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J PHYSIOTHER:短期冷冻疗法对减少膝骨关节炎患者的疼痛效果有限

2021-10-14 MedSci原创 MedSci原创

短期冷冻疗法是否能改善膝关节骨性关节炎(OA)患者的疼痛、功能和生活质量?

膝关节骨性关节炎(OA)是一种常见且治疗费用昂贵的慢性肌肉骨骼疾病,与疼痛和残疾有关。临床指南建议OA的治疗要结合患者教育、运动和一些其他物理治疗干预等非药物治疗,这样有助于改善疼痛和相关症状。

冷冻疗法是一种非药物治疗,因其对疼痛、炎症和水肿的作用而被广泛应用于各种风湿性关节病。此外,它既可以单独应用,也可以与其他疗法结合使用,更容易被膝关节OA患者所接受。那么,短期冷冻疗法是否能改善膝关节骨性关节炎(OA)患者的疼痛、功能和生活质量?

本研究为随机对照试验,纳入社区膝OA患者,实验组给予冷冻治疗,用碎冰包敷于膝关节,轻度压迫。对照组接受同样的治疗方案,但碎冰替换为假沙包。干预措施每天应用一次,连续4天。在基线和4天干预期后的第一天对参与者进行评估。主要结果是疼痛强度根据视觉模拟评分。

最后共有60名患者纳入研究,将60名参与者随机分为实验组(n=30)和对照组(n=30)。每组29名参与者完成了试验。组间疼痛严重程度变化的平均差异为20.8 cm(95%可信区间21.6至0.1),其中负值有利于实验组。该结果未达到1.75 cm的指定最小有价值效果。次要结果的估计不太精确,置信区间跨越了有价值、微不足道和轻度有害的影响。

组内和组间差异

这项研究表明,短期冷冻治疗在缓解疼痛或改善膝关节OA患者的功能和生活质量方面并不优于假干预。虽然冷冻疗法被认为是临床实践中广泛使用的资源,但与假对照相比,该研究并不表明它作为膝关节骨关节炎患者的非药物治疗具有重要的短期疗效。

参考文献:Short-term cryotherapy did not substantially reduce pain and had unclear effects on physical function and quality of life in people with knee osteoarthritis: a randomised trial - ScienceDirect. Journal of physiotherapy,  65(4):215-221.

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    2022-05-12 lisa438
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    2022-02-15 仁医06
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    2021-10-26 845857705

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    2021-10-16 lmm397
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