膝、髋关节周围肌力训练对青年女性髌股关节疼痛综合征治疗效果的比较  

Comparison of the therapeutic effects of knee-and hip-focused muscle strength training on patellofemoral pain syndrome in young female patients

作　　者：徐哲 冯学涛[1] 姜大帅 赵杰 韩冰[1] 李垂青[1] XU Zhe;FENG Xuetao;JIANG Dashuai;ZHAO Jie;HAN Bing;LI Chuiqing(Department of Joint Orthopaedics,Weifang Hospital of Traditional Chinese Medicine,Weifang 261000,Shandong,China)

机构地区：[1]潍坊市中医院东院区关节骨科,山东潍坊261000

出　　处：《中华骨与关节外科杂志》2025年第4期318-323,共6页Chinese Journal of Bone and Joint Surgery

基　　金：山东省中医药科技项目(2020M142)。

摘　　要：目的:比较膝、髋关节周围肌力训练对青年女性髌股关节疼痛综合征(PFPS)的治疗效果。方法:选取2021年11月至2022年12月于潍坊市中医院就诊的60例青年女性PFPS患者进行前瞻性研究。按照随机数字表法随机分为膝关节组与髋关节组,每组各30例,分别进行膝关节和髋关节周围肌力训练。所有患者均由同一康复师指导,每2周指导1次。所有患者训练频率、次数均一致。治疗前及治疗2周后、1个月后、3个月后均采用疼痛视觉模拟评分(VAS)、膝前疼痛量表(AKPS)评价两组患者髌股关节疼痛情况及功能,治疗前及治疗3个月后采用五水平欧洲五维健康量表(EQ-5D-5L)效用指数评分评估两组患者的生活质量,并进行比较。结果:治疗前及治疗2周后、1个月后及3个月后两组患者疼痛VAS评分总体呈逐渐降低趋势,AKPS评分总体呈逐渐升高趋势,治疗前后比较差异均有统计学意义(P均<0.05)。治疗2周后,髋关节组患者疼痛VAS评分及AKPS评分均优于膝关节组患者,且差异均有统计学意义(P均<0.05);治疗1个月后及3个月后,两组患者疼痛VAS评分及AKPS评分相似,两组患者间的差异均无统计学意义(P均>0.05)。治疗3个月后,两组患者EQ-5D-5L效用指数评分均较治疗前升高(P均<0.05),但两组患者间的差异无统计学意义(P均>0.05)。结论:膝、髋关节周围肌力训练能缓解髌股关节疼痛和改善髌股关节功能,且髋关节周围肌力训练的治疗效果优于膝关节周围肌力训练。对于PFPS患者,可首先进行髋关节周围肌力训练,以更快地缓解髌股关节疼痛、改善髌股关节功能。Objective:To compare the therapeutic effects of knee-focused versus hip-focused muscle strength training in young female patients with patellofemoral pain syndrome(PFPS).Methods:A prospective study was conducted on 60 young female patients with PFPS who were treated at Weifang Hospital of Traditional Chinese Medicine between November 2021 and December 2022.Participants were randomly assigned to either a knee group(n=30)or a hip group(n=30)using a random number table.Patients in the knee group received knee-focused muscle strength training,while those in the hip group underwent hip-focused muscle strength training.All patients were guided by the same rehabilitation therapist once every two weeks.Training frequency and repetitions were standardized across both groups.Pain and function were evaluated using the visual analog scale(VAS)and the anterior knee pain scale(AKPS)at baseline and 2 weeks,1 month,and 3 months post-intervention,respectively.Quality of life was assessed using the EuroQol-5 dimension-5 level(EQ-5 D-5 L)utility index at baseline and 3 months after treatment.Results:Both groups showed significant improvements over time,with decreased VAS scores and increased AKPS scores at each follow-up compared to baseline(all P<0.05).At 2 weeks post-treatment,the hip group demonstrated significantly better improvements in both VAS and AKPS scores compared to the knee group(all P<0.05).However,at 1 and 3 months post-treatment,there were no significant differences in VAS or AKPS scores between the two groups(all P>0.05).At 3 months post-treatment,EQ-5 D-5 L scores in both groups showed a significant increase compared to pre-treatment levels(all P<0.05),with no significant intergroup differences(all P>0.05).Conclusions:Both knee-and hip focused muscle strength training are effective in reducing pain and improving function in young female PFPS patients,and hip-focused strength training demonstrates superior therapeutic efficacy.Therefore,for patients with PFPS,the initial rehabilitation strategy with hip-focused mus

关 键 词：髌股关节疼痛综合征 肌力训练 疼痛 膝关节功能 

分 类 号：R684[医药卫生—骨科学]