发散式体外冲击波结合肌筋膜触发点针刺治疗膝骨关节炎疗效观察

Therapeutic efficacy of radial extracorporeal shock wave combined with myofascial triggerpoint acupuncture on knee osteoarthritis

目的 观察发散式体外冲击波结合肌筋膜触发点针刺治疗膝骨关节炎的临床疗效。方法 选取2022年1月—2023年10月在广西骨伤医院诊治的111例膝骨关节炎患者,采用随机数字表法分为3组,每组37例。冲击波组给予体外冲击波治疗,1次/周;触发点针刺组给予肌筋膜触发点针刺治疗,间隔6 d治疗1次;联合组予体外冲击波联合肌筋膜触发点针刺治疗。3组均治疗8周。观察比较3组患者治疗前、治疗4周后、治疗8周后的膝关节疼痛VAS评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、关节活动度,统计3组治疗8周后的临床疗效。结果 3组患者治疗4周、8周后膝关节VAS评分、WOMAC评分均较治疗前明显降低(P均<0.05),关节活动度均较治疗前明显增加(P均<0.05),且联合组VAS评分、WOMAC评分、关节活动度改善情况均明显优于冲击波组和触发点针刺组(P均<0.05)。治疗8周后,联合组、冲击波组和触发点针刺组的治疗总有效率分别为91.89%(34/37)、83.78%(31/37)、78.34%(29/37),联合组明显高于冲击波组和触发点针刺组(P均<0.05),冲击波组和触发点针刺组比较差异无统计学意义(P>0.05)。结论 发散式体外冲击波联合肌筋膜触发点针刺疗法在减轻膝关节疼痛、缓解僵硬、改善关节功能、提升关节活动度方面疗效更显著。

Objective It is to observe the clinical efficacy of radial extracorporeal shock waves(rESW)combined with myofascial trigger point acupuncture(MTPA)in the treatment of knee osteoarthritis.Methods One hundred and eleven patients with knee osteoarthritis diagnosed and treated in Guangxi Orthopedic and Traumatology Hospital from January 2022 to October 2023 were selected and divided into 3 groups by random number table method,with 37 cases in each group.The rESW group was treated with rESW,once per week;the MTPA group was treated with MTPA,once every 6 days;the combination group was treated with rESW combined with MTPA.All the three groups were treated for 8 weeks.The knee pain VAS scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,and joint mobility of the patients in the three groups before treatment,after 4 weeks of treatment,and after 8 weeks of treatment were observed and compared,and the clinical efficacies of the three groups after 8 weeks of treatment were assessed.Results The knee VAS scores and WOMAC scores of the patients in the three groups after 4 weeks and 8 weeks of treatment were significantly decreased,while their joint mobility was significantly increased compared with those before treatment(all P<0.05),and the improvements of VAS scores,WOMAC scores and joint mobility in the combination group were significantly better than those in the rESW group and MTPA group(all P<0.05).The total effective rates of the combination group,rESW group and MTPA group were 91.89%(34/37),83.78%(31/37),and 78.34%(29/37),respectively,the total effective rate of the combination group was significantly higher than that of the rESW group and MTPA group(both P<0.05),and there was no significant difference between the rESW group and MTPA group(P>0.05).Conclusion The efficacy of dispersive extracorporeal shockwave combined with myofascial trigger point acupuncture therapy is more significant in reducing knee pain,relieving stiffness,improving joint function,and improving joint mobility.