六步手法联合体外冲击波治疗老年膝关节炎的临床研究

Clinical Study of Six-Step Manipulation Combined with Extracorporeal Shock Wave on Elderly Knee Arthritis

目的:分析六步手法联合体外冲击波治疗老年膝关节炎的临床效果。方法:选取2017年1月至2019年6月到我科进行治疗的老年膝关节炎患者60例,根据治疗方式不同分为对照组和观察组(各30例),对照组采用塞来昔布胶囊联合体外冲击波治疗,观察组采用六步手法联合体外冲击波治疗,检测2组患者治疗前后血清中C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-1β(IL-1β)水平,观察和记录两组患者疗效、疼痛视觉模拟评分(VAS)、WOMAC骨关节炎指数评分及Barthel指数。结果:观察组治疗有效率(90.0%)高于对照组(67.7%),差异有统计学意义(P<0.05)。治疗后观察组CRP,TNF-α及IL-1β均低于对照组,差异有统计学意义(P<0.05)。治疗后1周、1个月、2个月和3个月观察组VAS评分及WOMAC骨关节炎指数评分均高于对照组,而Barthel指数均低于对照组,差异有统计学意义(P<0.05)。结论:六步手法联合体外冲击波治疗老年膝关节炎疗效明显,能降低患者炎症因子,减轻疼痛,改善膝关节功能,提高患者独立生活能力,且安全性较好。

Objective:To analyze the clinical effect of six-step manipulation combined with extracorporeal shock wave on elderly knee arthritis.Methods:60elderly patients with knee arthritis who were treated in our department from January 2017to June 2019were selected and divided into the control group(n=30)and observation group(n=30)according to different treatment.The control group used Celecoxib capsules combined with extracorporeal shock wave therapy,and the observation group used a six-step method combined with extracorporeal shock wave therapy.Serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-1β,visual analogue score(VAS),Western Ontario McMaster Universities osteoarthritis index score(WOMAC),Barthel index of the patients were documented and compared in the two groups.Results:The effective rate in the observation group was 90.0%which was higher than that in the control group with 67.7%(P<0.05).After treatment,the CRP,TNF-α,and IL-1βin the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).Patients in the observation group revealed lower VAS scores and WOMAC osteoarthritis index scores than those in the control group at 1st week,1st month,2nd month and 3rd month after treatment(P<0.05),while Barthel indexes were higher than those in the control group(P<0.05).Conclusion:Six-step technique combined with extracorporeal shock wave has obvious curative effect on senile knee arthritis,which can reduce patients’inflammatory factors,relieve pain,improve knee function,and improve independent living ability.