摘要
目的研究体外冲击波治疗(ESWT)联合中药外敷治疗膝骨关节炎(KOA)的临床效果及对血清炎症因子的影响。方法选取2022年1月至2023年3月常州市武进人民医院收治的114例KOA患者作为研究对象,根据随机数字表法分为对照组(38例)、冲击波组(38例)和联合治疗组(38例)。对照组给予外擦双氯芬酸二乙胺乳膏剂治疗,冲击波组给予ESWT治疗,联合治疗组行ESWT联合中药外敷治疗,三组患者均治疗4周。比较三组患者疗效、疼痛程度、膝关节功能指数、膝关节活动度的变化情况以及不良反应发生率,并检测所有患者治疗前后血清软骨寡聚基质蛋白(COMP)、白细胞介素1β(IL-β)、基质金属蛋白酶-13(MMP-13)水平。结果联合治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。联合治疗组不良反应总发生率低于冲击波组,差异有统计学意义(P<0.05)。治疗后,三组患者的11点数字评分(NRS-11)、西安大略和麦克马斯特大学骨关节炎指数(WOM-AC)、中医证候积分、COMP、IL-1β、MMP-13均低于本组治疗前,膝关节活动度(ROM)均高于本组治疗前,差异有统计学意义(P<0.05)。治疗后,联合治疗组的COMP、IL-1β、MMP-13、NRS-11评分、WOMAC评分低于对照组、冲击波组,膝关节ROM值高于对照组、冲击波组,差异有统计学意义(P<0.05)。结论ESWT联合中药外敷可有效缓解KOA患者疼痛,改善膝关节功能,增大膝关节活动度,调节COMP、IL-1β、MMP-13,且不增加不良反应发生。
Objective To study the clinical effect of extracorporeal shock wave therapy(ESWT)combined with external ap-plication of traditional Chinese medicine in the treatment of knee osteoarthritis(KOA)and its effect on serum inflammatory factors.Methods A total of 114 patients with KOA admitted to Changzhou Wujin People's Hospital from January 2022 to March 2023 were selected as study subjects and they were divided into control group(38 cases),shock wave group(38 cases)and combined treatment group(38 cases)according to random number table method.The control group was treated with ex-ternal rubbing Diclofenac diethylamine emulgel,the shock wave group was treated with ESWT,and the combined treatment group was treated with ESWT combined with external application of traditional Chinese medicine.All patients in the three groups were treated for 4 weeks.The therapeutic effect,pain degree,knee functional index,knee motion and the incidence of adverse reactions were compared among the three groups,and the levels of serum cartilage oligomeric matrix protein(COMP),interleukin-1β(IL-1β)and matrix metallopro-teinase-13(MMP-13)were detected in all patients before and after treatment.Results The total effective rate of combined treatment group was higher than that of the con-trol group,the difference was statistically significant(P<0.05).The total incidence of adverse reactions in combined treat-ment group was lower than that in shock wave group,and the difference was statistically significant(P<0.05).After treat-ment,the numerical rating scale-11(NRS-11),Western Ontario and McMaster University osteoarthritis index(WOMAC),traditional Chinese medicine syndrome score,COMP,IL-1βand MMP-13 of the three groups were all lower than those before treatment,and the range of motion(ROM)was higher than that before treatment,the differences were statistically significant(P<0.05).After treatment,COMP,IL-1β,MMP-13,NRS-11 and WOMAC scores in combined treatment group were lower than those in control group and shock wave group,and knee ROM values were higher than those in control group and shock wave group,the differences were statistically significant(P<0.05).Conclusion ESWT combined with tra-ditional Chinese medicine can effectively relieve pain in KOA patients,improve knee joint function,increase knee joint motion,regulate COMP,IL-1βand MMP-13,and do not increase the occurrence of adverse reactions.
作者
马文虎
祁晓
MA Wenhu;QI Xiao(Department of Traditional Chinese Medicine Orthopedics and Traumatology,Changzhou Wujin People's Hospital,Affili-ated Wujin Hospital of Jiangsu University,Jiangsu Province,Changzhou 213000,China;Department of Rehabilitation Medicine,Changzhou Wujin People's Hospital,Affiliated Wujin Hospital of Jiangsu University,Jiangsu Province,Changzhou 213000,China)
出处
《中国当代医药》
2025年第9期48-53,58,共7页
China Modern Medicine
关键词
体外冲击波
中药外敷
膝骨关节炎
炎症因子
Extracorporeal shock wave therapy
External application of traditional Chinese medicine
Knee osteoarthritis
Inflammatory factors
