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[利用关节功能状态评估氧/臭氧疗法对膝关节炎患者康复治疗的有效性]

[The use of the functional state of the joints for the estimation of the effectiveness of the application of oxygen/ozone therapy for the rehabilitative treatment of the patients suffering from knee arthritis].

作者信息

Baranova I V

机构信息

N.I. Pirogov Memorial National Medical University, Vinnytsya, the Ukraine, Vinnytsya Municipal Hospital #2, Vinnytsya, the Ukraine.

出版信息

Vopr Kurortol Fizioter Lech Fiz Kult. 2018;95(3):42-48. doi: 10.17116/kurort201895342.

Abstract

BACKGROUND

In the recent years, the ever increasing tendency toward the growth in the prevalence of degenerative-dystrophic articular diseases has been observed especially among the young subjects and the middle-aged people. The enhanced economic burden of treating the patients with this condition on the public health care system frequently comes not only from chronic pathology of the joints but also from the development of concomitant disorders which dictates the necessity of the search for the new methods for the management of such patients.

AIM

The objective of the present study was the optimization of the treatment of the patients presenting with stage I-II gonarthrosis by the para-articular application of oxygen/ozone therapy at the early stages of knee arthritis and the evaluation of the clinical effectiveness of this approach.

MATERIAL AND METHODS

A total of 89 patients suffering from I-II sg gonarthrosis were recruited for the participation in the study. They included 67.2% of men and 32.8% of women. The age of the patients varied from 33 to 54 (mean 42±5) years, the duration of the disease averaged 4±1.2 years. All the patients were randomly divided into two groups: matched for the age, gender, the duration and severity of the disease, and the methods of its treatment. The main group was comprised of 45 patients whereas the group of comparison consisted of 44 patients. The generally accepted therapeutic modalities were used to treat the patients of both groups. Those included in the main group (n=45) additionally received para-articular oxygen/ozone therapy applied to the affected knee at a permanent ozone concentration of 8 gr/l (the injection area 15-20 sq.cm), main group n=45). The results of the treatment were evaluated within 1 and 6 months after the onset of therapy.

RESULTS

The application of the up-to-date methods of oxygen/ozone therapy in the combination with the universally-accepted drug-based treatments for the patients of the main group resulted in the significant (p<0.01) improvement of the indicators of the biomechanical activity of the knee joints in comparison with that achieved by means of the generic drug-based treatment alone.

DISCUSSION

The results of the present study give evidence of the feasibility of application of oxygen/ozone therapy for the treatment of degenerative-dystrophic articular diseases of the knees. The positive dynamics of the indicators of the functional activity of the knee joints, intensity and duration of the pain syndrome as well as the reduction of the period of the temporary incapacity for work associated with exacerbation of knee arthrosis suggests the high clinical and economic effectiveness of the para-articular application of oxygen/ozone therapy.

CONCLUSIONS

The present study has demonstrated the expediency and effectiveness of the application of oxygen/ozone therapy during exacerbation of stage І-ІІ knee arthritis as evaluated based on the WOMAC index, VAS, and Lyshom scale within one and six months after the onset of the treatment. The resulting reduction in the number of days of temporary incapacity for work in the patients suffering from knee arthritis gives evidence of the clinical and economic validity of the proposed method of the combined treatment of this condition based on the application of oxygen/ozone therapy.

摘要

背景

近年来,退行性 - 营养不良性关节疾病的患病率呈不断上升趋势,尤其在年轻人和中年人中更为明显。治疗此类患者给公共卫生保健系统带来的经济负担日益加重,这不仅源于关节的慢性病变,还源于伴随疾病的发展,这就使得寻找治疗此类患者的新方法成为必要。

目的

本研究的目的是在膝关节炎早期通过关节周围应用氧/臭氧疗法优化I - II期膝关节炎患者的治疗,并评估该方法的临床效果。

材料与方法

共招募了89例患有I - II期膝关节病的患者参与研究。其中男性占67.2%,女性占32.8%。患者年龄在33至54岁之间(平均42±5岁),病程平均为4±1.2年。所有患者随机分为两组:在年龄、性别、疾病持续时间和严重程度以及治疗方法方面进行匹配。主要组由45例患者组成,而对照组由44例患者组成。两组患者均采用公认的治疗方式。主要组(n = 45)的患者额外接受关节周围氧/臭氧疗法,将其应用于受影响的膝关节,臭氧浓度恒定为8克/升(注射面积15 - 20平方厘米,主要组n = 45)。在治疗开始后的1个月和6个月内评估治疗结果。

结果

与仅采用传统药物治疗相比,主要组患者采用最新的氧/臭氧疗法并结合公认的药物治疗,膝关节生物力学活动指标有显著(p < 0.01)改善。

讨论

本研究结果证明了氧/臭氧疗法用于治疗膝关节退行性 - 营养不良性关节疾病的可行性。膝关节功能活动指标、疼痛综合征的强度和持续时间的积极变化,以及与膝关节炎加重相关的暂时丧失工作能力时间的缩短,表明关节周围应用氧/臭氧疗法具有较高的临床和经济效益。

结论

本研究表明,根据WOMAC指数、视觉模拟评分法(VAS)和Lyshom量表评估,在治疗开始后的1个月和6个月内,氧/臭氧疗法在I - II期膝关节炎加重期的应用是适宜且有效的。膝关节炎患者暂时丧失工作能力天数的减少证明了基于氧/臭氧疗法的联合治疗方法在临床上和经济上的有效性。

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