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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

24卷

期数:

2018年01期

页码:

55-58

栏目:

临床医学

出版日期:

2018-01-20

文章信息/Info

Title:

Comparison of short wave and laser therapy in the treatment of knee osteoarthritis

文章编号:

1006-8147(2018)01-0055-04

作者:

李聪聪; 翟艳萍; 罗媛媛; 谢 城; 安丙辰; 郑洁皎

（复旦大学附属华东医院康复科， 上海 200040）

Author(s):

LI Cong-cong ; ZHAI Yan-ping; LUO Yuan-yuan; XIE Cheng; AN Bing-chen; ZHENG Jie-jiao

(Department of Rehabilitation Medicine，Huadong Hospital，Fudan University ，Shanghai 200040， China)

关键词:

膝骨关节炎; 关节活动度训练; 股四头肌训练; 短波疗法; 激光疗法

Keywords:

knee osteoarthritis;  range of motion training of whole joint; quadriceps exercise;  short-wave therapy;  laser therapy

分类号:

R684.3

DOI:

-

文献标志码:

A

摘要:

目的：比较短波疗法与激光疗法治疗膝骨关节炎(KOA)的疗效，优化膝骨关节炎发作期物理因子治疗方案。方法：膝骨关节炎患者48例，随机分为短波组和激光组，每组24例，均口服扶他林，并进行全关节活动度牵伸和床边等长股四头肌训练，激光疗法组应用激光治疗，短波治疗组应用短波治疗。比较治疗15次后，WOMAC评分的疼痛、僵硬和功能障碍的变化。结果：15次治疗后短波治疗组患者较治疗前WOMAC评分的疼痛项（10.58±3.98 vs 3.54±2.15，P<0.05）、僵硬项（3.17±1.69 vs 1.17±0.87，P<0.05）和功能障碍项（33.54±12.96 vs 20.67±11.98， P<0.05）均明显改善。15次治疗后，激光治疗组较治疗前的WOMAC评分的疼痛项（10.50±3.53 vs 7.04±2.14， P<0.05）和功能障碍项（29.38±11.93 vs 21.29±7.89，P<0.05）均较治疗前有明显改善；僵硬项（2.79±1.96 vs 1.92±1.44， P>0.05）无明显改善。15次治疗后，短波治疗组和激光治疗组相比，WOMAC评分中疼痛项差值改变（6.96 vs 3.46, P<0.05）具有统计学意义，僵硬项差值（2 vs 0.88，P<0.05）具有统计学意义。结论：短波疗法缓解膝骨关节炎发作期疼痛、改善僵硬的疗效明显优于激光疗法，这可能与短波的穿透深度较深有关，提示软骨下骨病变是KOA的重要病理机制之一。

Abstract:

Objective: To compare the efficacy of short-wave therapy and laser therapy in the treatment of knee osteoarthritis（KOA） and to optimize the treatment plan of physical therapy during the onset of KOA. Methods: Forty-eight cases of KOA were randomly divided into short-wave group and laser group, 24 cases in each group, treated with Voltaren 75 mg once a day, and the range of motion training of whole joint and quadricep exercise were carried; laser therapy group was treated with laser therapy while the short-wave group was treated with short-wave. The pain, stiffness, and physical function changes of the WOMAC score were compared between 15 treatments. Results: From baseline to 15 treatments, the short-wave therapy group demonstrated improvement in WOMAC pain(10.58±3.98 vs 3.54±2.15，P<0.05), stiffness(3.17±1.69 vs 1.17±0.87，P<0.05), and physical function score(33.54±12.96 vs 20.67±11.98，P<0.05).The laser therapy group demonstrated improvement in WOMAC pain(10.50±3.53 vs 7.04±2.14,P<0.05), and physical function score(29.38±11.93 vs21.29±7.89，P<0.05). No significant improvement in stiffness(2.79±1.96 vs 1.92±1.44,P> 0.05) was observed. In addition, after the treatment, short-wave group vs laser group, the pain score in the WOMAC were(3.54±2.15 vs 7.04±2.14,P<0.05),stiffness score were (1.17±0.87 vs1.92±1.44,P<0.05). Conclusion: Short-wave therapy can alleviate the pain and improve the stiffness and is better than laser therapy, due to the deep penetration depth of short-wave, suggesting that the subchondral bone disease is one of most important pathological mechanism of KOA.

参考文献/References:

[1] Cowan S M, Bennell K L, Hodges P W, et al. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome.[J]. Arch Phys Med Rehab, 2001, 82(2):183

[2] Y?ld?r??m M A, U?ar D, ?ne? K. Comparison of therapeutic duration of therapeutic ultrasound in patients with knee osteoarthritis[J]. J Phys Ther Sci, 2015, 27(12):3667

[3] 陈庆奇, 龚敬乐. 基于国内外指南的适用于我国全科医疗的膝骨关节炎诊治流程[J]. 中国全科医学, 2016, 19(2):125

[4] Calindon T E, Bannuru R R, Sullivan M C, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis[J]. Osteoarthr Cartil , 2014, 22(6):890

[5] Beckwée D, Bautmans I, Scheerlinck T, et al. Exercise in knee osteoarthritis - preliminary findings: Exercise-induced pain and health status differs between drop-outs and retainers[J]. Exp Gerontol, 2015, 72:29

[6] 孙嘉利, 单守勤. 骨关节炎的物理治疗进展[J]. 中国疗养医学, 2014, 23(2):110

[7] 史鹏博, 赵如意, 赵利敬,等. 膝骨关节炎疼痛机制研究进展[J]. 风湿病与关节炎, 2016, 5(3):63

[8] Felson D T, Niu J, Guermazi A, et al. Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging.[J]. Arthr Rheumatol , 2007, 56(9):2986

[9] Kim I J, Kim D H, Jung J Y, et al. Association between bone marrow lesions detected by magnetic resonance imaging and knee pain in community residents in Korea[J]. Osteoarthr Cartil , 2013, 21(9):1207

[10] 耿晓鹏, 陈百成, 王霞,等. 软骨下骨髓水肿与膝骨关节炎疼痛相关性的影像学研究[J]. 中华骨科杂志, 2005, 25(11):682

[11] 余正红, 蔡胥, 钟世镇,等. 膝骨性关节炎性滑膜炎的临床特征及其意义[J]. 广东医学, 2008, 29(4):573

[12] 周玉红, 郭相萍, 周昆. He-Ne激光联合超短波疗法、股四头肌训练治疗膝关节骨关节炎的临床观察[J]. 中国激光医学杂志, 2014(6):350

[13] 马余鸿, 叶刚, 刘丽娟. 短波及调制中频电联合治疗膝关节骨性关节炎临床疗效观察[J]. 中国康复, 2011, 26(5):367

[14] Jan M H, Chai H M, Wang C L, et al. Effects of repetitive shortwave diathermy for reducing synovitis in patients with knee osteoarthritis: an ultrasonographic study.(Research Report)[J]. Phys Ther, 2006, 86(2):236

[15] Nora S, John G, Neil O. Short-wave diathermy: current clinical and safety practices[J]. Physiother Res Int , 2002, 7(4):191

[16] 吴并生, 薜华新, 刘晋,等. 超短波对家兔膝关节骨关节炎形成过程的影响[J]. 中华物理医学与康复杂志, 2003, 25(1):7

[17] 乔鸿飞, 雷建林, 杨峰. 超短波对家兔膝关节骨性关节炎自由基代谢影响的实验研究[J]. 陕西医学杂志, 2010, 39(5):536

[18] Brosseau L, Milne S, Robinson V, et al. Efficacy of the transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: a meta-analysis.[J]. Spine, 2002, 27(6):596

[19] Adams T, Band-Entrup D, Kuhn S, et al. Physical therapy management of knee osteoarthritis in the middle-aged athlete[J]. Sports Med Arthrosc, 2013, 21(1):2

[20] Angelova A, Ilieva E. Effectiveness of high intensity laser therapy for reduction of pain in knee osteoarthritis[J]. Pain Res Manag, 2016, 2016(1):9163618

相似文献/References:

[1]吴疆,赵斌,陈啸,等.关节镜联合胫骨高位截骨术促进膝关节内侧间室骨性关节炎软骨再生的机制研究[J].天津医科大学学报,2023,29(03):317.
　WU Jiang,ZHAO Bin,CHEN Xiao,et al.Mechanism of arthroscopy combined with high tibial osteotomy inpromoting cartilage regeneration in medial compartment of knee osteoarthritis[J].Journal of Tianjin Medical University,2023,29(01):317.

备注/Memo

备注/Memo:

作者简介 李聪聪 （1992-），女， 硕士在读，研究方向： 膝关节康复 ，E-mail：18321554693@163.com 。

常用功能

更新日期/Last Update: 2018-01-19