Clinical effect of scraping therapy in the treatment of knee osteoarthritis

Objective:The objective of this study is to investigate the effect of scraping therapy in the treatment of knee osteoarthritis.Materials and Methods:A total of eighty patients with knee osteoarthritis were assigned to the moxibustion group and the scraping therapy group according to the random numerical table method,with forty cases in each group.Patients in both two groups received functional exercise and moxibustion therapy,and those in the scraping therapy group were supplemented with scraping therapy.The serum indexes of interleukin‑1(IL‑1),IL‑6,tumor necrosis factor‑alpha(TNF‑α),and superoxide dismutase(SOD)were detected before and after the treatment.The clinical syndrome integral and Visual Analog Scale(VAS)on pain of patients were assessed.The clinical therapeutic efficacy was evaluated and compared between the two groups.Results:Patients in the scraping therapy group received better outcomes of serum IL‑1,IL‑6,TNF‑α,and SOD compared with those in the moxibustion group at 2 months after treatment(P<0.05).The scores of clinical syndrome integral and VAS on pain were decreased in two groups at 2 months after the treatment and were lower in the scraping therapy group than those in the moxibustion group(P<0.05).The overall effective rate in the scraping therapy group was higher than that in the control group(87.50%vs.67.50%,P<0.05).Conclusion:The scraping therapy is potentially effective to ameliorate the clinical symptom and pain degree of patients with knee osteoarthritis.

Application of five-element music therapy in pain coping skills training in patients with knee osteoarthritis

Objective:The objective of this study is to assess the application effect of five elements music therapy introduced in the pain coping skills training of knee osteoarthritis(KOA).Materials and Methods:Totally,80 patients with KOA were selected and randomly divided into the experimental group(39 cases)and the control group(41 cases).The control group was only given routine nursing measures,and the experimental group was additionally treated with five-element music therapy on the basis of the control group,twice a day,28 days in total.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)was used to evaluate the functional status of the knee joint of the two groups.The clinical efficacy of the two groups was evaluated by Guiding Principles for Clinical Research of New Chinese Medicine in the Treatment of Osteoarthritis.Results:WOMAC score statistically significantly decreased in the experimental group(35.92±9.48 vs.16.17±5.43,P<0.01)and the control group(36.73±6.42 vs.22.53±7.51,P<0.01)after 28 days of intervention when compared with that before intervention;WOMAC score in the experimental group was lower than that of the control group after 28 days of intervention(16.17±5.43 vs.22.53±7.51,P<0.01).The total effective rate of the experimental group was statistically higher than that of the control group(82.0%vs.51.2%,χ2=11.97,P=0.003).Conclusion:The combination of five-element music therapy and routine nursing measures has better effect in relieving pain and bad emotions of patients with KOA when compared with routine nursing measures alone.

Clinical effect of extracorporeal shockwave therapy for knee osteoarthritis: A meta analysis

Objective:To provide evidence-based evidence for the clinical use of shockwave therapy in KOA.Methods: Two researchers independently searched the randomized controlled study of shockwave therapy for KOA in the databases of CNKI、VIP、WanFang Data、 Sinomed and PubMed. Jadad rating scale was used for literature quality evaluation, and the extracted data was meta-analyzed by RevMan5.3 software.Results: A total of 15 randomized controlled trials involving 1248 patients were included. The results of meta-analysis showed: The clinical effective rate of shock wave therapy for knee osteoarthritis was reliable[RR=1.12, 95%CI(1.03, 1.20), p=0.005], and the efficacy was reliable in reducing the visual analogue scale [MD=-1.73, 95%CI(-2.31, -1.14), p<0.00001] , Lequesne osteoarthritis severity index[MD=-1.60, 95%CI(-2.55, -0.64), p<0.00001] and WOMAC[MD=-6.03, 95%CI(-9.49,-2.57) p=0.0006] of KOA patients, without serious adverse reactions.Conclusion:At present, the evidence shows that shock wave can effectively improve the pain and other related symptoms in KOA patients, and the curative effect is reliable.

Systematic evaluation and Meta-analysis of acupuncture and collaterals cupping therapy for Knee Osteoarthritis

目的:为获得最佳的治疗膝骨性关节炎方案,减轻膝骨性关节炎患者的痛苦,系统评价刺络拔罐法治疗膝骨性关节炎的疗效。方法:计算机检索CNKI(1989-2018.10)、Wanfang Data(1989-2018.10)、VIP(1989-2018.10)、PubMed(1966-2018.10)、EMbase(1986-2018.10)和Cochrane Library(2018年第3期)数据库,用Jadad量表对文献质量进行评分。结果:共纳入19项符合条件的RCT研究,共有2088名患者参加符合条件的临床研究。Meta分析结果显示:总有效率OR合并=2.85[OR=3.98,95%CI(2.98,5.32),P<0.00001]。结果表明,刺络拔罐治疗膝骨性关节炎疗效优于其他疗法。结论:中医刺络拔罐法治疗膝关节骨性关节炎有很好的疗效,且有很好的安全性。由于原始研究对Meta分析结果的影响,仍需进行更多大样本、高质量的临床试验加以验证。

The effect of hot intermittent cupping on pain,stiffness and disability of patients with knee osteoarthritis

目的:本研究旨在探讨间歇性热拔罐对膝骨关节炎患者疼痛、僵硬及无力的作用效果。方法:对Gonabad风湿病专科门诊的38例膝骨关节炎患者进行临床研究。采用置换阻滞法,将研究对象分为拔罐治疗组和对照组。拔罐治疗组每四天进行一次拔罐治疗,总共四次治疗。为了收集数据,采用人口统计信息形式,使用VAS和WOMAC量表,使用描述性统计、独立t检验、配对t检验、卡方检验和Fishers精确检验,用SPSS软件v16对数据进行分析。结果:拔罐疗法与对照组在人口学特征方面没有显著差异,而且是均质的。拔罐治疗后,基于VAS量表的治疗组左、右膝平均疼痛强度(P<0.001)以及基于WOMAC量表的僵硬度(P=0.006)、WOMAC疼痛强度(P<0.001)和残疾程度(P<0.001)的平均得分均显著低于对照组。结论:热间歇拔罐治疗可降低KO患者的疼痛强度、僵硬程度和残疾程度。

CTX-Ⅰ, TRACP, ADAMTS-4 and MMPs-3 expression and their correlation with different syndromes of knee osteoarthritis

Objective:To observe the expression of CTX-I(Ⅰcollagen C-terminal foreign body peptide)and TRACP(tartrate-resistant acid phosphatase)in different syndromes of knee osteoarthritis and their correlation with ADAMTS-4(polyproteoglycan enzyme-4)and MMPS-3(matrix metalloproteinase-3).Methods:A total of 98 patients diagnosed with knee osteoarthritis were enrolled from the Rehabilitation Pain Department and Rheumatology Department of Wuhan Caidian District People's Hospital.According to their syndrome types,they were divided into 40 cases of Yang deficiency and cold constipation type,28 cases of qi stagnation and blood stasis type,and 30 cases of kidney jing deficiency type.The contents of bone metabolism indexes,ADAMTS-4 and MMPS-3 in different syndromes of the three groups were compared.Correlation of bone metabolism indexes with ADAMTS-4 and MMPS-3.Results:There were statistically significant differences in the contents of CTX-I,TRACP,ADAMTS-4 and MMPS-3 among three groups with different syndromes(P<0.05).There was a positive correlation between CTX-I,TRACP,ADAMTS-4 and MMPS-3(P<0.05).The syndrome of qi stagnation and blood stasis was positively correlated with TRACP and ADAMTS-4,and negatively correlated with MMPS-3(P<0.05).The renal essence deficiency syndrome was positively correlated with CTX-I,ADAMTS-4 and MMPS-3(P<0.05).Bone metabolic indexes(CTX-I,TRACP)were positively correlated with ADAMTS-4 and MMPS-3(P<0.05).Conclusion:Different syndromes of knee osteoarthritis are correlated with bone metabolism indexes,ADAMTS-4 and MMPS-3,which can provide a certain objective basis for clinical TCM syndrome differentiation and classification。

Study on TCM Syndrome Types and Syndromes of Knee Osteoarthritis Based on Modern Literature

Objective: To explore the patterns of TCM syndromes and syndrome distribution of knee osteoarthritis through modern literature research. Methods: All journal articles from China Knowledge Network, Wanfang, and China Biomedical Database from January to August 1, 2019 were searched, and documents that met the criteria for inclusion and exclusion were screened out. Knee joints were extracted on the premise of data standardization. Inflammatory syndrome types, syndromes, regional distribution of literature, and commonly cited literature of syndrome reference standards are used to establish a database using an Excel table for analysis using frequency analysis. Results: A total of 2027 articles were included. The geographical distribution of the included articles was mainly East China (23.53%), Central China (19.93%), and South China (19.24%). The commonly cited reference for the knee osteoarthritis syndrome reference standard is "Chinese medicine" Guiding Principles for Clinical Research of New Drugs (47.09%),"Traditional Chinese Medicine Diagnosis and Efficacy Standards" (40.27%), "Traditional Chinese Medicine Diagnosis and Treatment Plan for 95 Major Diseases in 22 Specialties" (4.58%), "Diagnosis and Treatment Plan for Knee Paralysis", " KOA TCM Experts' Consensus (2015 Edition) "," Traditional Chinese Medicine ", the common types of knee osteoarthritis are liver and kidney deficiency (17.65%), blood stasis (12.40%), wind cold and dampness (11.76%) , Cold dampness obstruction, yang deficiency and cold coagulation, liver and kidney deficiency, tendon and blood stasis, qi stagnation and blood stasis syndrome;common disease site syndromes are liver and kidney, and disease syndrome syndromes are dampness, cold, blood stasis, and yin Deficiency, wind, yang deficiency, heat, qi stagnation, fine deficiency, sputum, qi deficiency, and blood deficiency;the most common form of syndrome combination is the combination of two and three syndromes. Conclusion: TCM syndrome types and the distribution of syndrome elements are in line with the current mainstream understanding of the pathogenesis of knee osteoarthritis. The syndrome differentiation of knee osteoarthritis can summarize the main pathogenesis of the disease. Helps to classify TCM syndromes of knee osteoarthritis.

Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis:a systematic review and Meta-analysis

OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang database,China Science and Technology Journal Database,and SinoMed were searched from inception to July 2020.The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews.The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis.The heterogeneity among the articles was evaluated using I2.RESULTS:A total of 17 studies,comprising 2000 individuals,were included in this Meta-analysis.The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA.Statistical analysis of clinical efficacy showed that[relative risk(RR)=1.21,95%confidence interval(CI)(1.12,1.30),P<0.01].Statistical analysis of visual analog scale showed that[standardized mean difference(SMD)=-2.84,95%CI(-4.01,-1.66),P<0.01].Western Ontario and McMaster University osteoarthritis index statistical analysis showed that[SMD=-1.57,95%CI(-2.52,-0.61),P<0.01].Lysholm score statistical analysis showed that[SMD=1.71,95%CI(0.98,2.44),P<0.01].In addition,only minor side effects,such as redness and swelling of the skin,were observed.CONCLUSIONS:Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive,welltolerated,safe,and effective method to improve pain and functionality in patients with KOA.However,tightly controlled,randomized,large multicenter trials are warranted to validate the current findings.

Application of ozone therapy in interventional medicine

Ozone therapy has been gradually accepted by doctors in various fields because it has been safe, convenient, and inexpensive since the twentieth century. It has been used in the treatment of various diseases with satisfactory results, especially in the application of interventional surgery. For lumbar disc herniation, knee osteoarthritis,tissue ischemia-reperfusion after revascularization, stroke, and cancer, ozone therapy can improve the efficacy of interventional surgery and reduce postoperative acute and chronic complications. Prospects of ozone therapy in interventional therapy and the underlying mechanisms of efficacy need further exploration.

Effectiveness of Maitland and Mulligan mobilization methods for adults with knee osteoarthritis:A systematic review and metaanalysis

BACKGROUND As a serious global problem,knee osteoarthritis(KOA)often leads to pain and disability.Manual therapy is widely used as a kind of physical treatment for KOA.AIM To explore further the efficacy of Maitland and Mulligan mobilization methods for adults with KOA.METHODS We searched PubMed,the Cochrane Library,EMbase,Web of Science and Google Scholar from inception to September 20,2020 to collect studies comparing Maitland and Mulligan mobilization methods in adults with KOA.The quality of the studies was assessed using the Physiotherapy Evidence Database Scale for randomized controlled trials.Data analyses were performed using Review Manager 5.0 software.RESULTS A total of 341 articles were screened from five electronic databases(PubMed,the Cochrane Library,EMbase,Web of Science and Google Scholar)after excluding duplicates.Ultimately,eight trials involving 471 subjects were included in present systematic review and meta-analysis.The mean PEDro scale score was 6.6.Mulligan mobilization was more effective in alleviating pain[standardized mean difference(SMD)=0.60;95%confidence interval(CI):0.17 to 1.03,P=0.007;I2=60%,P=0.020]and improving Western Ontario and McMaster Universities function score(SMD=7.41;95%CI:2.36 to 12.47,P=0.004;I2=92%,P=0.000).There was no difference in the effect of the two kinds of mobilization on improving the range of motion(SMD=9.63;95%CI:-1.23 to 20.48,P=0.080;I2=97%,P=0.000).CONCLUSION Mulligan mobilization technique is a promising intervention in alleviating pain and improving function score in KOA patients.

Controversial role of arthroscopic meniscectomy of the knee: A review

The role of arthroscopic partial meniscectomy(APM) in reducing pain and improving function in patients with meniscal tears remains controversial. Five recent highquality randomized controlled trials(RCTs) compared non-operative management of meniscal tears to APM, with four showing no difference and one demonstrating superiority of APM. In this review, we examined the strengths and weaknesses of each of these RCTs, with particular attention to the occurrence of inadvertent biases. We also completed a quantitative analysis that compares treatment successes in each treatment arm, considering crossovers as treatment failures. Our analysis revealed that each study was an excellent attempt to compare APM with non-surgical treatment but suffered from selection, performance, detection, and/or transfer biases that reduce confidence in its conclusions. While the RCT remains the methodological gold standard for establishing treatment efficacy, the use of an RCT design does not in itself ensure internal or external validity. Furthermore, under our alternative analysis of treatment successes, two studies had significantly more treatment successes in the APM arm than the non-operative arm although original intention-totreat analyses showed no difference between these two groups. Crossovers remain an important problem in surgical trials with no perfect analytical solution. With the studies available at present, no conclusion can be drawn concerning the optimal treatment modality for meniscal tears. Further work that minimizes significant biases and crossovers and incorporates sub-group and cost-benefit analyses may clarify therapeutic indications.

Efficacy of Slow Reversal Hold and Isometrics in Improving Muscle Strength, Increasing Range of Motion, and Reducing Pain in Patients with Osteoarthritis of Knee

Osteoarthritis of knee is a common problem in the elderly population worldwide. Physical therapy has been shown to be useful in decreasing pain and increasing mobility in this population. The aim of this study was to study the effectiveness of slow reversal hold and isometric exercise techniques in reducing pain, increasing muscle strength, and increasing range of motion for knee flexion in patients with osteoarthritis of knee. The other aim of this study was to compare the relative effectiveness of these two interventions. 60 subjects participated in this study and were randomly assigned either to the slow reversal hold group (n = 30) or, to the isometrics exercise group (n = 30). All subjects performed their respective exercises for 3 weeks. Pain scores using the visual analog scale, muscle strength using manual muscle testing of quadriceps and hamstrings, and range of motion (ROM) for knee flexion using a goniometer were recorded both pre-treatment and post-treatment for both left and right knees. Both the interventions showed a significant decrease in pain scores, an increase in muscle strength, as well as an increase in the ROM. However, ROM was significantly increased in the slow reversal hold group as compared to the isometrics group in both knees. It was concluded that both exercise techniques could be useful in patients with osteoarthritis of knee for decreasing pain and increasing muscle strength. Slow reversal hold technique might be a better technique than isometrics for increasing ROM for knee flexion.

Forty-seven Cases of Gonitis Treated by A Combined Therapy of Chinese Drugs and Acupuncture

Osteoarthritis, a nonspecific inflammatory lesion, is a commonly seen joint disease. Clinically, it is mainly characterized by arthralgia, swelling, and motor impairment. Since the knee joint is the load-bearing joint of the human body, and is susceptible to trauma, gonitis tends to have the highest morbidity in the four limbs, which manifests itself arthritis of patella and femur at the early stage; narrowness or disappearance of the medial joint space at the mid stage; and damage of the cartilage accompanied with flexion deformity at the late stage. In recent years, based on the experience of Prof. Cao Yiming, the author has treated 47 cases of gonitis by combined use of Chinese drugs and acupuncture, and obtained satisfactory therapeutic results as reported in the following.

Clinical Effect of Acupuncture Treatment in 109 Cases of Knee Osteoarthritis

Knee Osteoarthritis, a retrograde disease, is mainly characterized by pain in the knee joints and limitation of the movement. It is a common and frequently occurring disease affecting the health and life quality of old people. In recent years, acupuncture treatment of knee osteoarthritis with satisfactory therapeutic results has been repeatedly reported,2-3, 5-6 but there has been few report on the observation of long-term therapeutic effects after treatment. With acupuncture as the main therapy, 109 cases of knee osteoarthritis were treated in this series. 91 cases with good therapeutic results were followed up for 6 months. A report is presented in the following.

Analysis of Anthropometric Measurements and Dietary Intake in Patients Undergoing a Multi-Professional Osteoarthritis Education Program (PARQVE-Project Arthritis Recovering Quality of Life by Means of Education)

Background: Osteoarthritis (OA) has a major impact on mobility and the loss of productivity of patients, especially knee OA (KOA). Obesity is one of the main risk factors for the incidence and prevalence of KOA. Weight loss alone decreases pain and improves quality of life and functional scores. Objective: To use BMI, body fat, and calorie intake to measure the effect of a multi-professional educational program on patients with KOA and correlate these measurements with subjective questionnaire results. Methods: A total of 198 patients undergoing standard treatment for KOA were randomized to 4 groups. All groups received written and video information regarding KOA. Three groups (1, 2 and 3) also attended two days of lectures 1, 2 and 3 months apart, respectively, whereas group 4 did not. Each group was divided into subgroups A (bimonthly telephone calls) and B (no telephone calls). All patients were evaluated at baseline and at one year for BMI, waist-hip ratio (WHR), percentage of body fat, and calorie intake and with the WOMAC, LEQUESNE, VAS and SF-36 questionnaires. Results: The WHR showed 89.4% of android obesity at baseline and 87.9% at one year without improvement (p = 0.38). Body fat decreased by 0.44% regardless of group or subgroup. Calorie intake was different between groups (p = 0.019) according to phone calls and follow-up (p = 0.03). BMI and body fat percentage were correlated with the WOMAC, WOMAC pain, VAS and LEQUESNE scores at baseline and at reassessment. Weight was correlated with the baseline results of the WOMAC pain (r = 0.175, p = 0.014), VAS (r = 0.155, p = 0.029), LEQUESNE (r = 0.161, p = 0.023), SF-36-PCS (r = ?0.186, p = 0.009) and SF-36-MCS (r = 0.155, p = 0.029) scores and with the one-year results of the WOMAC (r = 0.155, p = 0.029) and WOMAC pain (r = 0.151, p = 0.034) scores. Conclusion: The multi-professional treatment program had very little impacts on the percentage of body fat. This improvement was independent of classes, telephone calls, or improvements in pain, function and quality of life. Calorie intake improvement was influenced by telephone calls and classes but was not associated with objective measurements of/or changes in weight, BMI, or body fat percentage or with subjective improvements.

关节镜半月板治疗膝骨关节炎对治疗有效率、VAS评分、HSS评分及TNF-α指标水平的应用研究

目的分析关节镜半月板治疗膝骨关节炎对治疗有效率、VAS评分、HSS评分及TNF-α指标水平的影响。方法选择2019年6月—2020年5月在我院进行治疗的86例因半月板损伤引起膝骨关节炎的患者作为研究对象,根据患者的意愿选择治疗方式,其中43例选择常规保守治疗的患者纳入对照组,另外43例选择关节镜半月板治疗的患者纳入研究组。对两组患者的治疗有效率、视觉模拟评分法(VAS)评分、HSS膝关节评分及肿瘤坏死因子-α(TNF-α)指标水平进行比较。结果研究组的治疗有效率显著高于对照组(P<0.05);研究组与对照组在治疗前的VAS评分、HSS评分、TNF-α水平进行比较均无显著差异(P>0.05),两组经治疗后的VAS评分、HSS评分及TNF-α水平均得到了改善,研究组在治疗后的VAS评分、TNF-α指标水平均低于对照组(P<0.05),HSS评分高于对照组(P<0.05)。结论对膝骨关节炎患者采取关节镜半月板治疗,具有显著效果,可有效减轻患者的疼痛程度与炎症反应,提升膝关节功能。

补肾活血疗法结合针刺治疗膝骨关节炎疗效及对膝关节功能、生活质量的影响

目的观察补肾活血疗法结合针刺治疗膝骨关节炎的临床疗效及对患者膝关节功能、生活质量的影响。方法研究纳入2021年1月—2023年3月四川省骨科医院诊治的肾虚血瘀型膝骨关节炎患者128例,以随机数字表法分为中西医结合组与对照组各64例,对照组给予美洛昔康片、盐酸氨基葡萄糖胶囊及玻璃酸钠注射液治疗,中西医结合组在对照组治疗基础上给予补肾活血疗法及针刺治疗。2组治疗时间均为1个月,治疗过程中每组各脱落2例。比较2组患者治疗前后中医证候积分、西安大略和麦克马斯特大学骨关节炎指数可视化量表(WOMAC)评分、疼痛视觉模拟评分法(VAS)评分、生活质量健康状况调查简表(SF-36)评分、关节活动度、步速、步长,统计2组临床疗效及不良反应发生情况。结果2组患者治疗后中医证候积分、WOMAC评分、VAS评分均明显降低(P均<0.05),SF-36评分、关节活动度、步速、步长均明显增加(P均<0.05),且中西医结合组上述各指标改善情况均明显优于对照组(P均<0.05);中西医结合组治疗总有效率明显高于对照组[96.77%(60/62)比87.10%(54/62),P<0.05];2组患者不良反应发生率均较低(对照组2例,中西医结合组3例),组间比较差异无统计学意义(P>0.05)。结论补肾活血疗法结合针刺治疗膝骨关节炎临床疗效显著,可明显减轻疼痛和相关症状,改善膝关节功能,提高生活质量,且应用安全。

运动疗法在膝关节骨性关节炎中的应用效果

目的 观察膝骨性关节炎治疗中运动疗法的临床疗效。方法 选取2022年2月至2023年10月本院门诊30例膝关节骨性关节炎患者,分为运动疗法组和对照组,各15例。运动疗法组在常规保守治疗基础上加入肌力训练及关节活动度训练等运动疗法,对照组行常规保守治疗。每周治疗1~2次。连续6周为一个疗程。治疗前后统计分析两组膝关节功能、功能障碍程度、疼痛程度、生活质量、血清NO水平、肌力、临床疗效。结果 运动疗法组患者的疼痛、屈膝畸形、活动度、稳定性、肌力、功能评分均高于对照组(P <0.05),疼痛、僵硬程度、日常生活难度评分均低于对照组(P <0.05),VAS评分低于对照组(P <0.05),SF-36评分高于对照组(P <0.05),血清NO水平低于对照组(P <0.05)。运动疗法组患者的肌力Ⅰ级、Ⅱ级、Ⅲ级比例均低于对照组,Ⅳ级、Ⅴ级比例均高于对照组(P <0.05)。运动疗法组总有效率93.33%(14/15)高于对照组66.67%(10/15)(P <0.05)。结论 膝骨性关节炎治疗中运动疗法能改善关节周围肌肉力量,提高关节稳定性及运动表现,缓解关节疼痛,提高生活质量。

下肢洗剂治疗膝骨关节炎临床观察

目的探讨下肢洗剂治疗膝骨关节炎的效果。方法选择60例膝骨关节炎患者作为研究对象,将其随机分成试验组和对照组,各30例。对照组给予双氯芬酸二乙胺乳胶剂外用,试验组给予下肢洗剂外用,2组均持续治疗2周。观察2组的临床疗效,比较2组治疗前后西安大略大学和麦克马斯特大学骨关节炎指数(WOMAC)量表评分、膝关节综合评分、血清学指标变化情况,以及不良反应发生情况。结果试验组的愈显率为66.67%(20/30),高于对照组的50.00%(15/30),差异有统计学意义(P<0.05)。治疗后,2组患者的WOMAC量表评分、膝关节综合评分及白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)水平均有不同程度下降,且试验组下降程度大于对照组,差异有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论下肢洗剂对于阳虚寒凝型膝骨关节炎具有治疗作用,可以很好地改善其临床症状,使血清炎性因子水平降低,在临床有一定的应用推广价值。

中药外敷联合复合超声关节治疗仪治疗膝骨关节炎的临床效果

目的探究中药外敷联合复合超声关节治疗仪在膝骨关节炎(KOA)中的应用效果。方法选取2022年8月至2023年8月就诊于安阳市中医院的99例KOA患者为研究对象,随机分为3组,每组33例。超声组接受超声关节治疗仪治疗,中药组接受中药外敷治疗,联合组接受中药外敷联合超声关节治疗仪治疗。对比3组疗效及治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、视觉模拟评分法(VAS)、奎森功能演算(Lequesne)指数评分、成纤维细胞生长因子2(FGF-2)、Ⅰ型胶原C-末端肽(CTX-I)、软骨寡聚基质蛋白(COMP)及不良反应。结果联合组总有效率[93.94%(31/33)]高于超声组[75.76%(25/33)]、中药组[72.73%(24/33)](P<0.05),超声组与中药组总有效率对比,差异无统计学意义(P>0.05);治疗3个疗程后联合组FGF-2高于超声组、中药组,CTX-1、COMP、Lequesne、WOMAC评分低于超声组、中药组(P<0.05),超声组、中药组组间对比,差异无统计学意义(P>0.05);治疗3个疗程后联合组静态、动态VAS评分<中药组<超声组(P<0.05);治疗期间3组均未出现不良反应。结论中药外敷与复合超声关节治疗仪联合治疗KOA患者效果确切,可有效调节骨代谢指标,有助于缓解患者疼痛感,恢复膝关节功能。