不同间隔时间体外冲击波治疗膝关节骨性关节炎的疗效观察

Observation of the Effect of Extracorporeal Shock Wave at Different Intervals in the Treatment of Knee Osteoarthritis

摘要: 目的：本研究通过比较不同间隔时间体外冲击波治疗(extracorporeal shock wave therapy, ESWT)膝关节骨性关节炎(knee osteoarthritis, KOA)的效果，以评估体外冲击波(ESW)治疗KOA的最佳间隔时间，为临床KOA提供实验数据，以期为KOA患者提供更精准的疗效。方法：选取我院运动医学康复中心住院及骨科门诊在2020年3月~2021年3月期间收治的KOA患者共90位，采用随机数字表法将患者分为ABC组，每组30人，三组均在常规康复治疗的基础上进行ESWT，完整治疗4次；A组患者每间隔6天使用一次ESWT；B组患者每间隔3天使用一次ESWT；C组患者每间隔1天使用一次ESWT。采用肢体活动疼痛视觉模拟评分法(visual analogue score, VAS)、WOMAC骨关节炎指数(The Western Ontario and McMaster Universi-ties, WOMAC)、5次坐立试验(five-times-sit-to-stand test, FTSST)来分析比较各组KOA患者的疗效。结果：1) 治疗前三组一般临床资料差异无统计学意义(P > 0.05)。2) 首次治疗结束后一个月，组间比较发现A组VAS、WOMAC及FTSST优于B、C组(P < 0.05)，C组各指标比B组差，差异具有统计学意义(P < 0.05)。3) 组内比较发现与治疗前相比三组各指标均明显下降(P < 0.05)。结论：体外冲击波用于膝关节骨性关节炎患者可以缓解疼痛，改善膝关节功能障碍，间隔时间为6天时ESW治疗KOA的疗效最佳。

Abstract: Objective: This study compares the effects of extracorporeal shock wave therapy (ESWT) at different intervals in the treatment of knee osteoarthritis (KOA). In order to evaluate the optimal interval for extracorporeal shock wave (ESW) treatment of KOA, KOA Standardized treatment provides experimental data to provide more accurate curative effects for KOA patients. Methods: A total of 90 KOA patients admitted to the inpatient and orthopedic clinics of our hospital’s Sports Medicine Rehabilitation Center from March 2020 to March 2021 were selected. The patients were divided into ABC groups by random number table method, 30 people in each group, and all three groups ESWT was performed on the basis of conventional rehabilitation treatment, and 4 complete treatments were performed; patients in group A used ESWT every 6 days; patients in group B used ESWT every 3 days; patients in group C used ESWT every 1 day. Using visual analogue score (VAS), WOMAC osteoarthritis index (The Western Ontario and McMaster Universi-ties, WOMAC), and five-times-sit-to-stand test, FTSST) to analyze and compare the efficacy of KOA patients in each group. Results: 1) There was no significant difference in general clinical data between the three groups before treatment (P > 0.05). 2) One month after the first treatment, VAS, WOMAC and FTSST in group A were better than those in group B and C (P < 0.05), and the indexes of group C were worse than group B. The difference was statistically significant (P < 0.05). 3) Compared within the group, it was found that the indexes of the three groups were significantly decreased compared with that before treatment (P < 0.05). Conclusion: Extracorporeal shock wave for knee osteoarthritis patients can effectively relieve pain and improve knee dysfunction. KOA has the best effect when the ESWT treatment interval is 6 days.