来源：风湿病与关节炎,2019,8（10）:14-18.

基于足底压力检测下牵引联合深部热疗治疗膝骨关节炎对照研究（临床研究）

张洪丽¹，吕　柳¹，王利春¹，陈　华²，付　强¹，赵建勇¹

　　【摘　要】目的：观察牵引联合深部热疗治疗膝骨关节炎的临床疗效及足底压力变化。方法：将120例膝骨关节炎患者采用随机数字表法分为牵引组、深部热疗组、联合组、对照组，每组30例。牵引组予皮牵引治疗，深部热疗组予深部热疗，联合组予牵引下深部热疗，对照组予常规治疗。4组疗程均为15 d。观察4组临床疗效，采用Foot Scan测量系统采集患者治疗前后足底各区域开始触地时间、结束触地时间以及触地时间比。结果：①临床疗效：联合组总有效率显著优于牵引组、深部热疗组、对照组（P < 0.05），深部热疗组总有效率显著优于对照组（P < 0.05）；深部热疗组总有效率优于牵引组，牵引组总有效率优于对照组，但差异无统计学意义（P > 0.05）。②开始触地时间：治疗后，牵引组、对照组无变化；深部热疗组M1～2区、联合组M1～4区较治疗前晚（P < 0.05，P < 0.01）。③结束触地时间：治疗后，对照组M5区，牵引组M4～5区，深部热疗组M3～5、HM、HL区，联合组M3～4、HM、HL区较治疗前早（P < 0.05或P < 0.01）。④触地时间比：治疗后，对照组无变化；牵引组M5区，深部热疗组M2～5、HM、HL区，联合组M1～4、HM、HL区较治疗前短（P < 0.05或P < 0.01）。结论：牵引下深部热疗治疗膝骨关节炎效果最佳，治疗可引起足底压力变化，足底压力的变化随治疗方案而变化，疗效越好，足底压力变化越明显。

　　【关键词】　骨关节炎，膝；牵引；深部热疗；足底压力；临床疗效

Controlled Study of Traction Combined with Deep Hyperthermia for Knee Osteoarthritis Based on Plantar Pressure Measurement

ZHANG Hong-li,LYU Liu,WANG Li-chun,CHEN Hua,FU Qiang,ZHAO Jian-yong

　　【ABSTRACT】Objective:To observe the clinical effect of traction combined with deep hyperthermia in the treatment of knee osteoarthritis and the change of plantar pressure.Methods:One hundred and twenty patients with knee osteoarthritis were randomly divided into a traction group,a deep hyperthermia group,a combined group and a control group with 30 cases in each.The traction group was treated with skin traction,the deep hyperthermia group was treated with deep hyperthermia,the combined group was treated with deep hyperthermia under traction,and the control group was treated with conventional therapy.The 4 groups were treated for 15 days.Observe the clinical efficacy of 4 groups.The measurement system Foot Scan was used to collect the onset time,the end time and the time ratio of touching the ground before and after treatment.Results:①Clinical effect:The total effective rate of the combined group was significantly better than that of the traction group,the deep hyperthermia group and the control group（P < 0.05）,and the deep hyperthermia group was significantly better than that of the control group（P < 0.05）.The total effective rate of the deep hyperth-ermia group was better than that of the traction group,and the total effective rate of the traction group was better than that of the control group,but there was no significant difference（P > 0.05）.②Onset time of touching:After treatment,there was no change in the traction group and the control group;M1～2 area in the deep hyperthermia group and M1～4 area in the combined group were earlier than those before treatment（P < 0.05 or P < 0.01）.③End time of touching:After treatment,M5 area in the control group,M4～5 area in the traction group,M3～5,HM and HL areas in the deep hyperthermia group,M3～4,HM and HL areas in the combined group were earlier than before treatment（P < 0.05 or P < 0.01）.④Ratio of ground-touching time :After treatment,there was no change in he control group;and M5 area in the traction group,M2～5,HM and HL areas in the deep hyperthermia group,M1～4,HM and HL areas in the combined group were shorter than before treatment（P < 0.05 or P < 0.01）.Conclusion:Deep hyperthermia under traction is the best treatment for knee osteoarthritis.Treatment can cause changes in plantar pressure.The change of plantar pressure varies with the treatment plan.The better the therapeutic effect,the more obvious the change of plantar pressure.

　　【Keywords】 osteoarthritis,knee;traction;deep hyperthermia;plantar pressure;clinical efficacy