神经肌肉电刺激联合臭氧、透明质酸治疗膝关节骨性关节炎的临床观察

摘要

Objective To investigate the efficacy and safety of treating knee osteoarthritis ( KOA) by neuromuscular electrical stimulation combined with ozone , hyaluronic acid.Methods Total of 94 KOA patients treated in Luoyang Bone-setting Hospital from Aug.2011 to Aug.2013 were included in the research.They were divided into observation group and control group according to random number table meth-od,47 cases each.The control group was treated by ozone,hyaluronic acid;the observation group was treated by neuromuscular electrical stimulation combined with ozone,hyaluronic acid(intra-articular injecting ozone, 40 mg/L,15 mL each time,one time per week,for 3 weeks continuously.Injecting sodium hyaluronate was subsequently administered,2.5 mL∶25 mg each time,one time per week,for 2 weeks continuously) .The clin-ical symptom score,total score,clinical efficacy and adverse reactions of the two groups were observed and compared.Results After treatment,the score of pain symptom,tenderness symptom,swelling symptom,float-ing patella test,squat test and total symptom score in the observation group were (1.0 ±0.4) scores,(1.1 ± 0.3) scores,(1.2 ±0.5) scores,(0.9 ±0.3) scores,(1.2 ±0.6) scores,(5.5 ±1.1) scores respectively,in the control group were (1.9 ±0.4) scores,(2.0 ±0.3) scores,(1.5 ±0.5) scores,(1.4 ±0.5) scores, (1.8 ±0.5) scores,(8.7 ±1.3 ) scores respectively,those in the observation group were significantly lower than the control group(P<0.05).After treatment, the total efficacy of the observation group was significantly higher than the control group [ 87.2%(41/47) vs 66.0%(31/47)],the difference was statistically signifi-cant(P<0.05).Obvious drug related adverse reactions were not observed in both groups.Conclusion Neuromuscular electrical stimulation combined with ozone,hyaluronic acid is better than ozone,hyaluronic acid in relieving symptoms,improving knee joint function of KOA patient,which is safe and reliable,and wor-thy of clinical application .%目的：探讨神经肌肉电刺激联合臭氧、透明质酸治疗膝关节骨性关节炎（ KAO）的疗效及安全性。方法选择2011年8月至2013年8月在洛阳正骨医院收治的 KAO 患者94例为研究对象，根据随机数字表法分为观察组和对照组，各47例。对照组采用臭氧、透明质酸治疗；观察组采用神经肌肉电刺激联合臭氧、透明质酸治疗，臭氧关节腔内注射，40 mg／L，每次15 mL，每周1次，连续治疗3周。随后给予玻璃酸钠关节腔注射，每次2.5 mL∶25 mg，每周1次，连续治疗2周。比较两组患者治疗前后的临床症状评分、总评分变化及临床疗效，同时观察不良反应发生情况。结果治疗后，观察组疼痛、压痛、肿胀、浮髌试验、下蹲试验评分及症状总积分分别为（1.0±0.4）分、（1.1±0.3）分、（1.2±0.5）分、（0.9±0.3）分、（1.2±0.6）分、（5.5±1.1）分，对照组分别为（1.9±0.4）分、（2.0±0.3）分、（1.5±0.5）分、（1.4±0.5）分、（1.8±0.5）分、（8.7±1.3）分，观察组明显低于对照组（P＜0.01）。观察组治疗后总有效率明显高于对照组[87.2％（41／47）比66.0％（31／47）]，差异有统计学意义（ P＜0.05）。两组患者均未出现明显药物相关不良反应。结论神经肌肉电刺激联合臭氧、透明质酸在缓解患者KAO症状、改善膝关节功能方面优于臭氧、透明质酸，且安全可靠，值得临床推广应用。