氟尿嘧啶联合对乙酰氨基酚治疗膝骨性关节炎的疗效和安全性及对相关指标的影响
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摘要
目的:观察氟尿嘧啶联合对乙酰氨基酚治疗膝骨性关节炎的疗效和安全性及对相关指标的影响。方法:选取2015年3月-2018年3月我院收治的115例膝骨性关节炎患者,按用药方案的不同分为对照组(57例)和观察组(58例)。对照组患者给予对乙酰氨基酚片0.3 g,口服,每日3次,连用8周;观察组患者在对照组治疗的基础上给予氟尿嘧啶注射液0.075 g,关节腔内注射,每周1次,4次为1个疗程,共治疗2个疗程。观察两组患者的临床疗效,治疗前后的视觉模拟评分(VAS)、Lysholm膝关节评分、Fugl-Meyer运动功能积分法(FMA)评分、Barthel指数、世界卫生组织(WHO)生存质量测定表(QOL-BREF)评分及不良反应发生情况。结果:观察组患者总有效率为94.83%,显著高于对照组的78.95%(P<0.05)。治疗前,两组患者VAS评分、Lysholm膝关节评分、FMA评分、Barthel指数及QOL-BREF评分比较,差异均无统计学意义(P>0.05);治疗后,两组患者VAS评分均显著低于同组治疗前,且观察组显著低于对照组;Lysholm膝关节评分、FMA评分、Barthel指数及QOL-BREF评分均显著高于同组治疗前,且观察组显著高于对照组(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05),且治疗期间均未见严重不良反应发生。结论:氟尿嘧啶联合对乙酰氨基酚可显著提高膝骨性关节炎患者的疗效,可改善其膝关节功能、运动功能、生活自理能力和生活质量,且未增加不良反应的发生。
OBJECTIVE:To observe the efficacy and safety of fluorouracil combined with paracetamol in the treatment of knee osteoarthritis and its effects on related indexes. METHODS:Totally 115 patients with knee osteoarthritis admitted to our hospital from March 2015 to March 2018 were divided into control group(57 cases) and observation group(58 cases) according to medication plan. Control group was given Paracetamol tablets 0.3 g orally,3 times a day,for consecutive 8 weeks. Observation group was additionally given intra-articular injection of Fluorouracil injection 0.075 g on the basis of control group,once a week,4 times as a treatment course,for 2 courses in total. Clinical efficacies,VAS scores,Lysholm knee scores,Fugl-Meyer Assessment(FMA)scores,Barthel indexes,WHO QOL-BREF scores before and after treatment and the occurrence of ADR of 2 groups were observed. RESULTS:The total response rate of observation group was 94.83%,which was significantly higher than 78.95% of control group(P<0.05). Before treatment,there was no statistical significance in VAS score,Lysholm knee scores,FMA scores,Barthel index or QOL-BREF scores between 2 groups(P>0.05). After treatment,VAS scores of 2 groups were significantly lower than before treatment,and the observation group was lower than the control group;Lysholm knee scores,FMA scores,Barthel indexes and QOL-BREF scores were significantly higher than the same group before treatment,and observation group was significantly higher than control group(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). No severe ADR was found in 2 groups during treatment. CONCLUSIONS:Fluorouracil combined with paracetamol can significantly improve therapeutic efficacy of patients with knee osteoarthritis,and can significantly improve knee function,motor function,self-care ability and quality of life without increasing the occurrence of ADR.
OBJECTIVE:To observe the efficacy and safety of fluorouracil combined with paracetamol in the treatment of knee osteoarthritis and its effects on related indexes. METHODS:Totally 115 patients with knee osteoarthritis admitted to our hospital from March 2015 to March 2018 were divided into control group(57 cases) and observation group(58 cases) according to medication plan. Control group was given Paracetamol tablets 0.3 g orally,3 times a day,for consecutive 8 weeks. Observation group was additionally given intra-articular injection of Fluorouracil injection 0.075 g on the basis of control group,once a week,4 times as a treatment course,for 2 courses in total. Clinical efficacies,VAS scores,Lysholm knee scores,Fugl-Meyer Assessment(FMA)scores,Barthel indexes,WHO QOL-BREF scores before and after treatment and the occurrence of ADR of 2 groups were observed. RESULTS:The total response rate of observation group was 94.83%,which was significantly higher than 78.95% of control group(P<0.05). Before treatment,there was no statistical significance in VAS score,Lysholm knee scores,FMA scores,Barthel index or QOL-BREF scores between 2 groups(P>0.05). After treatment,VAS scores of 2 groups were significantly lower than before treatment,and the observation group was lower than the control group;Lysholm knee scores,FMA scores,Barthel indexes and QOL-BREF scores were significantly higher than the same group before treatment,and observation group was significantly higher than control group(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). No severe ADR was found in 2 groups during treatment. CONCLUSIONS:Fluorouracil combined with paracetamol can significantly improve therapeutic efficacy of patients with knee osteoarthritis,and can significantly improve knee function,motor function,self-care ability and quality of life without increasing the occurrence of ADR.
引文
[1]马伟涛,张富运.降钙素联合盐酸氨基葡萄糖治疗膝骨关节炎的临床效果研究[J].北方药学,2018,15(7):64-65.
[2]杨永菊,张师侥,关雪峰.膝骨关节炎治疗最新进展[J].世界中西医结合杂志,2018,13(4):589-592.
[3]施文,王永铭,李端,等.对乙酰氨基酚与非甾体抗炎药治疗骨关节炎的疗效和安全性的观察[J].中国疼痛医学杂志,2004,10(6):327-331.
[4]柳霞,张弘,李柱.氟尿嘧啶关节腔注射治疗膝骨关节炎伴关节积液30例临床研究[J].中国医药导报,2012,9(31):63-64、67.
[5]颜江柱.羟考酮/对乙酰氨基酚的药理机制与临床应用进展[J].中国新药杂志,2014,23(14):1658-1664.
[6]张铁刚,于龙光,罗民,等.5-氟尿嘧啶腔内注射合中药内服外熨治疗膝关节滑膜炎90例[J].中国中医骨伤科杂志,2015,23(6):61-63.
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[8]师秀琴,王秀清,吕新全.玻璃酸钠联合氨基葡萄糖治疗膝骨性关节炎疗效观察[J].医药论坛杂志,2009,30(1):64-66.
[9]许美娟,冯献礼,林世磅.玻璃酸钠联合氨基葡萄糖治疗膝关节骨性关节炎的临床观察[J].中国药房,2015,26(21):2941-2943.
[10]赵传喜,刘欣,吴淮,等.关节镜清理术配合补肾强筋胶囊治疗退行性膝关节炎远期疗效观察[J].现代中西医结合杂志,2012,21(33):3713-3714.
[11]张国忠,何冀川.玻璃酸钠联合曲安奈德治疗髋关节骨性关节炎疗效分析[J].中国医药,2012,7(z1):38-39.
[12]WANG SM,LEI HY,HUANG KJ,et al.Pathogenesis of enterovirus 71 brainstem encephalitis in pediatric patients:roles of cytokines and cellular immune activation in patients with pulmonary edema[J].J Infect Dis,2003,188(4):564-570.
[13]潘勇,祝健,卢华斌.白细胞介素6、白细胞介素17、白细胞介素23与膝骨关节炎患者病情活动的相关性研究[J].中国卫生检验杂志,2018,28(11):1395-1396.
[14]肖壮,唐涛,孙先润,等.骨关节炎治疗药物的研究进展[J].中国药房,2016,27(35):5037-5040.
[15]毕素清,刘轶智.综合康复治疗膝关节骨性关节炎的疗效观察[J].疾病监测与控制,2017,11(8):661-663.
[16]林承宇,陈海鹏,陈凯.膝骨关节炎非手术治疗进展[J].风湿病与关节炎,2018,7(6):71-75.
[17]高丽丽,庞国勋.氟尿嘧啶类衍生物的设计、合成及其抗肿瘤活性研究[J].中南药学,2018,16(4):484-487.
[18]RILLO O,RIERA H,ACOSTA C,et al.PANLAR consensus recommendations for the management in osteoarthritis of hand,hip,and knee[J].J Clin Rheumatol,2016,22(7):345-354.
[19]丁国强.盐酸氨基葡萄糖与对乙酰氨基酚治疗膝骨关节炎的临床疗效观察[J].华西医学,2013,28(12):1840-1842.
[2]杨永菊,张师侥,关雪峰.膝骨关节炎治疗最新进展[J].世界中西医结合杂志,2018,13(4):589-592.
[3]施文,王永铭,李端,等.对乙酰氨基酚与非甾体抗炎药治疗骨关节炎的疗效和安全性的观察[J].中国疼痛医学杂志,2004,10(6):327-331.
[4]柳霞,张弘,李柱.氟尿嘧啶关节腔注射治疗膝骨关节炎伴关节积液30例临床研究[J].中国医药导报,2012,9(31):63-64、67.
[5]颜江柱.羟考酮/对乙酰氨基酚的药理机制与临床应用进展[J].中国新药杂志,2014,23(14):1658-1664.
[6]张铁刚,于龙光,罗民,等.5-氟尿嘧啶腔内注射合中药内服外熨治疗膝关节滑膜炎90例[J].中国中医骨伤科杂志,2015,23(6):61-63.
[7]胥少汀,葛宝丰,徐印钦,等.实用骨科学[M].4版.北京:人民军医出版社,2012:1001-1109.
[8]师秀琴,王秀清,吕新全.玻璃酸钠联合氨基葡萄糖治疗膝骨性关节炎疗效观察[J].医药论坛杂志,2009,30(1):64-66.
[9]许美娟,冯献礼,林世磅.玻璃酸钠联合氨基葡萄糖治疗膝关节骨性关节炎的临床观察[J].中国药房,2015,26(21):2941-2943.
[10]赵传喜,刘欣,吴淮,等.关节镜清理术配合补肾强筋胶囊治疗退行性膝关节炎远期疗效观察[J].现代中西医结合杂志,2012,21(33):3713-3714.
[11]张国忠,何冀川.玻璃酸钠联合曲安奈德治疗髋关节骨性关节炎疗效分析[J].中国医药,2012,7(z1):38-39.
[12]WANG SM,LEI HY,HUANG KJ,et al.Pathogenesis of enterovirus 71 brainstem encephalitis in pediatric patients:roles of cytokines and cellular immune activation in patients with pulmonary edema[J].J Infect Dis,2003,188(4):564-570.
[13]潘勇,祝健,卢华斌.白细胞介素6、白细胞介素17、白细胞介素23与膝骨关节炎患者病情活动的相关性研究[J].中国卫生检验杂志,2018,28(11):1395-1396.
[14]肖壮,唐涛,孙先润,等.骨关节炎治疗药物的研究进展[J].中国药房,2016,27(35):5037-5040.
[15]毕素清,刘轶智.综合康复治疗膝关节骨性关节炎的疗效观察[J].疾病监测与控制,2017,11(8):661-663.
[16]林承宇,陈海鹏,陈凯.膝骨关节炎非手术治疗进展[J].风湿病与关节炎,2018,7(6):71-75.
[17]高丽丽,庞国勋.氟尿嘧啶类衍生物的设计、合成及其抗肿瘤活性研究[J].中南药学,2018,16(4):484-487.
[18]RILLO O,RIERA H,ACOSTA C,et al.PANLAR consensus recommendations for the management in osteoarthritis of hand,hip,and knee[J].J Clin Rheumatol,2016,22(7):345-354.
[19]丁国强.盐酸氨基葡萄糖与对乙酰氨基酚治疗膝骨关节炎的临床疗效观察[J].华西医学,2013,28(12):1840-1842.