臭氧联合体外冲击波治疗膝关节骨性关节炎的疗效观察(1)
摘 要：目的 观察臭氧关节腔注射联合体外冲击波、玻璃酸钠联合体外冲击波这两种方法治疗膝关节骨关节炎的临床有效性，并对比其临床疗效。方法 将60例患者随机分为两组，每组30例，对照组行玻璃酸钠关节腔注射联合体外冲击波治疗，观察组给予臭氧关节腔注射联合冲击波治疗，1次/周，5次为一疗程。治疗前及治疗1、2、3、5周时行视觉模拟评分(VAS)评估患者疼痛变化，用WOMAC评分评估患者膝关节功能改变。结果 治疗后两组患者均未发现严重不良反应；两组患者疗程结束后VAS、WOMAC均较治疗前有显著改善，差异有统计学意义(P<0.05)。在治疗1周时，观察组VAS、WOAMC评分较对照组改善显著，差异有统计学意义(P<0.05)，在其他观察时间点，两组未见明显差异(P>0.05)。结论 臭氧联合体外冲击波、玻璃酸钠联合体外冲击波均能安全有效治疗膝关节骨关节炎，但臭氧联合体外冲击波起效更快，疗程更短。
关键词：臭氧；玻璃酸钠；体外冲击波；膝关节炎
中图分类号：R493 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.09.028
, http://www.100md.com
文章编号：1006-1959(2018)09-0094-04
Abstract：Objective To observe the clinical efficacy of ozone joint injection combined with extracorporeal shock wave therapy and sodium hyaluronate combined with extracorporeal shock wave in the treatment of knee osteoarthritis，and compare its clinical effect.Methods 60 patients were randomly divided into two groups，30 cases in each group.The control group received sodium hyaluronate injection combined with extracorporeal shock wave therapy，and the observation group received ozone joint cavity injection combined with shock wave therapy once a week for 5 times as a course of treatment.Visual analogue scale(VAS)was used to evaluate the pain changes before treatment and at 1，2，3，5 weeks after treatment.WOMAC score was used to evaluate the knee joint function changes in the patients.Results After treatment，no serious adverse reactions were found in both groups，and VAS，WOMAC was significantly improved after treatment in both groups，the difference was statistically significant(P<0.05).At the first week of treatment，the VAS，WOAMC score in the observation group was significantly improved than that in the control group，the difference was statistically significant(P<0.05).But there was no significant difference between the two groups at other observation time points(P>0.05).Conclusion Ozone combined with extracorporeal shock wave therapy，sodium hyaluronate combined with extracorporeal shock wave can be safe and effective for the treatment of knee osteoarthritis，but ozone combined with extracorporeal shock wave has faster effect and shorter course of treatment.
, 百拇医药
Key words：Ozone；Sodium hyaluronate；Extracorporeal shock wave therapy；Knee arthritis
骨关节炎(osteoarthritis，OA)是最常见的关节疾病。膝关节骨关节炎(knee osteoarthritis，KOA)临床上最为常见。研究表明[1]，全世界大约2.5亿人患有KOA。OA在中年以后多发，女性多于男性，随着年龄增长，发病率逐渐增高，到70岁以后，发病率可达80%。KOA是引起疼痛和活动受限的主要原因。KOA已成为65岁以上老年人最常见的致残疾病 [2，3]。WHO统计，目前全球人口 10%的医疗问题源于OA。但是，目前仍没有明确的治疗方法能阻止OA进展。治疗的主要目标是缓解疼痛，改善关节功能。关节内注射臭氧(O3)、关节内注射玻璃酸钠(hyaluronic acid，HA)治療KOA国内外均有较多的报道，并取得较好的临床疗效。近年来应用体外冲击波(extracorporeal shock wave therapy，ESWT)治疗KOA的报道逐渐增多。但是，ESWT联合O3、ESWT联合HA的报道较少。故我们临床采用ESWT联合O3、ESWT联合HA治疗KOA，以观察两种方法的临床疗效性，并取得了不错的临床疗效，现报道如下。, 百拇医药(王愉乐 李涛 向道明 牛陵川)
关键词：臭氧；玻璃酸钠；体外冲击波；膝关节炎
中图分类号：R493 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.09.028
, http://www.100md.com
文章编号：1006-1959(2018)09-0094-04
Abstract：Objective To observe the clinical efficacy of ozone joint injection combined with extracorporeal shock wave therapy and sodium hyaluronate combined with extracorporeal shock wave in the treatment of knee osteoarthritis，and compare its clinical effect.Methods 60 patients were randomly divided into two groups，30 cases in each group.The control group received sodium hyaluronate injection combined with extracorporeal shock wave therapy，and the observation group received ozone joint cavity injection combined with shock wave therapy once a week for 5 times as a course of treatment.Visual analogue scale(VAS)was used to evaluate the pain changes before treatment and at 1，2，3，5 weeks after treatment.WOMAC score was used to evaluate the knee joint function changes in the patients.Results After treatment，no serious adverse reactions were found in both groups，and VAS，WOMAC was significantly improved after treatment in both groups，the difference was statistically significant(P<0.05).At the first week of treatment，the VAS，WOAMC score in the observation group was significantly improved than that in the control group，the difference was statistically significant(P<0.05).But there was no significant difference between the two groups at other observation time points(P>0.05).Conclusion Ozone combined with extracorporeal shock wave therapy，sodium hyaluronate combined with extracorporeal shock wave can be safe and effective for the treatment of knee osteoarthritis，but ozone combined with extracorporeal shock wave has faster effect and shorter course of treatment.
, 百拇医药
Key words：Ozone；Sodium hyaluronate；Extracorporeal shock wave therapy；Knee arthritis
骨关节炎(osteoarthritis，OA)是最常见的关节疾病。膝关节骨关节炎(knee osteoarthritis，KOA)临床上最为常见。研究表明[1]，全世界大约2.5亿人患有KOA。OA在中年以后多发，女性多于男性，随着年龄增长，发病率逐渐增高，到70岁以后，发病率可达80%。KOA是引起疼痛和活动受限的主要原因。KOA已成为65岁以上老年人最常见的致残疾病 [2，3]。WHO统计，目前全球人口 10%的医疗问题源于OA。但是，目前仍没有明确的治疗方法能阻止OA进展。治疗的主要目标是缓解疼痛，改善关节功能。关节内注射臭氧(O3)、关节内注射玻璃酸钠(hyaluronic acid，HA)治療KOA国内外均有较多的报道，并取得较好的临床疗效。近年来应用体外冲击波(extracorporeal shock wave therapy，ESWT)治疗KOA的报道逐渐增多。但是，ESWT联合O3、ESWT联合HA的报道较少。故我们临床采用ESWT联合O3、ESWT联合HA治疗KOA，以观察两种方法的临床疗效性，并取得了不错的临床疗效，现报道如下。, 百拇医药(王愉乐 李涛 向道明 牛陵川)