放射狀沖擊波治療膝骨關節炎的臨床研究

張田　劉文波　李華　肖立

【摘要】 目的：分析體外放射狀沖擊波（RSWT）治療膝骨關節炎（KOA）的臨床效果。方法：將確診為膝骨關節炎的患者106例，按隨機數字表法分為對照組51例和研究組55例。對照組采用傳統的超聲波治療，研究組采用RSWT治療。分別在治療前及治療結束時、治療后1周、治療后1個月采用視覺類比疼痛評分（VAS）及膝關節功能評分（Lysholm）評價其臨床療效，治療期間均需觀察患者出現的不良反應。結果：治療結束時及治療后1周，研究組和對照組患者的VAS和Lysholm評分較治療前均明顯改善，差異均有統計學意義（P<0.05），但兩組比較差異均無統計學意義（P>0.05）。治療后1個月，對照組患者的VAS評分較治療前有明顯改善（P<0.05），Lysholm評分與治療前比較雖有所下降，但差異無統計學意義（P>0.05）；研究組患者VAS和Lysholm評分均優于治療前及對照組，差異均有統計學意義（P<0.05）。對照組的不良反應發生率為3.9%（2/51），與研究組的3.6%（2/55）比較，差異無統計學意義（P>0.05）。結論：放射狀沖擊波治療膝骨關節炎是一種安全有效、患者易于接受的物理療法。

【關鍵詞】 膝骨關節炎； 放射狀沖擊波； 膝關節功能

The Clinical Study of Radial Shock Wave Therapy in the Treatment of Knee Osteoarthritis/ZHANG Tian，LIU Wen-bo，LI Hua，et al.//Medical Innovation of China，2017，14（30）：036-040

【Abstract】 Objective：To analyze the clinical efficacy of radial shock wave therapy （RSWT）in the treatment of knee osteoarthritis （KOA）.Method：A total of 106 patients with knee osteoarthritis were randomly divided into the control group （51 cases） and the study group （55 cases）.The control group was treated with traditional ultrasound therapy，and the study group was treated with RSWT.Respectively before and after treatment，1 week and 1 month after treatment，the visual analog pain score （VAS） and knee function score （Lysholm） were used to evaluate its clinical efficacy，the adverse effects of the two groups were observed during the treatment period.Result：At the end of treatment and 1 week after treatment，VAS and Lysholm scores in the study group and the control group were significantly improved than those before treatment，the differences were statistically significant（P<0.05），but there were no significant differences between the two groups（P>0.05）.1 month after the treatment，the VAS score of the control group was significantly improved （P<0.05），compared with before treatment，but the Lysholm score was lower than that before treatment，but the difference was not statistically significant（P>0.05）；the VAS and Lysholm scores of the patients in the study group were better than those before treatment and the control group，the differences were statistically significant（P<0.05）.The incidence of adverse reactions in the control group was 3.9%（2/51），compared with 3.6%（2/55） in the study group，there was no significant difference（P>0.05）.Conclusion：Radial shock wave is a safe，effective and physically acceptable treatment for osteoarthritis of the knee.

【Key words】 Knee osteoarthritis； Radial shock wave therapy； Function of knee

First-authors address：Guizhou Orthopaedic Hospital，Guiyang 550007，Chinaendprint

doi：10.3969/j.issn.1674-4985.2017.30.011

膝骨關節炎（Knee osteoarthritis，KOA）是關節軟骨退行性改變導致的軟骨丟失、破壞，伴有關節周圍骨質增生反應的疾病，又稱骨關節病、退行性關節炎等。一般由膝關節退行性病變、外傷、過度勞累等因素引起。膝關節炎多發于中老年人，是引起老年人腿疼的主要原因。另外，體重過重、不正確的走路姿勢、長時間下蹲、膝關節的受涼受寒也是導致膝關節炎的原因。其臨床表現多為膝關節疼痛、腫脹、關節內彈響，病變發展到后期可伴有不同程度的膝關節僵硬及活動受限等癥狀，嚴重影響了患者的日常生活質量。為此筆者運用常規藥物治療的同時采用國際上先進的放射狀沖擊波療法（Radial Shock Wave Therapy，RSWT）治療膝骨關節炎，臨床上取得了較佳療效，現報道如下。……