内热针联合体外冲击波对膝骨关节炎患者膝关节活动度、生活质量及骨代谢指标的影响OA
Effects of internal heated needle therapy combined with extracorporeal shock wave therapy on knee range of motion,quality of life,and bone metabolism markers in patients with knee osteoarthritis
目的 观察内热针联合体外冲击波对膝骨关节炎(KOA)患者膝关节活动度、生活质量及骨代谢指标的影响.方法 选择 2021 年 6 月至 2023 年 11 月华中科技大学同济医学院附属武汉中心医院疼痛科 KOA 患者 86 例,按照随机数字表法分为治疗组和对照组,每组 43 例.对照组采用体外冲击波治疗,治疗组在对照组基础上加内热针.比较2组治疗前后中医证候积分、膝关节活动度、生活质量[欧洲癌症研究与治疗组织癌症患者生活质量核心问卷(EORTCQLQ-30)量表]、骨代谢指标[骨保护素(OPG)、骨钙素(BGP)及降钙素];统计并比较 2 组临床疗效和不良反应.结果 治疗组总有效率为 95.35%(41/43),对照组总有效率为 79.07%(34/43),治疗组总有效率高于对照组(P<0.05).治疗后,2组患者关节疼痛、腰膝酸软及活动受限评分均降低(P<0.05),且治疗组显著低于对照组(P<0.05).治疗后,2 组伸直度、屈曲度、屈伸弧度及 EORTCQLQ-30 各项评分均升高(P<0.05),且治疗组均显著高于对照组(P<0.05).治疗后,2 组OPG、BGP 水平均显著高于治疗前(P<0.05),且治疗组高于对照组(P<0.05).2 组治疗前后降钙素水平比较差异无统计学意义(P>0.05).2 组患者治疗中未出现明显不良反应.结论 内热针联合外冲击波治疗 KOA 患者效果显著,能有效减轻患者症状,提升膝关节活动度、生活质量,改善骨代谢.
Objective To observe the effects of internal heated needle therapy combined with extracorporeal shock wave therapy on knee range of motion,quality of life,and bone metabolism markers in patients with knee osteoarthritis(KOA).Methods A total of 86 patients with KOA treated in the Department of Pain Management of the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,from June 2021 to November 2023 were selected and randomly assigned to a treatment group and a control group,with 43 patients in each group.The control group received extracorporeal shock wave therapy,while the treatment group received internal heated needle therapy in addition to the treatment given to the control group.Before and after treatment,traditional Chinese medicine syndrome scores,knee range of motion,quality of life(European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30[EORTC QLQ-30]),and bone metabolism markers(osteoprotegerin[OPG],bone gla protein[BGP],and calcitonin)were compared between the two groups.Clinical efficacy and adverse reactions were also recorded and compared.Results The total effective rate was 95.35%(41/43)in the treatment group and 79.07%(34/43)in the control group,with a significantly higher total effective rate in the treatment group(P<0.05).After treatment,scores for joint pain,lumbar and knee weakness,and limited activity decreased in both groups(P<0.05),and were significantly lower in the treatment group than in the control group(P<0.05).After treatment,extension,flexion,flexion-extension arc,and all EORTC QLQ-30 scores increased in both groups(P<0.05),with significantly greater increases in the treatment group than in the control group(P<0.05).After treatment,OPG and BGP levels were significantly higher than before treatment in both groups(P<0.05),and were higher in the treatment group than in the control group(P<0.05).No significant difference was observed in calcitonin levels before and after treatment in either group(P>0.05).No obvious adverse reactions occurred during treatment in either group.Conclusion Internal heated needle therapy combined with extracorporeal shock wave therapy is effective for patients with KOA.It can effectively relieve symptoms,improve knee range of motion and quality of life,and regulate bone metabolism.
王婷;吴群;蔡毅;曹娟;徐慧丽
华中科技大学同济医学院附属武汉中心医院疼痛科,湖北 武汉 430000华中科技大学同济医学院附属武汉中心医院疼痛科,湖北 武汉 430000华中科技大学同济医学院附属武汉中心医院疼痛科,湖北 武汉 430000华中科技大学同济医学院附属武汉中心医院疼痛科,湖北 武汉 430000华中科技大学同济医学院附属武汉中心医院疼痛科,湖北 武汉 430000
医药卫生
骨关节炎,膝内热针体外冲击波疗法骨代谢指标
Knee osteoarthritisInternal heated needleExtracorporeal shock waveBone metabolism markers
《河北中医》 2026 (6)
1010-1014,5
武汉市中医药科研项目立项(编号:WZ22Q47)
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