体外冲击波联合玻璃酸钠治疗膝骨性关节炎的临床疗效

目的 观察体外放射式冲击波联合关节腔注射玻璃酸钠治疗膝关节骨性关节炎（knee osteoarthritis,KOA）的临床疗效。方法 将62例KOA患者随机分为观察组与对照组，每组各31例，其中观察组男13例，女18例；平均年龄（62.35±9.70）岁，病程（3.06±1.49）a。对照组男16例，女15例；平均年龄（60.87±1.56）岁，病程（2.74±1.53）a。观察组患者先给予体外放射式冲击波治疗（extracorporeal shockwave therapy,ESWT），治疗后2d再常规行关节腔内注射玻璃酸钠（intra-articular injections of hyaluronic acid,HA）治疗。对照组患者单纯给予HA治疗。2组患者均每周治疗1次，连续治疗5周。治疗前、治疗结束后1周及治疗结束后3个月分别对2组患者进行疼痛视觉模拟评分（visual analogue scale,VAS）和骨关节炎指数（Western Ontario and McMaster University osteoarthritis index, WOMAC）评分，以评价2...

Clinical Study of Extracorporeal Shock Wave Combined with Sodium Hyaluronate in the Treatment of Knee Osteoarthritis

  Objective  To observe the clinical efficacy of external radiative shock wave combined with sodium hyaluronate injection in the treatment of knee osteoarthritis （KOA）.   Methods  Sixty-two patients with KOA be divided into observation group and control group randomly, with 31 cases in each group. The observation group included 13 males and 18 females, the mean age was （62.35±9.70） years old, and the course of disease was （3.06±1.49） years. There were 16 males and 15 females in the control group, the mean age was （60.87±1.56） years old, and the course of disease was （2.74±1.53） years. The Extracorporeal Shockwave therapy （ESWT） was given firstly , then the Intra-articular injection of hyaluronic acid （HA） was injected 2 days later in the observation group. The control group was treated with HA only 1 week. Both of the groups were treated once a week for 5 weeks. The Visual Analogue Scale （VAS） and Western Ontario and McMaster University Osteoarthritis Index （WOMAC） were used to evaluate the difference in efficacy between the two groups, at the time of before the treatment, 1 week after the treatment and 3 months after that.KOA patients were divided into observation group Ⅱ and control group Ⅱ according to Kellgren-Lawrence grading （Ⅱ, Ⅲ）. VAS score and WOMAC score of observation group Ⅲ and control group Ⅲ were compared before and after treatment, respectively.   Results  The VAS score and WOMAC score in both group were significantly lower than those before at the time of 1 week and 3 months after treatment （P < 0.05）, while 1 week after treatment and 3 months after treatment the VAS and WOMAC scores in the observation group were lower than those in the control group （P < 0.05）. The WOMAC score of the observation group was further decreased after 3 months than 1 week after treatment （P < 0.05）. In kellgren-Lawrence class Ⅱ and Ⅲ patients, the scores of observation group and control group decreased after treatment compared with before treatment （P < 0.05）, VAS of observation group decreased 1 week after treatment in class Ⅱ group, but the difference was not statistically significant, WOMAC score decreased （P < 0.05）. VAS and WOMAC scores of kellgren-Lawrence grade Ⅲ patients were lower than those of control group 3 months after treatment （P < 0.05）, VAS and WOMAC scores of Kellgren-Lawrence grade Ⅲ patients were lower than those of control group 1 week and 3 months after treatment （P < 0.05）.   Conclusion  The ESWT combined with HA can significantly reduce the joint pain and improve knee joint mobility more effectively than HA alone in the treatment of KOA.