体外冲击波联合痛点阻滞治疗膝骨性关节炎的疗效

Efficacy of extracorporeal shock wave therapy combined with pain points block for patients with knee osteoarthritis

目的评价体外冲击波联合痛点阻滞治疗膝骨性关节炎的疗效。方法膝关节骨性关节炎患者50例，按照随机数字表法分为A、B两组（n=25）。A组给予膝周痛点阻滞治疗，每周1次，连续阻滞2次；B组给予相同的膝周痛点阻滞治疗，同时每次痛点阻滞治疗24h后行体外冲击波治疗。比较两组患者治疗前、治疗后2周、1个月时及3个月时VAS评分、膝关节活动度（ROM）及WOMAC评分。结果两组患者治疗后VAS评分较治疗前均明显下降（P〈0．05），膝关节ROM较治疗前明显增加（P〈0．05），膝关节WOMAC评分包括疼痛评分、僵硬评分、进行日常活动的难度评分及总分较治疗前明显下降（P〈0．05）；与A组比较，治疗后相应时点B组VAS评分更明显下降（P〈0．05），膝关节ROM更明显增加（P〈0．05），膝关节WOMAC评分包括疼痛评分、僵硬评分、进行日常活动的难度评分及总分更明显下降（P〈0．05）。两组患者均未见严重并发症的发生。结论体外冲击波联合局部痛点阻滞可安全、有效地改善膝关节骨性关节炎患者症状，疗效优于单纯痛点阻滞。

Objective To investigate the efficacy of extracorporeal shock wave therapy combined with pain points block for patients with knee osteoarthritis. Methods Fifty patients with knee osteoarthritis were randomly divided into two groups, 25 cases in each group. The patients in group A received pain points block, once a week for 2 times and group B received pain points block and extracorporeal shock wave therapy after 24 h. VAS, the range of motion of knee joint and WOMAC scale were recorded before the therapy, and at 2 weeks, 1 and 3 months after the therapy respectively. Side effects were also observed in both groups. Results VAS, ROM and WOMAC scale were all improved significantly after the treatment （P〈0.05）. VAS and WOMAC scale were significantly decreased in group B than those in group A. ROM was increased than that in group A （P〈 0.05）. No severe related side effects occurred in both groups. Conclusion Extraeorporeal shock wave combined with pain points block can safely and effectively relieve the pain and improve the joint function of patients with knee osteoarthritis.