放射状体外冲击波穴位疗法对老年膝骨关节炎患者的疗效及作用机制

Radial extracorporeal shock wave acupoint therapy for elderly patients with knee osteoarthritis and analysis of its mechanism

摘要:

目的 探讨放射状体外冲击波穴位疗法在老年膝骨关节炎(KOA)患者治疗中的应用价值,并分析其作用机制。方法 选择上海中医药大学附属曙光医院2018年1月到2019年6月收治的108例老年KOA患者为研究对象,根据随机数表法将患者分为药物组和冲击波组,各54例。药物组采用药物治疗,冲击波组采用放射状体外冲击波穴位疗法。比较2组治疗前后疼痛视觉模拟评分(VAS)、Lysholm评分、血清超氧化物歧化酶(SOD)、肿瘤坏死因子-α(TNF-α)水平及相关并发症发生率。采用SPSS 20.0统计软件进行数据分析。根据数据类型分别采用t检验、方差分析或χ²检验进行组间比较。结果 冲击波组治疗后VAS评分低于药物组,治疗后及6个月后Lysholm评分高于药物组(P＜0.05)。治疗后冲击波组SOD高于药物组,TNF-α低于药物组(P＜0.05)。冲击波组并发症发生率与药物组比较,差异无统计学意义(P＞0.05)。结论 与药物治疗相比,放射状体外冲击波穴位疗法能促进关节功能恢复,这可能与其进一步减轻氧化应激与炎症反应有关。

Abstract:

Objective To explore the application value of radial extracorporeal shock wave acupoint therapy in the treatment of the elderly patients with knee osteoarthritis (KOA) and to analyze its mechanism. Methods The study selected 108 elderly KOA patients admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2018 to June 2019. They were randomized into drug group and shock wave group, with 54 in each group. The former was treated with drug therapy, and the latter with radial extracorporeal shock wave acupoint therapy. The visual analogue scale (VAS), Lysholm score, serum supero-xide dismutase (SOD), tumor necrosis factor-α (TNF-α) and the incidence of related complications were compared between the two groups before and after treatment. SPSS statistics 20.0 was used for data analysis. According to different data type, t test, analysis of variance or χ² test was used for data comparison between two groups.Results The VAS score of the shock wave group was lower than that of the drug group after treatment, and the Lysholm score was higher than that of the drug group after treatment and 6 months later (P<0.05). After treatment, the SOD of the shock wave group was higher than that of the drug group, and TNF-α was lower than that of the drug group (P<0.05). There was no statistically significant difference in the complication rate between the shock wave group and the drug group (P>0.05). Conclusion Compared with drug therapy, radial extracorporeal shock wave acupoint therapy can promote the recovery of joint function, which may be related to its further reduction of oxidative stress and inflammation.