运动疗法联合体外冲击波治疗膝骨关节炎的疗效观察  

Therapeutic Efficiency of Exercise Therapy Combined Extracorporeal Shock Wave on Patients with Knee Osteoarthritis

作　　者：刘旸[1] 张亚菲[1] 翁浩[1] 武玲华 LIU Yang;ZHANG Yafei;WENG Hao;WU Linghua(Department of Rehabilitation Medicine,Aerospace Central Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院康复医学科,北京100049

出　　处：《医学综述》2022年第16期3297-3301,3307,共6页Medical Recapitulate

基　　金：中国航天科工集团医疗卫生科研项目(2019-LCYL-009)。

摘　　要：目的探讨运动疗法联合体外冲击波(ESW)治疗膝骨关节炎(KOA)的临床疗效。方法选取2019年9月至2021年3月在航天中心医院康复医学科门诊就诊的90例单侧原发性KOA患者,按随机数字表法分为对照组(采用运动疗法+脉冲短波治疗,45例)和观察组(采用运动疗法+ESW治疗,45例)。治疗前及治疗后4周采用视觉模拟评分法(VAS)、西安大略及麦克马斯特大学骨关节炎指数(WOMAC)评价患者疼痛程度及病程,比较两组治疗前后VAS、WOMAC评分及相关并发症发生情况。结果治疗前后VAS、WOMAC评分以及WOMAC中的疼痛、僵直及活动能力评分的主效应差异有统计学意义(P<0.01);不考虑测量时间,两组间VAS、WOMAC评分以及WOMAC中的疼痛、僵直及活动能力评分的主效应差异有统计学意义(P<0.01);VAS、WOMAC评分以及WOMAC中的疼痛、僵直及活动能力评分的时点间与组间存在交互作用(P<0.05),两组治疗前后VAS、WOMAC评分以及WOMAC中的疼痛、僵直及活动能力评分的变化幅度不同,观察组变化更明显。治疗期间,观察组和对照组分别有2例和3例患者出现疼痛加重,但全部治疗完成后,患者诉症状明显好转,且治疗后次日无不适主诉,且未影响后续训练及治疗。所有患者训练及治疗期间未诉其他不适。结论运动疗法联合ESW可减轻KOA患者膝关节疼痛、提高膝关节功能、改善患者生活质量,且安全性好。Objective To investigate the clinical efficacy of exercise therapy combined with extracorporeal shock wave(ESW)in the treatment of knee osteoarthritis(KOA).Methods 90 patients with unilateral primary KOA were selected from the outpatient department of Rehabilitation Medicine of Aerospace Central Hospital From Sep.2019 to Mar.2021.According to the random number table method,they were divided into a control group(45 cases receiving exercise therapy+pulsed short-wave therapy)and an observation group(45 cases receiving exercise therapy+ESW treatment).Visual analogue scale(VAS)and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)were used to evaluate the pain degree and course of disease before and 4 weeks after treatment,and VAS,WOMAC score and related complications were compared between the two groups before and after treatment.Results There were statistically significant differences in the main effects of VAS,WOMAC score,and pain,stiffness and mobility score in the WOMAC before and after treatment(P<0.01).Regardless of measurement time,there were statistically significant differences in the main effects of VAS,WOMAC score,pain,stiffness and mobility score in the WOMAC between the two groups(P<0.01).There were interactions in VAS,WOMAC score,pain,stiffness and mobility score in WOMAC between groups and time points(P<0.05).The changing amplitudes of VAS,WOMAC score and pain,stiffness and mobility score in WOMAC before and after treatment of the two groups were different,and the changes were more obvious in the observation group.During the treatment,2 and 3 patients in the observation group and the control group showed increased pain,respectively.However,after all the treatment,the patients expressed obvious improvement in symptoms,and there was no complaint of discomfort the next day after treatment,and the subsequent training and treatment were not affected.All patients were no other complaints during the training and treatment.Conclusion Exercise therapy combined with ESW can relieve knee pain,i

关 键 词：膝骨关节炎 运动疗法 体外冲击波 

分 类 号：R684.3[医药卫生—骨科学]