基于肌筋膜触发点理论的体外冲击波疗法治疗膝骨性关节炎的临床效果

Clinical effect of extracorporeal shock wave therapy based on myofascial trigger points theory in the treatment of knee osteoarthritis

目的探讨基于肌筋膜触发点(MTrPs)理论的体外冲击波疗法(ESWT)治疗膝骨性关节炎(KOA)的临床效果。方法将2018年3月至2019年12月在西安交通大学附属红会医院康复医院中医骨科住院的98例KOA患者采用随机数字表法分为对照组(47例)和观察组(51例)。对照组给予临床常规治疗,观察组在对照组基础上加用基于MTrPs理论的ESWT。比较两组治疗前、后的膝关节疼痛程度、局部压痛程度、膝关节活动度(ROM)、Lequesne指数评分、临床疗效及住院时间。结果治疗后,两组患者的膝关节疼痛程度和局部压痛程度评分均较治疗前显著降低,且观察组显著低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的膝关节ROM均较治疗前显著增大,Lequesne指数评分均较治疗前显著降低,且观察组显著优于对照组,差异具有统计学意义(P<0.05)。观察组的治疗总有效率显著高于对照组,住院时间显著短于对照组,差异具有统计学意义(P<0.05)。结论基于MTrPs理论的ESWT治疗KOA能有效缓解膝关节疼痛,改善关节功能,提高临床疗效,缩短住院时间,值得临床推广及应用。

Objective To explore the clinical effect of extracorporeal shock wave therapy(ESWT)based on myofascial trigger points(MTrPs)theory in the treatment of knee osteoarthritis(KOA).Methods A total of 98 patients with KOA hospitalized in the orthopedics department of TCM in rehabilitation hospital of Honghui hospital affiliated to Xi'an Jiaotong university from March 2018 to December 2019 were divided into control group(47 cases)and observation group(51 cases)by random number table method.The control group was given clinical conventional treatment,and the observation group was additionally ESWT based on MTrPs theory on the basis of the control group.The degree of knee pain,degree of local tenderness,knee range of motion(ROM),Lequesne index score before and after treatment,clinical efficacy and hospital stay were compared between the two groups.Results After treatment,the degree of knee pain and local tenderness scores of the two groups were significantly lower than those before treatment,and those of the observation group were significantly lower than the control group,the differences were statistically significant(P<0.05).After treatment,the knee ROM of the two groups significantly increased and the Lequesne index score significantly decreased compared with those before treatment,and those in the observation group were significantly better than the control group,the differences were statistically significant(P<0.05).The total effective rate of treatment of the observation group was significantly higher than that of the control group,and the hospital stay was significantly shorter than that of the control group,the differences were statistically significant(P<0.05).Conclusion ESWT based on MTrPs theory in the treatment of KOA can effectively alleviate the knee pain,ameliorate the joint function,improve the clinical efficacy and shorten the hospital stay,which is worthy of clinical promotion and application.