膝关节稳定性训练与双氯芬酸钠治疗膝骨关节炎的临床对照研究

A Comparison between Knee Joint Stability Training and Diclofenac in the Treatment of Osteoarthritis of the Knee

目的观察膝关节稳定性训练治疗膝骨关节炎患者的疗效和安全性。 方法2014年4月-2015年4月将61例膝骨关节炎患者随机分为康复训练组（30例，膝关节稳定性训练，30~40 min/次，1次/d）和双氯芬酸钠对照组（31例，双氯芬酸钠25 mg/次，3次/d，口服），疗程5周。治疗前后两组均进行西安大略和麦克马斯特大学骨关节炎指数评分（WOMAC）和健康状况调查问卷（SF-36），患者及医生对治疗反应的总有效率进行评价。 结果治疗5周后，康复训练组和对照组患者评价总有效率分别为93.33%和87.10%，医生评价总有效率分别为86.67%和80.65%，差异均无统计学意义（P＞0.05）。康复训练组和对照组在WOMAC和SF-36方面均较治疗前明显改善（P＜0.05），两组疗效比较差异无统计学意义（P＞0.05）。康复训练组无药物相关不良事件发生，对照组发生率为16.13%，差异有统计学意义（P＜0.05）。 结论应用膝关节稳定性训练治疗膝骨关节炎疗效与双氯芬酸钠基本相当，但耐受性更好，具有良好的临床应用前景。

ObjectiveTo evaluate the efficacy and safety of knee joint stability training in treating patients with knee osteoarthritis. MethodsSixty-one patients with knee osteoarthritis treated between April 2014 and April 2015 were randomly divided into 2 groups：rehabilitation group （n=30） and control group （n=31）.Patients in the rehabilitation group received knee joint stability training （30-40 minutes once, once every day）; the control group received diclofenac sodium orally at 75 mg/d （25 mg per time, 3 times every day）.The Western Ontario and McMaster Universities Arthritis index （WOMAC） and short-form health survey （SF-36） were used before and after treatment.Patients＇ and physicians＇ assessment of the total efficacy rate was also analyzed. ResultsAfter 5 weeks of treatment, the total efficacy rate assessed by the patients for the rehabilitation group and the control group was respectively 93.33% and 87.10%, and those two numbers assessed by physicians were respectively 86.67% and 80.65%;the differences were not statistically significant （P 〉 0.05）.Significant improvement was observed in the results of WOMAC and SF-36 in both two groups （P 〈 0.05）.There was no significant difference in the clinical efficacy between the two groups （P 〉 0.05）.No incidence of related adverse events occurred in the rehabilitation group, while the incidence of adverse events was 16.13% in the control group （P 〈 0.05）. ConclusionThe knee joint stability training is as effective as diclofenac sodium in treating patients with knee osteoarthritis, but the joint stability training is better tolerated than the latter.