疼痛症状,对KOA有一定的防治作用,是一种行之有效且安全简便的防治一体化方案。Objective To observe the effect of manipulation combined with muscle strength training on knee osteoarthritis(KOA).Methods A total of 120 patients with KOA were randomly divided into observation group and control group,60 cases in each group.Observation group received manipulation combined with muscle strength training,and control group received intra-articular injection of sodium hyaluronate.Visual analogue sc ore(VAS),Western Ontario and McMaster University(WOMAC) osteoarthritis index,serum contents of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and far-infrared thermogram(IRT) were evaluated before and 5 weeks after treatment.Results After treatment,the total effective rate of observation group was higher than that of control group(P<0.05);VAS score,WOMAC osteoarthritis index score,serum contents of TNF-α and IL-1β in observation group were lower than those in control group(P<0.05).Before treatment,knee IRT of typical cases in the two groups showed different degrees of hypothermia response,and after treatment,the color gamut of knee IRT became warmer.Conclusion Manipulation combined with muscle strength training can improve the functional activities of knee joint in KOA patients,reduce pain symptoms,and have certain prevention and treatment effects on KOA,which is an effective,safe and simple integrated prevention and treatment program.

关 键 词：膝骨关节炎 膝关节 手法 等长收缩 远红外热像图 

分 类 号：R274.9[医药卫生—中西医结合]