渐进式阻力训练联合神经肌肉运动治疗膝骨关节炎的效果及对炎性因子的影响

杨军; 褚如再; 陈正滨; 陈颖; 陈聪萍

doi:10.16766/j.cnki.issn.1674-4152.004412

渐进式阻力训练联合神经肌肉运动治疗膝骨关节炎的效果及对炎性因子的影响

doi: 10.16766/j.cnki.issn.1674-4152.004412

浙江省天台县人民医院骨科，浙江台州 317200

基金项目:

浙江省医药卫生科技计划项目 2025KY1908

详细信息

通讯作者:
杨军，E-mail: 326095393@qq.com

中图分类号: R493 R684.3
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- 文章访问数: 16
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- 被引次数: 0
出版历程
- 收稿日期: 2025-11-22
- 网络出版日期: 2026-06-02

Progressive resistance training combined with neuromuscular exercise for the treatment of knee osteoarthritis and its impact on inflammatory factors

Department of Orthopedics, Tiantai People's Hospital of Zhejiang Province, Taizhou, Zhejiang 317200, China

摘要

摘要: 目的非药物治疗(如运动疗法)在膝骨关节炎(KOA)管理中的地位日益凸显，但传统单一模式的康复干预存在局限。本研究旨在探索渐进式阻力训练(PRT)联合神经肌肉运动治疗(NEMEX)在KOA患者中的临床疗效和对膝关节滑液中炎性因子的影响。方法选取2024年7月1日—2025年7月1日天台县人民医院骨科收治的KOA患者110例作为研究对象。随机数表法分为观察组(55例)和对照组(55例)，对照组采取NEMEX治疗，观察组实施NEMEX+PRT治疗，共治疗8周。收集2组患者治疗前、治疗后8周的临床数据，主要包括疼痛视觉模拟量表(VAS)评估患者的疼痛程度；膝骨关节炎评分量表(KOOS)和膝关节功能评分(Lysholm)评估患者的病情程度；膝关节活动度(AROM)和10米步行测试(10MWT)评估患者的活动能力；膝关节滑液白细胞介素-17(IL-17)、白细胞介素-1β(IL-1β)和前列腺素E2(PGE2)水平；生活质量量表(QOL)和生活活动能力量表(ADL)评估患者的生活质量。结果治疗后，观察组患者VAS评分和10MWT均显著低于对照组[(2.52±0.71)分vs. (3.18±0.86)分；(10.37±1.27)s vs.(11.21±1.36)s，P＜0.05]。观察组患者KOOS、Lysholm、AROM、QOL和ADL评分均高于对照组(P＜0.05)。治疗后，2组患者IL-17、IL-1β和PGE2水平均下降，且观察组低于对照组(P＜0.05)。结论渐进式阻力训练联合神经肌肉运动治疗在膝骨关节炎患者中效果良好，可改善疼痛情况，提高膝关节运动能力，降低膝关节炎性因子水平，改善患者的生活能力和质量。
- 膝骨关节炎 /
- 渐进式阻力训练 /
- 神经肌肉运动治疗 /
- 炎性因子
Abstract: Objective In recent years, non-pharmacological treatments (such as exercise therapy) have become increasingly prominent in the management of knee osteoarthritis (KOA), but traditional single-mode rehabilitation interventions have therapeutic limitations. This study aims to explore the clinical efficacy of progressive resistance training (PRT) combined with neuromuscular exercise therapy (NEMEX) in patients with knee osteoarthritis (KOA) and its impact on inflammatory factors in knee synovial fluid. Methods A total of 110 patients with KOA admitted to the Department of Orthopedics, People's Hospital of Tiantai County from July 1, 2024 to July 1, 2025 were selected as the research subjects. The patients were randomly grouped, with 55 cases in each group. The control group was treated with NEMEX, while the observation group was treated with NEMEX+PRT for a total of eight weeks. The system collected the clinical data of the two groups of patients before treatment and eight weeks after treatment, mainly including the assessment of the degree of pain by the visual analogue scale (VAS) for pain. The knee osteoarthritis score scale (KOOS) and the knee joint function score (Lysholm) were used to assess the severity of the patient's condition. Knee joint range of motion (AROM) and 10-meter walk test (10MWT) were used to assess the patients' mobility. The levels of IL-17, IL-1β, and PGE2 in knee joint synovial fluid. The quality of life of patients was evaluated by using the Quality of Life Scale (QOL) and the Activity of Daily Living Scale (ADL). Results After treatment, the VAS score and 10MWT of the patients in the observation group were significantly lower than those in the control group [(2.52±0.71) points vs. (3.18±0.86) points; (10.37±1.27) s vs.(11.21±1.36) s, P < 0.05]. The scores of KOOS, Lysholm, AROM, QOL, and ADL in the observation group were higher than those in the control group (P < 0.05). After treatment, the levels of IL-17, IL-1β, and PGE2 in both groups decreased, and those in the observation group were lower than those in the control group during the same period (P < 0.05). Conclusion Progressive resistance training combined with neuromuscular exercise therapy has a good clinical application effect in patients with knee osteoarthritis. It can improve pain conditions, enhance the motor capacity of the knee joint, reduce the levels of inflammatory factors in the knee joint, and improve the living ability and quality of life of patients.
- Knee osteoarthritis /
- Progressive resistance training /
- Neuromuscular motor therapy /
- Inflammatory factors

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表 1 2组KOA患者一般资料比较

Table 1. Comparison of general data of KOA patients between the two groups

项目	对照组(n=55)	观察组(n=55)	统计量	P值
性别(例)			0.036^a	0.849
男性	27	26
女性	28	29
年龄(x±s，岁)	58.74±4.37	58.67±4.16	0.086^b	0.932
BMI(x±s)	23.17±1.86	23.23±1.92	0.166^b	0.868
病程(x±s，d)	6.77±0.83	6.82±0.94	0.296^b	0.768
患侧(例)			0.036^a	0.849
右膝	25	26
左膝	30	29
K-L分级(例)			0.214^a	0.899
Ⅰ级	12	11
Ⅱ级	31	30
Ⅲ级	12	14
合并基础疾病(例)			0.783^a	0.676
冠心病	8	7
糖尿病	6	9
高脂血症	4	3
注：^a为χ²值，^b为t值。

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表 2 2组KOA患者VAS评分比较(x±s，分)

Table 2. Comparison of VAS scores between the two groups of KOA patients (x±s, points)

组别	例数	治疗前	治疗后	t值	P值
对照组	55	4.98±0.91	3.18±0.86	5.329	0.018
观察组	55	4.97±0.87	2.52±0.71	7.615	0.012
统计量		0.427^a	5.438^b
P值		0.926	0.023
注：^a为t值，^b为F值。

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表 3 2组KOA患者膝关节病情程度比较(x±s，分)

Table 3. Comparison of knee joint disease degree between the two groups of KOA patients (x±s, points)

组别	例数	KOOS		Lysholm
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	55	41.27±4.62	49.06±4.23^b	45.73±3.88	59.89±4.39^b
观察组	55	41.38±4.45	58.76±3.89^b	46.10±5.04	72.33±5.02
统计量		0.732^a	4.806^c	0.807^a	5.546^c
P值		0.413	0.031	0.396	0.015
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 4 2组KOA患者活动能力比较(x±s)

Table 4. Comparison of activity ability of KOA patients in two groups (x±s)

组别	例数	AROM(°)		10MWT(s)
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	55	102.45±7.68	113.23±5.43^b	12.47±1.44	11.21±1.36^b
观察组	55	103.28±8.23	119.02±9.81^b	12.89±1.72	10.37±1.27^b
统计量		0.629^a	6.997^c	0.522^a	5.654^c
P值		0.374	0.011	0.429	0.017
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 5 2组KOA患者膝关节液炎性因子水平比较(x±s，pg/mL)

Table 5. Comparison of inflammatory factors in knee fluid between the two groups (x±s, pg/mL)

组别	例数	IL-17		IL-1β		PGE2
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	55	32.18±2.96	18.32±1.88^b	79.16±5.42	42.53±2.13^b	331.48±23.17	264.73±24.56^b
观察组	55	31.96±2.85	11.03±1.62^b	78.23±5.31	24.27±2.01^b	330.26±30.42	203.28±25.71^b
统计量		0.702^a	4.312^c	0.599^a	4.634^c	0.894^a	6.088^c
P值		0.358	0.037	0.403	0.034	0.227	0.009
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 6 2组KOA患者生活质量评分比较(x±s，分)

Table 6. Comparison of quality of life scores between the two groups of KOA patients (x±s, points)

组别	例数	QOL		ADL
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	55	53.56±4.83	70.53±4.93^b	55.37±4.72	75.48±4.72^b
观察组	55	53.62±4.71	86.19±5.32^b	56.26±4.16	86.35±5.22^b
统计量		0.713^a	6.342^c	0.822^a	6.117^c
P值		0.342	0.015	0.326	0.016
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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