半导体激光穴位照射联合川芎嗪 治疗膝骨关节炎的临床研究

Clinical study of semiconductor laser irradiation combined with tetramethylpyrazine for knee joint osteoarthritis

摘要:

目的 探讨半导体激光穴位照射联合川芎嗪治疗膝骨关节炎的临床疗效。方法 选取符合入组标 准的膝骨关节炎患者72 例，使用SPSS19.0 的随机数字发生器分为3 组，分别是半导体激光穴位注射组（A 组）、 川芎嗪关节内注射组（B 组）和半导体激光穴位照射联合川芎嗪关节内注射组（C 组），治疗周期为4 周。采 用Lysholm 评分标准和视觉模拟评分量表（VAS）对患者进行膝关节功能和疼痛的评估，并由专业的康复治疗 师评估患者治疗后的膝关节活动度（ROM）和疗效缓解情况；采用医院焦虑抑郁量表（HAD）和匹茨堡睡眠 质量指数量表（PSQI）评估患者的情绪和睡眠质量；采用股骨头前后位和侧位X 射线测量各患者的影像学角 度。结果 3 组患者的总有效率分别是83.3%、73.1% 和93.1%。所有患者治疗后VAS 评分、ROM 和膝关节 功能评分均较治疗前显著改善。A、B 两组治疗后VAS 评分、ROM、膝关节功能评分、PSQI、HAD-A 和 HAD-B 评分差异无统计学意义（P >0.05）。与A 组和B 组比较，C 组治疗后的VAS 评分、膝关节功能评分、 PSQI、HAD-A 和HAD-B 评分降低，ROM 角度增加，差异有统计学意义（P <0.05）。A 组和B 组影像学检 测的各个角度参数差异无统计学意义（P >0.05），C 组影像学检测的各个角度参数较A 组和B 组减小，差异 有统计学意义（P <0.05）。3 组患者治疗后股骨长度、局部肿胀疼痛、照射部位损伤和过敏反应发生率差异 无统计学意义（P >0.05）。结论 半导体激光穴位照射联合川芎嗪关节内注射能有效改善膝骨关节炎患者的疼 痛，促进膝关节功能的恢复，提高患者睡眠质量和情绪。

Abstract:

Objective To explore the clinical effect of semiconductor laser irradiation combined with intraarticular injection of tetramethylpyrazine in the patients with knee joint osteoarthritis. Methods A total of 72 patients with knee joint osteoarthritis meeting the inclusion criteria were randomly divided into three groups using a random number generator of SPSS 19.0: a semiconductor laser irradiation group (group A), a tetramethylpyrazine intraarticular injection group (group B) and a combination group (group C). The period of treatment in each group was 4 weeks. The function and pain of the knee joints after treatment were assessed by Lysholm score and Visual Analogue Scale (VAS) respectively. Then, the range of motion (ROM) of the knee joints and remission after treatment were evaluated by professional rehabilitation therapists, and Hospital Anxiety and Depression Scale (HAD) and Pittsburgh Sleep Quality Index (PSQI) were performed to evaluate the emotion and sleep quality of included patients. All radiographic measurements were obtained from true long-standing anteroposterior and femoral lateral radiographs. Results The total effective rate of the three groups were 83.3%, 73.1% and 93.1% respectively. The VAS score, ROM and functional score of the knee joints in all the patients after treatment were significantly improved in comparison with the baseline condition. The VAS score, ROM, functional score of the knee joints, PSQI, HAD-A and HAD-B scores were not significantly different between the groups A and B (P > 0.05). Compared with the groups A and B, the VAS score, functional score of the knee joints, PSQI, HAD-A and HAD-B scores were significantly decreased while ROM was increased in the group C (P < 0.05). The measured parameters by radiographs were not significantly different between the groups A and B (P > 0.05), but these parameters in the group C were decreased compared to those in the groups A and B (P < 0.05). The femoral length and incidence of local swelling and pain, damage of irradiation site and anaphylactic reaction were not significantly different among the 3 groups (P > 0.05). Conclusions Semiconductor laser irradiation combined with intra-articular injection of tetramethylpyrazine can effectively ameliorate the pain of the patients with knee joint osteoarthritis, improve the recovery of knee joint function, sleep quality and motion.