不同剂量体外冲击波治疗早中期膝骨关节炎近期疗效比较

Comparison of short-term clinical efficacy of extracorporeal shock wave therapy in different energy dosage for prometaphase knee osteoarthritis

目的:探讨不同剂量体外冲击波治疗早中期膝骨关节炎的近期疗效,为临床提供参考。方法:选取原发性早中期膝骨关节炎患者80例(80膝),按随机数字表法分为低能流密度组(A组)和高能流密度组(B组)各40例(40膝),均使用体外冲击波治疗4周。剂量选择:A组为0.12 mJ/mm2,B组为0.24 mJ/mm2。分别在治疗前(T1)、治疗结束时(T2)、治疗后4周(T3)采用疼痛目测类比(VAS)、美国西安大略及麦克马斯特大学骨性关节炎指数问卷(WOMAC)对所有患者进行评定,比较临床疗效。结果:组间相同时点比较:T1时点,两组患者VAS及WOMAC评分无显著性差异;T2、T3时点,A组VAS和WOMAC评分与B组比较有显著降低(P<0.01)。组内不同时点比较,2组患者T2与T1、T3与T1比较,VAS和WOMAC明显降低(P<0.01),T2与T3比较则无显著性差异。结论:体外冲击波能有效缓解早中期膝骨关节炎患者的临床症状、改善膝关节功能,采用能流密度0.12 mJ/mm2的体外冲击波治疗,近期临床效果更佳。

Objective:To investigate the short-term clinical efficacy of extracorporeal shock wave therapy in different energy dosage for prometaphase knee osteoarthritis and provide reference for clinical treatment.Methods:Totally,80 patients with original prometaphase knee osteoarthritis,in accordance with the random number table,were selected and divided into low energy flux density group(group A)and high energy flux density group(group B)(40 cases each).Both two groups were treated with extracorporeal shock wave therapy for 4 weeks.The group A received energy flux density of 0.12 mJ/mm2,and the group B received 0.24 mJ/mm2.All the patients were assessed with VAS and WOMAC before the treatment(time point 1,T1),at the end of the treatment(time point 2,T2)and 4 weeks after the treatment(time point 3,T3).Results:There were no significant differences in VAS and WOMAC between two groups at T1.The scores of VAS and WOMAC in the group A were significantly lower(P<0.01)than those in the group B at T2 and T3.The scores of VAS and WOMAC in both two groups at T2 and T3 were significantly lower than those at T1(P<0.01).Between T2 and T3,there were no significant differences in two groups.Conclusion:Treatment based on extracorporeal shock wave therapy can significantly relieve symptoms of prometaphase knee osteoarthritis and improve function of knee.By comparison,the 0.12 mJ/mm2 energy flux density of extracorporeal shock wave therapy is more satisfactory for prometaphase knee osteoarthritis.