臭氧注射联合髌骨活动康复治疗疗对老年髌股关节疼痛缓解及功能恢复的影响

目的探讨臭氧注射联合髌骨活动康复治疗对老年髌股关节疼痛缓解及功能恢复的影响。方法选择髌股关节疼痛伴功能障碍的病人60例,随机分为两组,单纯臭氧注射组(O组,n=30)和臭氧注射加髌骨活动康复治疗组(O-P组,n=30)。两组均按照试验设计和操作常规于病变膝关节腔内注入40μg/ml臭氧10 ml,每周1次共4次,O-P组注射后进行髌骨活动度手法康复项目治疗1次/d。观察指标:①X线K-L分级评分;②VAS疼痛评分(通常痛和最痛评分);③kujala髌股关节功能评分。结果①不同治疗组组内比较,治疗后均显示较治疗前VAS疼痛评分分值降低,髌股关节功能评分分值升高(P<0.05);②髌骨关节X线分级中Ⅰ～Ⅱ级不同治疗组治疗后组间比较显示:两组VAS疼痛评分分值降低程度和髌股关节功能评分分值升高程度不具有相关性(P>0.05)。③髌骨关节X线分级中Ⅲ级和Ⅳ级的不同治疗组治疗后结果组间比较显示:O-P组的VAS疼痛评分分值的降低明显低于O组(P<0.05),髌股关节功能评分分值明显高于O组(P<0.05)。结论应用臭氧注射结合髌骨活动性康复治疗较单纯臭氧注射治疗可以更有效地缓解老年髌股关节疼痛,恢复退行性髌骨关节功能。

Study on effect of ozone injection combined with rehabilitation therapy of patellar activity on pain relief and functional recovery of patellofemoral joint in elderly patients

Objective To explore the effect of combination of ozone injection（OI） and rehabilitation therapy of patellar activity（RTPC） on pain relief and functional recovery of patellofemoral joint（PJ） in elderly patients.Methods Sixty patients with pain and functional disturbance in PJ were randomly divided into 2 groups,patients in group O（n = 30） received OI and patients in group O-P（n = 30） received combination of OI and RTPC.All patients in these two groups received injection of 10 ml ozone（40 μg / ml） into the damaged cavity of knee joint once a week and the course of treatment was four weeks according to the designed and conventional operation.Patients in group O-P received manual RTPC once a day after the OI.Items for observation including the Kellgren and Lawrence classification（KLC） under X-ray,the visual analogue scale（VAS） for general pain and severe pain,and the Kujala patellofemoral score（KPS） for the function of PJ had been carried out.Results The VAS for general pain and severe pain and KPS for the function of PJ after treatment were significantly higher than those before treatment（P 0.05）.The decrease in VAS in general pain and severe pain had no significant correlation with the increase in KPS on function of PJ（P 0.05）.The decrease in VAS in general pain and severe pain in patients with KLC Ⅲ and Ⅳ in group O-P was significantly larger than that of group O（P 0.05）.The increase in KPS for function of PJ in patients of group O-P was significantly larger than that of patients in group O（P 0.05）.Conclusion The combination of ozone injection and rehabilitation therapy of patellar activity can effectively restore the function of degenerated patellofemoral joint.