踝关节骨关节病注射治疗联合康复治疗对踝关节功能恢复影响的临床探讨

目的探讨踝关节腔注射治疗联合踝关节康复治疗对踝关节功能恢复疗效的影响。方法选择踝关节疼痛伴功能障碍的病人32例,随机分为两组,单纯关节腔注射组(Ⅰ组,n=16)和关节腔注射加踝关节康复治疗组(IR组,n=16)。按照试验设计和操作常规,两组均于病变踝关节腔内注入治疗药物及臭氧(40μg/ml),每周1次,共4次。IR组注射后进行踝关节康复运动项目治疗,1次/天。观察指标:①X线K-L分级评分;②VAS疼痛评分;③Mazur踝关节功能评分。结果两组组内比较结果显示,治疗后较治疗前VAS疼痛评分值明显降低,踝关节Mazur功能评分值升高(P0.05)。根据踝关节X线K-L分级,组间对比疗效结果显示,Ⅰ-Ⅱ级中,两组治疗后VAS疼痛评分值降低程度和Mazur踝关节功能评分值升高程度无统计学差异(P0.05);Ⅲ级和Ⅳ级中,IR组治疗后VAS疼痛评分分值的降低明显低于Ⅰ组(P0.05),Mazur踝关节功能评分值明显高于Ⅰ组(P0.05)。结论应用关节腔注射治疗联合踝关节康复项目治疗踝关节骨关节病可以更有效地恢复踝关节功能。

The effect of the combination of intra - articular injection and rehabilitation therapy on the functional recovery of ankle osteoarthrosis.

Objective To explore the effect of the combination of intra - articular injection （IAI） and rehabilitation therapy （RT） on the functional recovery of ankle osteoarthrosis （OA）. Methods Thirty - two patients with pain and functional disturbance in ankles were randomly divided into group I （ n = 16 ） in which patients received IAI and group IR （ n = 16） in which patients received the combination of IAI and RT. All patients in two groups received the injection of ten milliliters ozone （40 μg/ml） into the damaged cavity of ankle joint one time a week and the treatment time was four weeks. Patients in group IR received ankle rehabilitation exercise treatment one time a day after IAI. The Kellgren and Lawrence classification under X - ray （KLC） , the visual analogue scale （ VAS）, and the Mazur ankle joint scoring system （MS） on the function of ankle were used to evaluate the effect of the treatment. Results After the treatment, the VAS was significantly lower than that before the treatment, and MS on the function of ankle was significantly higher than that before the treatment （ P 〈 0.05 ）. The decrease in the VAS had significant correlation with the increase in the MS on the function of ankle joint in patients with KLC I and II. The decrease in the VAS in patients with KLC III and IV in group IR was significantly larger than that in group I （ P 〈 0.05 ）. The increase in the MS on the function of ankle joint in patients in group IR was significantly larger than that in patients in group I （ P 〈 0.05 ）. Conclusion The combination of IAI and RT can effectively restore the function of ankle OA.