摘要
目的:系统阐述膝关节骨性关节炎的各种康复评价及干预措施,旨在为患者提供较为理想的治疗方案。资料来源:应用计算机检索Medline1980-01/2003-04期间有关膝关节骨性关节炎康复评定及治疗方面的文章,检索词为“osteoarthritis,knee,rehabilitation,treatment”,并限定语言种类为English。同时计算机检索CBM1980-01/2003-04期间有关膝关节骨性关节炎康复评定及治疗方面的文章,检索词为“膝关节,骨性关节炎,评定,治疗”,限定文章语言种类为中文。资料选择:对资料进行初审,筛选出明显不随机对照的实验文章,对剩余的文献查找全文,进一步判断是否为随机对照临床实验。纳入标准:①随机对照临床实验。②实验包含平行对照组,即安慰剂对照、空白对照、阳性对照、剂量反应对照等。③治疗组应用本文所涉及到的不同疗法进行干预。资料提炼:共收到29篇关于膝关节骨性关节炎的康复评定和治疗的临床实验的文章,12篇文献符合纳入标准,排除的17篇试验中,均为重复的同一课题。资料综合:膝关节骨性关节炎主要的病理特征是关节软骨纤维化,退行性变和新骨生成,以至关节不稳,半脱位,屈曲性挛缩。可以通过诊断标准、形态学检查、肌力测定、膝关节活动度测定、步态分析、本体感觉、日常生活能力评定、生活质量评定及残疾指数评定等进行患者的康复评定。干预措施主要包括药物、物理、运动、作业、中医、心理、生物工程及手术治疗等。结论:关于膝关节骨性关节炎的康复评定可以从不同侧面全面进行,治疗也有多种方法可供选择实施,但目前尚无单一的特效手段,多种治疗方法联合使用可能会起到最佳的效果。
OBJECTIVE： To systematically explain the various rehabilitation evaluation and intervention measures for osteoarthritis of knee, so as to provide more satisfactory therapeutic programs for the patients. DATA SOURCES： A computer-based online search of Medline database was undertaken to identify articles about the rehabilitation evaluation and treatments for osteoarthritis published in English from January 1980 to April 2003 by using the keywords of “osteoarthritis, knee, rehabilitation, treatment”. Meanwhile, Chinese articles about the rehabilitation evaluation and treatments for osteoarthritis published between January 1980 and April 2003 were searched with computer in CBM database, the keywords were “osteoarthritis, knee, rehabilitation, treatment”. STUDY SELECTION： The data were checked firstly, the obvious nonrandomized controlled studies were screened, and then the full-texts of tire rest articles were looked up to further judge whether it was clinical randomized controlled trial or not. Inclusive criteria： ①clinical randomized controlled trial; ② containing parallel control group in the study, that was, placebo control, blank control, positive control, dose-effect control, etc.; ③different therapeutic methods involved in the article were used in the treatment. DATA EXTRACTION： Totally 29 articles of clinical studies about the rehabilitation evaluation and treatments for osteoarthritis of knee were collected, 13 of them accorded with the inclusive criteria, and the 16deleted trials were repetitive. DATA SYNTHESIS： The main pathological characteristics of osteoarthritis of knee were the fibrosis of articular cartilage, degeneration and new bone formation, which could lead to the lability, subluxation and flexion contracture of joints. The rehabilitation of the patients could be evaluated with the diagnostic criteria, morphological examination, testing of muscle strength, assay of knee joint motion, gait analysis, proprioception, assessments of abilities of daily life, quality of life and disabled index. The main intervention measures were the treatments of medicine, physics, exercise, work, traditional Chinese medicine, physiology, biological engineering and operation. CONCLUSION： The rehabilitation of osteoarthritis of knee can be evaluated from different aspects, and various therapeutic methods can be selected in the treatment, but there is still no single effective method at present, and the together application of various therapeutic methods may have the best effect.
出处
《中国临床康复》
CSCD
北大核心
2005年第30期201-203,共3页
Chinese Journal of Clinical Rehabilitation
