体外冲击波联合电针治疗膝骨关节炎临床效果  

Clinical analysis of extracorporeal shock wave combined with electroacupuncture in the treatment of knee osteoarthritis

作　　者：王利波 邵鸿飞[2] 董云[2] 杨勇[2] 张西科 刘欣婧 苑志军 马增路[2] 尹志改[2] 李玲 李嘉 高彦平 WANG Libo;SHAO Hongfei;DONG Yun(Xingtai Third Hospital,Hebei,Xingtai 054000,China)

机构地区：[1]河北省邢台市中心医院,054000 [2]河北省邢台市人民医院 [3]邢台经济开发区医院 [4]广东省人民医院广东省医学科学院南方医科大学

出　　处：《河北医药》2024年第3期388-391,395,共5页Hebei Medical Journal

摘　　要：目的探讨体外冲击波(extracorporeal shock wave,ESW)联合电针治疗膝关节骨关节炎临床疗效,通过相关性分析明确不同Kellgren-Lawrence(KL)分级下膝骨关节炎(knee osteoarthritis,KOA)的最优治疗疗效。方法以2019年8月至2021年12月就诊的168例膝骨关节炎患者为研究对象进行回顾性研究,根据治疗方案分为ESW组(n=58)、电针治疗组(n=50)、ESW联合电针治疗的ESW+电针组(n=60)。比较3组患者治疗前、治疗后1周、3周、5周的HSS评分量表、疼痛视觉模拟评分(VAS)、Lequesne指数评分量表和膝关节活动度变化,采用相关性分析明确KL分级、治疗方法和年龄对治疗效果的影响。结果经Spearman相关性分析,治疗前KL分级与VAS平方差呈正相关(P<0.05),与关节活动度呈负相关(P<0.05);治疗方法与VAS评分差、Lequesne指数差呈负相关(P<0.05),与关节活动度水平差呈正相关(P<0.05)。其中电针治疗患者VAS评分改变、关节活动度水平差与KL分级呈负相关(P<0.05),ESW+电针治疗患者关节活动度水平差与KL分级呈正相关(P<0.05)。结论ESW+电针联合治疗对KL分级Ⅰ~Ⅲ级KOA患者整体疗效较单一的ESW或电针治疗更优,KL分级为Ⅰ级的KOA患者适合选择电针治疗。Objective To explore the clinical efficacy of extracorporeal shock wave(ESW)combined with electroacupuncture in the treatment of knee osteoarthritis(KOA),and to determine the optimal therapeutic efficacy of knee osteoarthritis under different Keiigren-Lawrence(KL)grades through correlation analysis.Methods A retrospective study was conducted on 168 KOA patients treated in our hospital from August 2019 to December 2021.According to the treatment schemes,they were divided into ESW group(n=58),electroacupuncture treatment group(n=50)and ESW+electroacupuncture group(n=60).The changes in the Harris Hip Scale(HHS)score,the Visual Analogue Scale(VAS)score,Lequesne index and range of motion of the knee before treatment and 1 week,3 weeks and 5 weeks after treatment were compared.The influences of the KL grade,treatment method and age on the treatment effect were determined by correlation analysis.Results Spearman correlation analysis showed that KL grade was positively correlated with the difference in the VAS score(P<0.05)and negatively correlated with the range of motion of the knee(P<0.05).The treatment method was negatively correlated with the differences in the VAS score and Lequesne index(P<0.05),and positively correlated with the range of motion of the knee(P<0.05).The changes in the VAS score and range of motion of the knee in patients treated with electroacupuncture were negatively correlated with the KL grade(P<0.05),and the range of motion of the knee in patients treated with ESW+electroacupuncture was positively correlated with the KL grade(P<0.05).Conclusion The overall efficacy of ESW+electroacupuncture in patients with KL gradeⅠ-Ⅲis better than that of the monotherapy of ESW or electroacupuncture.Patients with KL grade I are suitable for the treatment of electroacupuncture.

关 键 词：膝骨关节炎 体外冲击波 电针 KeIIgren-Lawrence分级 

分 类 号：R684.3[医药卫生—骨科学]