Effect of joint mobilisation combined with massage on knee osteoarthritis and functional recovery
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摘要:
目的 观察膝关节骨关节炎应用关节松动术联合推拿治疗的效果及功能恢复情况，探讨有效疗法，以提高疗效，改善预后。 方法 选取温州市中医院骨科2019年10月—2020年10月膝关节骨关节炎患者94例，根据不同治疗方案分为A组(47例)与B组(47例)；A组应用关节松动术治疗，B组应用关节松动术联合推拿治疗，比较2组患者膝关节疼痛程度、膝关节功能、膝关节活动度、关节液炎症因子水平以及总体疗效。 结果 B组治疗后的VAS评分[(1.21±0.72)分]低于A组[(2.19±1.04)分]，B组治疗后的KSS评分[(80.02±5.66)分]高于A组[(73.17±6.20)分]，B组治疗后的主动ROM与被动ROM(121.68°±10.16°、128.49°±12.35°)大于A组(102.34°±7.24°、110.34°±7.83°)，B组治疗后的白介素-6、肿瘤坏死因子-α、C反应蛋白水平[(17.93±3.01)ng/L、(11.02±1.76)ng/L、(20.25±5.31)mg/L]低于A组[(22.61±3.27)ng/L、(13.21±2.05)ng/L、(27.69±7.14)mg/L]，B组的总有效率(95.74%)高于A组(80.85%)，均P < 0.05。 结论 膝关节骨关节炎应用关节松动术联合推拿治疗的效果确切，可减轻膝关节疼痛，提高膝关节功能，增加膝关节活动度、减轻关节液炎症反应。 Abstract:Objective This study aimed to observe the effect and functional recovery of joint mobilisation combined with massage in the treatment of knee osteoarthritis and explore effective treatment to improve curative effect and prognosis. Methods A total of 94 patients who were diagnosed with knee osteoarthritis from October 2019 to October 2020 in the Department of Orthopedics of our hospital were selected and divided into group A (47 cases) and group B (47 cases) on the basis of different treatment schemes; group A was treated with joint mobilisation, and group B was treated with joint mobilisation combined with massage. The knee joint pain degree (VAS score), knee joint function (KSS score) and knee joint range of motion of the two groups were compared (active ROM and passive ROM) with the levels of inflammatory factors in synovial fluid (IL-6, TNF-α and C-reactive protein) and overall efficacy. Results The VAS score of group B (1.21±0.72) points was lower than that of group A (2.19±1.04) points, and the KSS score of group B (80.02±5.66) points was higher than that of group A (73.17±6.20) points. Active ROM and passive ROM of group B (121.68°±10.16° and 128.49°±12.35°, respectively) were higher than those of group A (102.34°±7.24° and 110.34°±7.83°, respectively). In addition, the levels of interleukin-6, tumour necrosis factor-α and C-reactive protein in group B [(17.93±3.01) ng/L, (11.02±1.76) ng/L and (20.25±5.31) mg/L, respectively] were lower than those in group A [(22.61±3.27) ng/L, (13.21±2.05) ng/L and (27.69±7.14) mg/L, respectively]. The total effective rate of group B (95.74%) was higher than that of group A (80.85%), all P < 0.05. Conclusion The effect of joint mobilisation combined with massage in the treatment of knee osteoarthritis is exact, which can significantly reduce the pain of knee joint, improve the function of knee joint, increase the range of motion of knee joint and reduce the inflammatory reaction of joint fluid. -
Key words:
- Knee osteoarthritis /
- Joint mobilisation /
- Massage /
- Pain /
- Knee joint function /
- Inflammatory factor level
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表 1 2组膝关节骨关节炎患者VAS评分及KSS评分比较(x ±s，分)
组别 例数 VAS评分 KSS评分 治疗前 治疗后 治疗前 治疗后 A组 47 4.88±1.23 2.19±1.04 60.23±7.65 73.17±6.20 B组 47 4.90±1.20 1.21±0.72 60.17±7.62 80.02±5.66 t值 0.080 5.311 0.038 5.594 P值 0.468 ＜0.001 0.485 ＜0.001 
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表 2 2组膝关节骨关节炎患者膝关节活动度对比(x ±s，°)
组别 例数 主动ROM 被动ROM 治疗前 治疗后 治疗前 治疗后 A组 47 70.21±3.46 102.34±7.24 80.45±3.35 110.34±7.83 B组 47 70.14±3.50 121.68±10.16 80.38±3.40 128.49±12.35 t值 0.098 10.628 0.101 8.509 P值 0.461 ＜0.001 0.460 ＜0.001
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表 3 2组膝关节骨关节炎患者关节液炎症因子水平比较(x ±s)
组别 例数 白介素-6（ng/L） 肿瘤坏死因子-α（ng/L） C反应蛋白（mg/L） 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 A组 47 32.54±4.15 22.61±3.27 16.23±2.76 13.21±2.05 37.68±10.67 27.69±7.14 B组 47 32.29±4.12 17.93±3.01 16.30±2.73 11.02±1.76 37.75±10.59 20.25±5.31 t值 0.293 7.219 0.124 5.557 0.032 5.732 P值 0.385 ＜0.001 0.451 ＜0.001 0.487 ＜0.001
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表 4 2组膝关节骨关节炎患者总有效率比较(例)
组别 例数 治愈 显效 有效 无效 总有效[例（%）] A组 47 9 11 18 9 38(80.85) B组 47 17 16 12 2 45(95.74) 注：2组总有效率比较，χ2=5.045，P=0.025。
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