CAJ | 학술논문

目的采用新型悬吊运动疗法联合玻璃酸钠注射治疗髌股疼痛综合征患者,观察联合疗法对患者髌骨稳定性影像学指标和临床疗效的影响.方法髌股疼痛综合征患者70例,按就诊顺序及患者意愿分为治疗组和对照组.对照组36例患者,仅给予关节腔玻璃酸钠注射治疗；治疗组34例患者,在关节腔注射玻璃酸钠注射治疗基础上给予新型悬吊运动疗法,即膝关节稳定肌群神经肌肉激活技术训练治疗.2组分别于治疗前、治疗5周后测评患者疼痛评分(VAS)、股四头肌和腘绳肌肌力以及主动屈伸膝角度；治疗前及治疗5周后行膝关节CT检查,测量髌股倾斜角和髌股匹配角.结果治疗5周后与治疗前比较,2组患者的髌骨匹配角、仰卧位Q角、站立位Q角等反映髌骨轨迹异常的指标均降低.治疗5周后,2组患者的VAS评分降低(P＜0.05),治疗组的治疗前、后VAS评分差值及有效率高于对照组(P＜0.05),且治疗组的股四头肌肌力、腘绳肌肌力、主动屈伸膝角度较治疗前明显提高(P＜0.01).结论新型悬吊运动疗法联合玻璃酸钠注射治疗髌股疼痛综合征疗效较好,明显改善股四头肌外翻矢量和髌骨外侧移位.
목적 채용신형현조운동요법연합파리산납주사치료빈고동통종합정환자,관찰연합요법대환자빈골은정성영상학지표화림상료효적영향.방법 빈고동통종합정환자70례,안취진순서급환자의원분위치료조화대조조.대조조36례환자,부급여관절강파리산납주사치료；치료조34례환자,재관절강주사파리산납주사치료기출상급여신형현조운동요법,즉슬관절은정기군신경기육격활기술훈련치료.2조분별우치료전、치료5주후측평환자동통평분(VAS)、고사두기화객승기기력이급주동굴신슬각도；치료전급치료5주후행슬관절CT검사,측량빈고경사각화빈고필배각.결과 치료5주후여치료전비교,2조환자적빈골필배각、앙와위Q각、참립위Q각등반영빈골궤적이상적지표균강저.치료5주후,2조환자적VAS평분강저(P＜0.05),치료조적치료전、후VAS평분차치급유효솔고우대조조(P＜0.05),차치료조적고사두기기력、객승기기력、주동굴신슬각도교치료전명현제고(P＜0.01).결론 신형현조운동요법연합파리산납주사치료빈고동통종합정료효교호,명현개선고사두기외번시량화빈골외측이위.
Objective To investigate the effects of a new sling exercise treatment combined with injections of sodium hyaluronate on the radiographic findings and clinical variables of patients with patellofemoral pain.Methods Seventy patients with patellofemoral pain syndrome were divided into a group which was treated using a new sling exercise therapy combined with injections of sodium hyaluronate (the combined therapy group,n=34) and another which received only sodium hyaluronate injections (the control group,n=36).The patients of both groups were assessed pre-and post-treatment.The clinical assessment modalities were pain scores (using a visual analogue scale,VAS),quadriceps and hamstring strength and range of motion in the active flexion and extension of the knee.Q angles were measured supine and standing.Patellofemor tilt angle and congruence and sulcus angle were determined by CT scanning.Results After 5 weeks the average VAS pain score of the combined therapy group was significantly lower than that of the control group.Muscle strength and range of motion in the combined therapy group were both significantly higher than pro-treatment,the Q angles were significantly smaller,and the congruence and sulcus angles were significantly better.Conclusion Five weeks of practicing the new sling exercise therapy combined with injections of sodium hyaluronate can yield satisfactory clinical and radiologic outcomes in patients with patellofemoral pain syndrome.