等速肌力训练联合肌内效贴对骨关节炎患者膝关节稳定性的影响

杨珺 盛扬 赵玥 郑斌 熊贤诗

【摘 要】目的：探討等速肌力训练联合肌内效贴对骨关节炎患者膝关节稳定性的影响。方法：将80例骨关节炎患者按照数字双盲法分为治疗组和对照组，每组40例。对照组给予常规臭氧治疗，治疗组在对照组的基础上加用等速肌力训练联合肌内效贴治疗。观察2组临床疗效，以及治疗前后疼痛视觉模拟评分法（VAS）评分、膝关节稳定性Lysholm评分，关节液中白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-3（MMP-3）含量。结果：治疗组优秀35例，良好2例，尚可2例，较差1例，总有效率为97.50%;对照组优秀25例，良好3例，尚可3例，较差9例，总有效率为77.50%。2组比较，差异有统计学意义（P < 0.05）。治疗后，对照组VAS评分、Lysholm评分较治疗前均有改善（P < 0.05），治疗组VAS评分、Lysholm评分、IL-1β、TNF-α、MMP-3较治疗前均有改善（P < 0.05），且优于对照组（P < 0.05）。结论：骨关节炎患者常规治疗期间接受等速肌力训练、肌内效贴治疗，可提高临床疗效，有效缓解疼痛，减少关节液中炎症因子含量，保证膝关节稳定性。

【关键词】 骨关节炎;等速肌力训练;肌内效贴;膝关节稳定性;临床疗效

Effect of Isokinetic Muscle Strength Training Combined with Intramuscular Patch on Knee Joint Stability in Patients with Osteoarthritis

YANG Jun，SHENG Yang，ZHAO Yue，ZHENG Bin，XIONG Xian-shi

【ABSTRACT】Objective：To investigate the effect of isokinetic muscle strength training combined with intramuscular patch on the stability of knee joint in patients with osteoarthritis.Methods：Eighty patients with osteoarthritis were randomly divided into a treatment group and a control group，40 cases in each.The control group was given conventional ozone treatment，and the treatment group was given isokinetic muscle strength training combined with intramuscular patch on the basis of the treatment for the control group.The clinical efficacy，visual analogue scale（VAS），Lysholm score of knee joint stability before and after treatment，and the contents of IL-1β，

TNF-α and MMP-3 in synovial fluid were observed.Results：As for the effect，in the treatment group，37 cases were excellent，2 cases were good，1 case was not so good，and the total effective rate was 97.50%;in the control group，28 cases were excellent，3 cases were good，9 cases were not so good，and the total effective rate was 77.50%.The difference between the two groups was statistically significant（P < 0.05）.After treatment，the VAS and Lysholm score of the control group were improved compared with those before treatment（P < 0.05），and the VAS，Lysholm score，IL-1β，TNF-α and MMP-3 of the treatment group were improved compared with those before treatment（P < 0.05），and were better than those of the control group（P < 0.05）.Conclusion：Isokinetic muscle strength training and intramuscular plaster therapy can improve the clinical efficacy，effectively relieve pain，reduce the content of inflammatory factors in synovial fluid and ensure the stability of knee joint.

【Keywords】 osteoarthritis;isokinetic muscle strength training;intramuscular plaster;knee joint stability;clinical efficacy

骨关节炎（osteoarthritis，OA）是临床上常见的退行性骨关节疾病，患者以中老年人居多，主要表现为关节疼痛[1]。随着OA病情的进一步发展会出现关节变形、活动障碍等症状，对患者的日常生活等造成严重影响[2-3]。相关调查显示，国内OA患者中超过65岁者高达65%，已成为影响老年患者日常生活的主要因素[4]。目前，本病的发病机制尚未完全明确[5]，治疗较为棘手。主要采取保守治疗，如运动康复疗法、对症用药治疗、水疗、肌内效贴等。随着研究的不断深入，OA患者逐渐接受等速肌力训练，通过训练系统提供的可靠准确信息，使肌肉训练更加科学、安全、高效，因此，该训练方式在临床被逐渐重视[6]。肌内效贴属于一种软组织扎贴治疗方法，最初该方法主要用于预防和治疗运动损伤，止痛、消肿效果理想，而且能够促进正确感觉反馈，近年来已经在临床康复领域中广泛应用[7]。……