摘要
目的:研究中药熏洗配合髋膝强化训练治疗早中期膝骨关节炎(Knee Osteoarthritis,KOA)的临床疗效,为早中期膝骨关节炎患者的治疗提供参考。方法:将符合早中期KOA诊断标准的64例患者随机分为观察组和对照组各32例,观察组采用中药熏洗配合髋膝强化训练,对照组采用中药熏洗治疗,共进行为期6周的治疗和训练。分别于治疗前、后采集视觉模拟评分(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)量表评分,采用等速肌力训练测试系统(BTE PRIMUSRS)获取膝关节屈、伸,髋屈、伸,髋内收、外展的峰力矩(Peak Torque,PT)、平均功率(Average Power,AP)等指标数据,采用三维动作捕捉分析系统(D-WALL)进行30 s坐立转换测试评分进行临床疗效评价。结果:治疗前,各指标组间比较差异均无统计学意义(P>0.05);治疗后,两组患者在VAS、WOMAC评分均较治疗前有降低(P<0.05),观察组低于对照组(P<0.05);临床有效率观察组高于对照组(P<0.05);在30°/s、60°/s、180°/s三种角速度下进行等速肌力测试,两组患者治疗后膝屈肌PT、膝伸肌PT及AP、髋屈肌PT、髋伸肌PT及AP、髋外展PT、髋内收PT及AP等指标均优于治疗前(P<0.05),观察组较对照组改善更显著(P<0.05);两组患者30 s坐立转换测试评分均优于治疗前(P<0.05),观察组高于对照组(P<0.05)。结论:中药熏洗配合髋膝强化训练有助于提高肌肉力量、肌肉耐力,缓解关节疼痛程度,减轻关节僵硬度,提升日常活动能力及提高临床疗效,有临床推广价值。
Objective:To study the clinical efficacy of herbal fumigation combined with hip and knee strengthening training in the treatment of knee osteoarthritis(KOA)in the early-to-mid stage,in order to provide reference for the treatment of patients with earlyto-mid stage knee osteoarthritis.Methods:A total of 64 patients who met the diagnostic criteria for early-to-mid stage KOA were randomly divided into the observation group(n=32)and the control group(n=32).The observation group received herbal fumigation combined with strengthening training for the hip and knee,while the control group received herbal fumigation treatment,with a total treatment and training period of 6 weeks.Corresponding indicators were collected before and after treatment,and visual analogue scale(VAS)was used to evaluate the degree of knee joint pain.The Western Ontario Mc-Master University Osteoarthritis Index(WOMAC)was used to evaluate knee joint pain,stiffness,and daily activities.Before and after treatment,the isokinetic muscle strength training test system(BTE PRIMUSRS,USA)was used to to obtain objective data such as the peak torque(PT),average power(AP).A 30-second sit-to-stand test was conducted on patients using a three-dimensional motion capture analysis system(DWALL,Tecnobody s.r.l.Italy)to evaluate lower limb strength and endurance before and after treatment.Results:Before treatment,there was no significant difference between the two groups(P>0.05).After treatment,the VAS and WOMAC scores of the two groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).The clinical effective rate of the observation group was higher than that of the control group(P<0.05).The isokinetic muscle strength test was performed at three angular velocities of 30°/s,60°/s and 180°/s.After treatment,the PT,PT and AP of knee flexor,PT and AP of knee extensor,PT and AP of hip flexor,PT and AP of hip extensor,PT and AP of hip abduction,PT and AP of hip adduction in the two groups were better than those before treatment(P<0.05),and the improvement in the observation group was more obvious than that in the control group(P<0.05).The 30-second sit-to-stand conversion test scores of the two groups were better than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).Conclusion:Herbal fumigation combined with hip and knee strengthening training can improve muscle strength,muscle endurance,relieve joint pain,reduce joint stiffness,improve daily activity ability and clinical efficacy,and has clinical promotion value.
作者
李炯华
刘学勇
孙艾华
崔文
王小利
韩文义
LI Jionghua;LIU Xueyong;SUN Aihua;CUI Wen;WANG Xiaoli;HAN Wenyi(Shandong University of Traditional Chinese Medicine,Ji'nan,Shandong 250011;Jinan Vocational College of Nursing,Ji'nan,Shandong 250102;Shandong Sports Hospital,Ji'nan,Shandong 250102;Shehong Municipal Hospital of TCM,Suining,Sichuan 629000;Shandong Sports Rehabilitation Research Center,Ji'nan,Shandong 250102)
出处
《中医康复》
2025年第11期24-31,37,共9页
Traditional Chinese Medicine Rehabilitation
关键词
膝骨关节炎
中药熏洗
髋膝强化训练
等速肌力测试
生活质量
knee osteoarthritis
herbal fumigation
isokinetic muscle strength testing
isokinetic test
quality of life
