超声波结合经皮神经电刺激对膝骨关节炎患者膝关节疼痛和功能的影响

关键词：膝骨关节炎  疼痛  功能障碍  超声波  经皮神经电刺激  步行功能

Keywords:knee osteoarthritis  pain  dysfunction  ultrasound  transcutaneous electrical nerve stimulation  function of walking

摘要：

      摘要 目的：探讨超声波结合经皮神经电刺激对膝骨关节炎患者膝关节疼痛和功能的影响。 方法：将122例Kellgren-Lawrence（K-L）分级1—3级的膝骨关节炎患者随机分为试验组和对照组，每组各61例。试验组患者在常规康复治疗基础上给予超声波结合经皮神经电刺激治疗，对照组患者在常规康复治疗基础上仅给予超声波治疗。2组患者在治疗前、治疗4周后及治疗结束后第3月时，采用VAS疼痛评分量表、WOMAC膝骨关节炎指数、步行能力评定量表、6min步行距离评定患者的膝关节疼痛和功能状况。 结果：治疗前，试验组和对照组各项数据相比差异无显著性意义，治疗4周后，两组患者的VAS评分、WOMAC疼痛和功能评分均有明显下降（P<0.05）；两组患者的步行能力评分和6min步行距离均有明显提高（P<0.05），WOMAC僵硬评分两组患者均无明显改变（P＞0.05），且试验组联合治疗下的VAS评分 、WOMAC疼痛和功能评分、步行能力评分和6min步行距离与对照组相比均有显著性意义（P＜0.05）。随访时，两组患者除WOMAC僵硬评分和功能评分外其余指标与治疗前比仍有显著性差异（P<0.05），试验组的VAS评分 、WOMAC疼痛评分、步行能力评分和6min步行距离均优于对照组（P<0.05）。 结论：超声波结合经皮神经电刺激可明显改善膝骨关节炎患者的膝关节疼痛、提高其步行功能和步行距离，但对膝关节僵硬无明显改善作用。

Abstract:

      Abstract Objective： To investigate the effect of ultrasound combined with transcutaneous electrical nerve stimulation on pain and function of knee joint in patients with knee osteoarthritis. Method： A total of 122 patients with knee osteoarthritis graded 1 to 3 according to Kellgren-Lawrence （K-L）classification were randomly divided into the experimental group （n=61）and the control group（n=61）. The patients in the experimental group were treated with ultrasound combined with transcutaneous electrical nerve stimulation on the basis of conventional rehabilitation treatment， and the patients in the control group were only treated with ultrasound on the basis of conventional rehabilitation treatment. The Visual Analogue Scale (VAS) for pain，Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)， walking ability rating scale and 6-minute walk distance were used to evaluate the pain and function of knee joint before treatment， 4 weeks after treatment and 3 months after treatment. Result： Before treatment， there was no significant difference between the experimental group and the control group. After 4 weeks of treatment， the VAS score， WOMAC pain and function scores of the two groups were significantly decreased （P<0.05）. Improvements in walking ability scores and 6-minute walk distance were significant in both groups （P<0.05）. No significant changes were observed in the WOMAC stiffness score between the two groups （P>0.05）， The VAS score， WOMAC pain and function score， walking ability score and 6-minute walk distance in the experimental group had statistical significance when compared with those in the control group （P<0.05）. At follow-up， except for the WOMAC stiffness score and function score， there were significant differences when compared with those before treatment in the two groups （P<0.05）. The VAS score， WOMAC pain score， walking ability score and 6-minute walk distance in the experimental group were significantly improved than those in the control group （P<0.05）. Conclusion： Ultrasound combined with transcutaneous electrical nerve stimulation could significantly relieve pain， enhances walking function and improve walking ability in people with knee osteoarthritis， but does not have a marked effect on joint stiffness.