医用臭氧水关节腔灌洗联合运动疗法治疗膝骨关节炎的疗效观察

Medical ozone water joint cavity lavage combined with exercise therapy in the treatment of knee osteoarthritis

目的观察医用臭氧水膝关节腔灌洗联合运动疗法治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法将2018年10月至2019年12月,于我院接受治疗的60例KOA患者采用随机数字表分为治疗组(n=30)和对照组(n=30),治疗组采用医用臭氧水进行膝关节腔灌洗联合膝关节运动疗法治疗,对照组采用生理盐水进行膝关节腔灌洗联合膝关节运动疗法,关节腔灌洗每周1次,运动疗法每日1次,总治疗周期为22天;于治疗前、治疗结束时、治疗结束后4周观察疼痛视觉模拟评分(visual analogue scale,VAS),于治疗前、治疗结束时观察膝关节骨关节炎严重性指数(index of severity for osteoarthritis,ISOA)及西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and MC-Master University osteoarthritis index,WOMAC),治疗前后检测血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)。结果治疗组治疗前、治疗结束时、治疗结束后4周的VAS分别为 4.26±1.27、2.07±1.26、1.53±1.28,对照组治疗前、治疗结束时、治疗结束后4周的VAS分别为4.73±1.14、3.10±0.99、3.40±0.97;治疗后同时期对比,治疗组优于对照组,差异有统计学意义(P<0.01)。治疗组治疗前的ISOA指数、WOMAC指数、TNF-α、IL-6分别为16.67±2.89、68.60±19.89、(35.80±20.65) pg/ml、(34.32±9.07) pg/ml,治疗结束时分别为8.13±3.82、26.57±18.69、(13.43±8.94)pg/ml、(33.23±8.45)pg/ml;对照组治疗前的ISOA指数、WOMAC指数、TNF-α、IL-6分别为17.03±2.16、66.30±13.59、(35.03±20.85) pg/ml、(14.67±6.00)pg/ml,治疗结束时分别为10.63±3.67、35.27±12.64、(19.27±11.04) pg/ml、(18.43±6.98) pg/ml;治疗组优于对照组,差异有统计学意义(P<0.05)。结论臭氧水关节腔灌洗联合运动疗法能显著改善患者症状及活动功能,提高生活质量,值得临床推广应用。

Objective To observe the clinical effect of medical ozone water joint cavity lavage combined with exercise therapy in the treatment of knee osteoarthritis (KOA).Methods A total of 60 patients with KOA,treated in our hospital from October 2018 to December 2019,were divided into treatment group (n=30) and control group(n=30) using a random number table.The treatment group underwent medical ozone water joint cavity lavage (once a week) combined with exercise therapy (once a day),while the control group normal saline lavage (once a week)with exercise therapy (once a day).The treatment lasted for 22 days.Visual analogue scale (VAS) was observed before treatment,at the end of treatment and 4 weeks after treatment.Index of severity for osteoarthritis (ISOA) and Western Ontario and MC-Master University osteoarthritis index (WOMAC) were observed before and after treatment.Detection of serum Tumor necrosis factor-α (TNF-α) and Interleukin-6 (IL-6) in serum were detected before and after treatment.Results VAS scores of the treatment group (2.07±1.26,1.53±1.28) at the end of treatment and4 weeks after treatment were significantly lower than that of the control group (3.10±0.99,3.40±0.97) (P<0.01).ISOA,WOMAC,TNF-α and IL-6 of the treatment group[(16.67±2.89),(68.60±19.89),(35.80±20.65) pg/ml,(34.32±9.07) pg/ml before treatment;(8.13±3.82),(26.57±18.69),(13.43±8.94) pg/ml,(33.23±8.45) pg/mlafter treatment]were significantly superior than that of the control group[(17.03±2.16),(66.30±13.59),(35.03±20.85) pg/ml,(14.67±6.00) pg/ml before treatment;(10.63±3.67),(35.27±12.64),(19.27±11.04) pg/ml,(18.43±6.98) pg/ml after treatment]at the end of treatment (P<0.05).Conclusions Ozone water joint cavity lavage combined with exercise therapy can significantly improve the symptoms,functions and the quality of life.It is worthy of clinical application.