骨通贴膏结合免荷型膝关节护具治疗内侧间室膝骨性关节炎临床研究

Clinical Study of Gutong Plaster Combined with Off-Loading Brace in Treating Medial Compartment Knee Osteoarthritis

目的观察骨通贴膏与免荷型膝关节护具治疗内侧间室膝骨性关节炎的临床疗效。方法选取114例内侧间室膝骨性关节炎患者,按治疗方式的不同均分为3组,A组为骨通贴膏联合免荷型膝关节护具组(简称贴膏护具组),B组为免荷型膝关节护具组(简称护具组),C组为骨通贴膏组(简称贴膏组)。各组治疗前及治疗后1个月比较股四头肌肌力、双足四点负重d值(简称d值)、压痛和疼痛视觉模拟评分(VAS),结合膝关节功能HSS评分和骨痹的疗效标准评定临床综合疗效。结果共108例患者完成治疗并获得随访,均未出现明显不良反应。治疗后1个月,各组股四头肌肌力、d值均有明显改善(P<0.01),但组间无明显差异(P>0.05);治疗后,各组压痛、VAS及HSS评分均明显改善(P<0.01),且A组改善均优于B组及C组。自拟疗效评价标准显示,各组患者临床疗效比较,差异有统计学意义(χ~2=8.922,P=0.012<0.05),进一步比较,A组和C组中位数有明显差异(χ~2=-20.778,P=0.009<0.01),A组和B组、B组和C组中位数差异无统计学意义(χ~2=-12.431,-8.347,P=0.227,0.699>0.05)。结论骨通贴膏结合免荷型膝关节护具治疗可显著提高内侧间室膝骨性关节炎的临床疗效。

Objective To investigated the clinical effects of Gutong Plastercombined with off-loading brace in treating medial compart-ment knee osteoarthritis. Methods Totally 114 patients with medial compartment knee osteoarthritis were divided into three groups ac-cording to the different treatment methods. The group A was treated with Gutong Plastercombined with off-loading brace,the group B was treated with off-loading brace,the group C was treated withGutong Plaster. Before treatment and 1 month after treatment,the quadriceps femoris myodynamia,double foot four point weight d value （referred to as d value）,VAS and HSS scores were compared be-tween the two groups. The clinical efficacy was evaluated by HSS score and Criteria of heumatism. Results Totally 108 patients finished treatment and followed up for 1 month,there were no adverse reactions in the 3 groups. After 1 months treatment,thequadriceps femoris myodynamia and d value in each group were significantly changed （P 〈 0. 01）,but there was no significant difference among the three groups（P〉0. 05）. After treatment,the tenderness,VAS and HSS scores of all groups were significantly improved （P 〈 0. 01）,and the improvement of group A was better than that of group B and group C. According to the evaluation standard of efficacy,the clinical ef-fects of the 3 groups had significantly difference（χ2=8. 922,P=0. 012 〈 0. 05）,and the difference of median between group A and group C was statistically significant（χ2= -20. 778,P=0. 009〈0. 01）,the differences of median between group A and group B,group B and group C were not statistically significant（χ2= -12. 431,-8. 347,P=0. 227,0. 699 〉 0. 05）. Conclusion Gutong Plastercombined with off-loading brace in treating medial compartment knee osteoarthritis can obviously improve the clinical efficacy.