体外冲击波治疗早中期膝骨关节炎的临床效果观察

Clinical observation of extracorporeal shock wave in the treatment of early and middle-stage knee osteoarthritis

目的分析体外冲击波疗法在膝骨关节炎治疗中的应用效果。方法金牛区人民医院收治的膝骨关节炎患者92例,采用随机数字表法分为对照组和研究组各46例。对照组行透明质酸钠关节腔穿刺治疗,研究组行体外冲击波疗法治疗。比较干预前后两组患者骨关节炎指数评分、关节疼痛评分、治疗满意度、奎森功能演算指数评分,及白细胞介素10(IL-10)、趋化素(Chemerin)与白细胞介素-1β(IL-1β)血清因子水平。结果治疗5周后两组骨关节炎指数评分、关节疼痛评分、治疗满意度、奎森功能演算指数评分均较治疗前降低,且研究组低于对照组(P<0.05);两组IL-1β、Chemerin较治疗前下降、IL-10上升,且研究组指标优于对照组(P<0.05);研究组治疗满意度(93.48%)明显高于对照组(78.26%)(P<0.05)。结论采用体外冲击波治疗膝骨关节炎,对IL-1β、Chemerin、IL-10等血清细胞因子具调节作用,可使疼痛减轻,关节机能得到改善,获得较高的治疗满意度。

Objective To analyze the therapeutic effect of extracorporeal shock wave in the treatment of knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis in JinNiu District People′s Hospital were selected.The patients were divided into a control group and a study group by using random number table method,46 in each group.The control group was treated with sodium hyaluronate arthrocentesis while the study group was treated with extracorporeal shock wave therapy.WOMAC,VAS,treatment satisfaction,and Lequesne as well as interleukin 10(IL-10),chemerin and interleukin-1βbefore and after intervention were compared between the two groups.Results After 5 weeks of treatment,the VAS,Lequesne,and WOMAC scores of the two groups were lower than those before treatment,and the study group was lower than the control group(P<0.05).After 5 weeks of treatment,chemerin,IL-1βwere lower and IL-10 was higher in the study group than those in the control group(P<0.05).The treatment satisfaction of the study group was 93.48%that was higher than 78.26%of the control group(P<0.05).Conclusion Extracorporeal shock wave therapy for knee osteoarthritis can regulate the serum factors as IL-1β,Chemerin,and IL-10,relieve the pain,improve the joint function,and achieve the high treatment satisfaction.