国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (19): 3303-3308.DOI: 10.3760/cma.j.cn441417-20250311-19027

• 临床研究 • 上一篇    下一篇

经皮神经电刺激疗法联合闭链功能训练对膝骨关节炎患者的影响研究

武小岗1  何海燕1  杨春琴1  景旗1  袁景和2   

  1. 1延安大学附属医院疼痛康复医学科,延安 716000;2延安市中医医院疼痛科,延安 716000

  • 收稿日期:2025-03-11 出版日期:2025-10-01 发布日期:2025-10-24
  • 通讯作者: 袁景和,Email:876612065@qq.com
  • 基金资助:

    陕西省重点研发计划(2018-ZDXM-SF-057);延安市科技计划(2023-SFG G-077)

Study on the effect of transcutaneous electrical nerve stimulation combined with closed-chain functional training on patients with knee osteoarthritis

Wu Xiaogang1, He Haiyan1, Yang Chunqin1, Jing Qi1, Yuan Jinghe2   

  1. 1 Department of Pain Rehabilitation Medicine, Yan'an University Affiliated Hospital,Yan'an 716000,China; 2 Department of Pain Medicine, Yan'an Traditional Chinese Medicine Hospital, Yan'an 716000, China

  • Received:2025-03-11 Online:2025-10-01 Published:2025-10-24
  • Contact: Yuan Jinghe, Email: 876612065@qq.com
  • Supported by:

    Shaanxi Province Key Research and Development Program (2018-ZDXM-SF-057); Yan'an City Science and Technology Plan (2023-SFG G-077)

摘要:

目的 探讨经皮神经电刺激疗法(TENS)联合闭链功能性训练对膝骨关节炎患者疼痛缓解及功能恢复的影响。方法 采用前瞻性、单中心、单盲试验。研究对象为2022年1月至2024年1月在延安大学附属医院接受治疗的96例膝骨关节炎患者,通过随机数字表法分为两组,每组48例。对照组:男21例、女27例,年龄(65.11±7.63)岁,病程(7.73±1.28)个月;采用常规康复训练和TENS治疗。观察组:男19例、女29例,年龄(64.72±7.51)岁,病程(7.81±1.32)个月;在对照组基础上联合闭链功能性训练。两组均治疗4周。比较两组患者治疗前后的膝关节液炎症因子水平、膝关节周径、积液厚度、膝关节屈伸肌群等速肌力、三维步态参数,以及疼痛情况和膝关节功能。统计学方法采用t检验、χ2检验。结果 治疗后,观察组膝关节周径和积液厚度均小于对照组[(37.15±1.05)cm比(38.01±1.21)cm、(37.46±4.52)mm比(41.68±5.84)mm],差异均有统计学意义(t=3.719、3.959,均P<0.05);膝关节液中炎症因子水平均低于对照组,膝关节屈伸肌群平均峰力矩、三维步态参数均高于对照组(均P<0.05)。治疗后,观察组的视觉模拟评分法(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分均低于对照组[(2.60±0.71)分比(3.81±1.06)分、(29.94±3.69)分比(40.01±5.41)分],Lysholm膝关节评分高于对照组[(71.01±7.82)分比(60.24±6.31)分],差异均有统计学意义(t=6.571、10.654、7.426,均P<0.05)。结论 TENS联合闭链功能性训练能有效缓解膝骨关节炎患者的疼痛症状,促进关节功能恢复。

关键词:

经皮神经电刺激, 闭链功能性训练, 膝骨关节炎, 膝关节功能

Abstract:

Objective To explore the effect of transcutaneous electrical nerve stimulation (TENS) combined with closed-chain functional training on pain relief and functional recovery in patients with knee osteoarthritis. Methods A prospective, single-center, single-blind trial was conducted. The research subjects were 96 patients with knee osteoarthritis who received treatment at the Affiliated Hospital of Yan'an University from January 2022 to January 2024. They were randomly divided into two groups, with 48 cases in each group.Control group: 21 males and 27 females, with an average age of (65.11±7.63) years and a disease duration of (7.73±1.28) months.Conventional rehabilitation training and TENS therapy were adopted.Observation group: 19 males and 29 females, with an average age of (64.72±7.51) years and a disease duration of (7.81±1.32) months.Combined with closed-chain functional training on the basis of the control group.Both groups were treated for 4 weeks.Compare the levels of inflammatory factors in the knee joint fluid, the circumference of the knee joint, the thickness of the effusion, the isokinetic muscle strength of the knee flexion and extension muscle groups, the three-dimensional gait parameters, as well as the pain condition and knee joint function of the two groups of patients before and after treatment.Statistical methods employed t-test and χ2 test. Results After treatment, the knee joint circumference and the thickness of the effusion in the observation group were smaller than those in the control group [(37.15±1.05) cm vs. (38.01±1.21) cm, (37.46±4.52) mm vs. (41.68±5.84) mm], and the differences were statistically significant (t=3.719 and 3.959; both P<0.05). The levels of inflammatory factors in the knee joint fluid were all lower than those in the control group, and the average peak torque of the knee flexion and extension muscle groups, as well as the three-dimensional gait parameters, were all higher than those in the control group (all P<0.05).After treatment, the visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores of the observation group were lower than those of the control group [(2.60±0.71) points vs. (3.81±1.06) points, (29.94±3.69) points vs. (40.01±5.41) points], and the Lysholm knee joint score of the observation group was higher than that of the control group [(71.01±7.82) points vs. (60.24±6.31) points], and all the differences were statistically significant (t=6.571, 10.654,and 7.426, all P<0.05). Conclusion The combination of TENS (Transcutaneous Electrical Nerve Stimulation) and closed-chain functional training is beneficial in alleviating the pain of patients with knee osteoarthritis and promoting the recovery of joint function.

Key words:

Transcutaneous electrical nerve stimulation, Closed-chain functional training, Knee osteoarthritis, Knee joint function