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评估电针与物理治疗对诊断为髌骨软化症士兵减轻疼痛和残疾的疗效:一项随机临床试验。

Evaluating the Efficacy of Electroacupuncture Compared to Physiotherapy in Reducing Pain and Disability in Soldiers Diagnosed with Chondromalacia Patella: A Randomized Clinical Trial.

作者信息

Kazempour Mofrad Reza, Dadarkhah Afsaneh, Rezasoltani Zahra, Najafi Sharif

机构信息

Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran.

Clinical Biomechanics and Ergonomics Research Center, AJA University of Medical Sciences, Tehran, Iran.

出版信息

Anesth Pain Med. 2024 Sep 3;14(4):e143688. doi: 10.5812/aapm-143688. eCollection 2024 Aug.

Abstract

BACKGROUND

One of the most prevalent causes of anterior knee pain is chondromalacia patella (CMP), particularly among young populations, including soldiers. Although various treatments have been suggested to relieve the symptoms and improve the functioning of patients with CMP, none have proven to be adequately effective.

OBJECTIVES

This study assessed the effectiveness of electroacupuncture as a complementary treatment for CMP, noting its minimal complications.

METHODS

In this randomized clinical trial, soldiers diagnosed with CMP who met the inclusion criteria and referred to Imam Reza Hospital in Tehran in 2023 were assigned to one of two treatment groups. The electroacupuncture group received treatment at specific acupuncture points combined with an electrical current. The physical therapy group underwent treatment consisting of 10 sessions of routine physical therapy modalities. The Visual Analog Scale (VAS) for pain and disability and the knee injury and osteoarthritis outcome score (KOOS) questionnaire were used to assess the outcomes before the intervention and three months after the intervention.

RESULTS

Twenty participants were analyzed in each group. The VAS for pain and disability reduced in both groups during the study; however, the difference between the two groups was not significant (P = 0.999 for pain and P = 0.873 for disability). No significant difference was observed in the KOOS symptom score either during the study or between the two groups (P = 0.423). The changes in the "pain" scores of the KOOS questionnaire were significant both in the electroacupuncture group (P = 0.003) and in the physical therapy group (P = 0.038); however, the difference was not significant between the two groups. The "activities of daily living" scores of the patients were significant both during the study and between the two groups (P = 0.042), with a steeper improvement in the electroacupuncture group. The patients' "sports and recreational activities" scores were significant in the electroacupuncture group (P = 0.001) and between the two groups (P = 0.023). The "knee-related quality-of-life" scores were significant in both groups, and the comparison of the two groups indicated that the slope of the changes was higher in the electroacupuncture group than in the physical therapy group (P = 0.001).

CONCLUSIONS

According to the results of the current research, electroacupuncture can improve the symptoms and function of patients with CMP, and its efficacy is equivalent to that of physical therapy.

摘要

背景

髌软骨软化症(CMP)是前膝痛最常见的病因之一,在包括士兵在内的年轻人群中尤为普遍。尽管已提出多种治疗方法来缓解CMP患者的症状并改善其功能,但尚无一种方法被证明具有足够的有效性。

目的

本研究评估电针作为CMP辅助治疗方法的有效性,并指出其并发症极少。

方法

在这项随机临床试验中,2023年被诊断为CMP且符合纳入标准并转诊至德黑兰伊玛目礼萨医院的士兵被分配到两个治疗组之一。电针组在特定穴位接受电针治疗。物理治疗组接受由10次常规物理治疗方式组成的治疗。使用视觉模拟疼痛和残疾量表(VAS)以及膝关节损伤和骨关节炎疗效评分(KOOS)问卷在干预前和干预后三个月评估结果。

结果

每组分析20名参与者。在研究期间,两组的疼痛和残疾VAS均降低;然而,两组之间的差异不显著(疼痛方面P = 0.999,残疾方面P = 0.873)。在研究期间或两组之间,KOOS症状评分均未观察到显著差异(P = 0.423)。KOOS问卷中“疼痛”评分的变化在电针组(P = 0.003)和物理治疗组(P = 0.038)中均有显著意义;然而,两组之间的差异不显著。患者的“日常生活活动”评分在研究期间以及两组之间均有显著意义(P = 0.042),电针组改善更为明显。电针组患者的“运动和娱乐活动”评分有显著意义(P = 0.001),两组之间也有显著意义(P = 0.023)。两组的“膝关节相关生活质量”评分均有显著意义,两组比较表明电针组变化斜率高于物理治疗组(P = 0.001)。

结论

根据当前研究结果,电针可改善CMP患者的症状和功能,其疗效与物理治疗相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffd9/11895788/9e2eee28f295/aapm-14-4-143688-i001.jpg

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