膝周痛点体外冲击波治疗膝骨关节炎疼痛的临床观察

CLINICAL OBSERVATION OF GENICULAR EXTRACORPOREAL SHOCK WAVE ON TREATMENT OF KNEE OSTEOARTHRITIC PAIN

摘要:

目的：探讨膝周痛点体外冲击波治疗膝骨关节炎（knee osteoarthritis,KOA）疼痛的临床疗效观察。方法：60例膝骨关节炎疼痛病人，按照随机数字表随机分为两组：观察组：膝周痛点冲击波组(B组)，行膝周痛点冲击波治疗加关节腔内玻璃酸钠注射；对照组：痛点注射组(A组)，行膝周痛点注射加关节腔内玻璃酸钠注射。分别于治疗前、治疗后1周、治疗后6周、治疗后3月和治疗后6月,记录视觉模拟评分(visual analogue scale,VAS)、骨关节炎指数(western ontario and mcMaster universities osteoarthritis index,WOMAC)以及不良反应。结果：两组病人术后1周骨关节炎指数均降低，6周及以后B组骨关节炎指数显著低于A组(P<0.01)。A组治疗后1周疼痛VAS评分较治疗前显著降低(P<0.01,或P<0.05)；B组治疗后各时间点的疼痛VAS评分较治疗前均显著降低(P<0.01或P<0.05)；与A组相比，B组治疗后6周、3月和6月的疼痛VAS评分均显著降低(P<0.01或P<0.05)。两组病人均未发生明显的不良反应。结论：膝周痛点体外冲击波治疗膝骨关节炎疗效良好，比痛点注射治疗效果更持久。

Abstract:

Objective: To investigate the treatment effects of genicular extracorporeal shock wave on the knee osteoarthritis pain. Methods: Sixty patients with knee osteoarthritic pain were randomly divided into two groups: treatment group (groupB ) and control group (groupA ). Group B received genicular extracorporeal shock wave. Group A received pain spot injection. Visual analogue scale (VAS), western ontario and mcMaster universities osteoarthritis index (WOMAC) questionnaire score, and potential adverse effects were measured before, 1 week, 6 weeks, 3 and 6 months after treatment.Results: WOMAC decreased 1 week after surgery in both groups, and it was significantly lower than that of group A 6 weeks after treatment (P<0.01). VAS in both group A and were significantly decreased after treatment (P<0.01, or P<0.05). Compared with group A, VAS in group B were significantly reduced 6 weeks, 3 months and 6 months after treatment (P<0.01 or P<0.05). No significant adverse effects were observed in each group. Conclusion: Genicular extracorporeal shock wave can reduce the pain and improve the function of the knee greatly. It might be a promising method for elderly knee osteoarthritis pain.