牵引结合关节松动术联合臭氧注射治疗膝关节骨性关节炎患者的疗效观察

The efficacy of traction-joint mobilization combined with ozone injection in the treatment of knee osteoarthritis

目的探讨牵引结合关节松动术联合臭氧注射治疗膝关节骨性关节炎患者的疗效观察及对膝关节影响。方法采用分层随机化将2015年5月至2017年7月本院膝关节骨性关节炎患者92例分为观察组和对照组各46例，对照组患者行臭氧注射治疗，观察组患者行牵引结合关节松动术联合臭氧注射治疗。比较两组患者治疗前后膝关节（Lysholm）评分、骨性关节炎指数（WOMAC）评分及关节液中炎症因子水平，对比两者的临床疗效。结果治疗后，两组较治疗前Lysholm评分均升高，WOMAC评分均降低，观察组Lysholm评分（85．61±6．42）升高及WOMAC评分（27．12±4．54）降低较对照组[（73．77±5．81）、（37．47±6．03）]更明显，差异有统计学意义（P〈0．05）；两组炎症因子IL-1、MMP-3、TNF-α较治疗前均降低，但观察组IL—1（61．11±6．45）、MMP-3（121．33±10．67）、TNF-α（19．61±3．49）水平降低较对照组[（69．91±7．38）、（135．24±12．93）、（25．52±4．27）]明显，差异有统计学意义（P〈0．05）；观察组治疗有效率高于对照组（97．83％比84．78％），差异有统计学意义（P〈0．05）。结论牵引结合关节松动术联合臭氧注射治疗膝关节骨性关节炎具有显著临床效果，能明显减少炎症反应，改善膝关节功能。

Objective To explore the efficacy of traction-joint mobilization combined with ozone injection in the treatment of knee osteoarthritis and its influence on knee joint. Methods 92 patients with knee osteoarthritis were chosen from our hospital from May 2015 to July 2017, and were divided into observation group and control group by the stratified randomization method. The control group was treated by ozone injection, and the observation group was treated by traction-joint mobilization combined with ozone injection. Lysholm score, WOMAC score, and the levels of inflammatory factors in the synovial fluid were compared between the two groups before and after the treatment, the efficacy was compared between the two groups after the treatment. Results After the treatment, Lysholm score of the two groups were higher than those before the treatment, WOMAC score of the two groups were lower than those before the treatment; Lysholm score of the observation group was higher than that of the control group [（85.61±6.42） vs.（73.77±5.81）], WOMAC score of the observation group was lower than that of the control group [（27.12±4,54） vs.（ 37.47±6.03）], with statistically significant differences （P〈0.05）. After the treatment, the levels of inflammatory factors （IL-1, MMP-3, TNF-α） of the two groups were lower than those before the treatment; the levels of inflammatory factors （IL-1, MMP-3, TNF-α） of the observation group were lower than those of the control group [（61.11±6.45 ） vs.（69.91±7.38）, （121.33±10.67） vs.（135.24±12.93）, （19.61±3.49） vs.（25.52±4.27）], with statistically significant differences （P〈0.05）. The efficiency of the observation group was higher than that of the control group （97.83% vs.84.78%）, with statistically significant difference （P〈0.05）. Conclusion The clinical efficacy of traction-joint mobilization combined with ozone injection in the treatment of knee osteoarthritis is significant, it reduces inflammatory reaction and improves the function of knee joint.