[1]秦伟凯,陈彦飞,张宽,等.负重监测下扶拐减重联合股四头肌锻炼治疗轻中度膝骨关节炎的临床研究[J].中医正骨,2018,30(11):13-16.
　QIN Weikai,CHEN Yanfei,ZHANG Kuan,et al.Crutch-assisted weight relief under the guidance of weight-bearing monitor combined with quadriceps exercises for treatment of mild-to-moderate knee osteoarthritis:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(11):13-16.
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负重监测下扶拐减重联合股四头肌锻炼治疗轻中度膝骨关节炎的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年11期
页码:
13-16
栏目:
临床研究
出版日期:
2018-11-20

文章信息/Info

Title:
Crutch-assisted weight relief under the guidance of weight-bearing monitor combined with quadriceps exercises for treatment of mild-to-moderate knee osteoarthritis:a clinical study
作者:
秦伟凯; 陈彦飞; 张宽; 赵勇
(中国中医科学院望京医院,北京 100102)
Author(s):
QIN Weikai; CHEN Yanfei; ZHANG Kuan; ZHAO Yong
Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China
关键词:
骨关节炎; 膝;  负重;  股四头肌;  运动疗法;  临床试验
Keywords:
osteoarthritis; knee;  weight-bearing;  quadriceps femoris;  exercise therapy;  clinical trial
摘要:
目的:观察负重监测下扶拐减重联合股四头肌锻炼治疗轻中度膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:将符合要求的60例KOA患者随机分为2组,每组30例。联合治疗组采用负重监测仪监测下扶拐减重联合股四头肌锻炼治疗,股四头肌锻炼组单纯采用股四头肌锻炼治疗。分别于治疗前和治疗2周后评定患者的膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、Lysholm膝关节评分、美国特种外科医院(The Hospital for Special Surgery,HSS)膝关节评分,并于治疗2周后采用《中药新药临床研究指导原则(试行)》中KOA的疾病疗效判定标准评定总体疗效。结果:至观察结束时,联合治疗组1例脱落、股四头肌锻炼组2例脱落。治疗前2组患者的疼痛VAS评分比较,差异无统计学意义(t=0.631,P=0.531); 治疗2周后,2组患者的疼痛VAS评分均较治疗前降低[(4.97±1.02)分,(1.90±0.77)分,t=12.943,P=0.000;(4.79±1.13)分,(2.75±1.53)分,t=5.655,P=0.000],联合治疗组的评分低于股四头肌锻炼组(t=-2.644,P=0.012)。治疗前2组患者的Lysholm评分比较,差异无统计学意义(t=-2.817,P=0.077); 治疗2周后,2组患者的Lysholm评分均较治疗前增高[(59.45±14.06)分,(77.86±13.27)分,t=-5.129,P=0.000;(69.14±11.77)分,(80.64±12.73)分,t=-3.059,P=0.001]; 2组治疗2周后的评分比较,差异无统计学意义(t=-0.807,P=0.423)。治疗前2组患者的HSS评分比较,差异无统计学意义(t=-1.558,P=0.125); 治疗2周后,2组患者的HSS评分均较治疗前增高[(78.76±7.68)分,(86.65±8.61)分,t=-3.685,P=0.001;(82.04±8.19)分,(86.89±9.24)分,t=-2.081,P=0.042]; 2组治疗2周后的评分比较,差异无统计学意义(t=-0.100,P=0.920)。治疗2周后,2组患者的总体疗效比较,差异无统计学意义(u=1.592,P=0.328)。结论:负重监测下扶拐减重联合股四头肌锻炼可有效缓解轻中度KOA患者的疼痛症状、改善膝关节功能,在缓解疼痛方面的效果优于单纯股四头肌锻炼。
Abstract:
Objective:To observe the clinical curative effects of crutch-assisted weight relief under the guidance of weight-bearing monitor combined with quadriceps exercises for treatment of mild-to-moderate knee osteoarthritis(KOA).Methods:Sixty patients with KOA were enrolled in the study and were randomly divided into combination treatment group and quadriceps exercise group,30 cases in each group.The patients in combination treatment group were treated with crutch-assisted weight relief under the guidance of weight-bearing monitor,while the others in quadriceps exercise group were treated with monotherapy of quadriceps exercises.The knee pain visual analogue scale(VAS)scores,Lysholm knee joint scores and Hospital for Special Surgery(HSS)knee scores were evaluated before treatment and after 2-week treatment respectively,and the total curative effects were evaluated after 2-week treatment according to the therapeutic effect evaluation standard of KOA which was extracted from Guiding principles of clinical research on new Chinese medicine(try out).Results:One patient in combination treatment group and 2 patients in quadriceps exercise group dropped out of the trial by the end of observation period.There was no statistical difference in knee pain VAS scores between the 2 groups before the treatment(t=0.631,P=0.531).The knee pain VAS scores decreased after 2-week treatment compared to pretreatment in the 2 groups(4.97+/-1.02 vs 1.90+/-0.77 points,t=12.943,P=0.000; 4.79+/-1.13 vs 2.75+/-1.53 points,t=5.655,P=0.000),and were lower in combination treatment group compared to quadriceps exercise group(t=-2.644,P=0.012).There was no statistical difference in Lysholm scores between the 2 groups before the treatment(t=-2.817,P=0.077).The Lysholm scores increased after 2-week treatment compared to pretreatment in the 2 groups(59.45+/-14.06 vs 77.86+/-13.27 points,t=-5.129,P=0.000; 69.14+/-11.77 vs 80.64+/-12.73 points,t=-3.059,P=0.001),and there was no statistical difference in Lysholm scores between the 2 groups after 2-week treatment(t=-0.807,P=0.423).There was no statistical difference in HSS scores between the 2 groups before the treatment(t=-1.558,P=0.125).The HSS scores increased after 2-week treatment compared to pretreatment in the 2 groups(78.76+/-7.68 vs 86.65+/-8.61 points,t=-3.685,P=0.001; 82.04+/-8.19 vs 86.89+/-9.24 points,t=-2.081,P=0.042),and there was no statistical difference in HSS scores between the 2 groups after 2-week treatment(t=-0.100,P=0.920).There was no statistical difference in total curative effect between the 2 groups after 2-week treatment(u=1.592,P=0.328).Conclusion:The combination therapy of crutch-assisted weight relief under the guidance of weight-bearing monitor and quadriceps exercises can effectively relieve the knee pain and improve the knee function in treatment of mild-to-moderate KOA,and it surpasses the monotherapy of quadriceps exercises in relieving the knee pain.

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备注/Memo

备注/Memo:
基金项目:北京中医药科技发展资金项目(JJ2016-67); 中国中医科学院望京医院院级科研课题(WJYY2016-PY-011)
通讯作者:赵勇 E-mail:zhaoyong423@163.com
更新日期/Last Update: 2018-11-30