推拿联合本体感觉训练治疗髌股关节炎的临床效果分析

Clinical effect of massage combined with proprioceptive training on patellofemoral osteoarthritis

目的观察推拿联合本体感觉训练治疗髌股关节炎(PFOA)的临床疗效。方法选取2019年4月至2020年4月于浙江中医药大学附属第一医院治疗的PFOA患者60例,根据随机数字表法分为对照组与观察组,各30例。对照组予以推拿治疗,观察组在对照组基础上同时联合本体感觉训练,1次/d,共10次。比较2组患者治疗前后美国西部安大略大学和麦克马斯特大学骨关炎指数(WOMAC)评分、膝关节肌骨超声检查结果及总有效率。结果治疗后,2组行走痛、久坐痛、僵硬、上下楼梯、正常活动、下蹲屈膝评分及滑膜厚度、关节积液范围均低于治疗前,且观察组行走痛、久坐痛、上下楼梯、正常活动、下蹲屈膝评分及滑膜厚度、关节积液范围均低于对照组[(2.7±0.9)分比(4.2±0.8)分、(2.8±1.0)分比(3.4±1.2)分、(3.0±1.2)分比(3.4±2.0)分、(2.8±1.3)分比(3.9±1.1)分、(2.8±1.2)分比(4.0±1.1)分、(1.53±0.19)mm比(2.01±0.22)mm、(2.2±0.7)cm^(2)比(3.1±0.9)cm^(2)],差异均有统计学意义(均P<0.05)。观察组总有效率高于对照组[90.0%(27/30)比60.0%(18/30)],差异有统计学意义(P<0.05)。结论推拿联合本体感觉训练可改善PFOA患者的临床症状,降低膝关节滑膜厚度及积液范围,具有一定疗效。

Objective To observe the clinical efficacy of massage combined with proprioceptive training on the treatment of patellofemoral osteoarthritis(PFOA).Methods From April 2019 to April 2020,60 patients with PFOA treated in the First Affiliated Hospital of Zhejiang Chinese Medical University were selected.The patients were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with massage,while the observation group was treated with proprioceptive training on the basis of control group.Patients in both groups were treated once a day for a total of 10 times.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,results of knee musculoskeletal ultrasonography and total effective rate were compared between both groups before and after treatment.Results After treatment,the scores of walking pain,sedentary pain,stiffness,walking up and down stairs,normal activity,squat knees,and synovial thickness and range of joint effusion were lower than before treatment,and the scores of walking pain,sedentary pain,walking up and down stairs,normal activity,squat knees,synovial thickness and range of joint effusion in observation group were lower than those in control group[(2.7±0.9)vs(4.2±0.8),(2.8±1.0)vs(3.4±1.2),(3.0±1.2)vs(3.4±2.0),(2.8±1.3)vs(3.9±1.1),(2.8±1.2)vs(4.0±1.1),(1.53±0.19)mm vs(2.01±0.22)mm,(2.2±0.7)cm^(2)vs(3.1±0.9)cm^(2)](all P<0.05).The total effective rate in the observation group was significantly higher than that in the control group[90.0%(27/30)vs60.0%(18/30),P<0.05].Conclusion Massage combined with proprioceptive training can improve the clinical symptoms of patients with PFOA,reduce the joint synovial thickness and effusion range of knee with certain efficacy.