膝骨性关节炎关节腔内药物注射治疗疗效评价
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摘要
目的探讨关节腔内药物注射治疗对膝骨性关节炎(KOA)的疗效。方法采用回顾性分析,选取2014年1月—2015年1月于中国人民解放军总医院康复医学中心接受治疗并且符合纳入与排除标准的KOA患者100例为研究对象。采用随机数字表法将患者分为治疗组(采用关节腔内药物注射治疗)和对照组(采用中药涂擦法治疗)各40例,空白对照组(不做任何处理)20例。治疗前和治疗后1个月采用视觉模拟(VAS)评分对患者疼痛程度进行评估,采用《中药新药治疗骨性关节炎的临床研究指导原则》有关的疗效标准评定KOA临床疗效。结果治疗前3组VAS评分比较,差异无统计学意义(P>0.05)。治疗后3组VAS评分比较,差异有统计学意义(P<0.05);治疗后治疗组VAS评分低于空白对照组和对照组,对照组VAS评分低于空白对照组(P<0.05)。对照组和治疗组治疗后VAS评分均低于治疗前(P<0.05)。3组治疗后KOA临床疗效比较,差异有统计学意义(P<0.05)。治疗前3组膝关节Lysholm评分比较,差异无统计学意义(P>0.05)。治疗后3组膝关节Lysholm评分比较,差异有统计学意义(P<0.05);治疗后治疗组膝关节Lysholm评分高于空白对照组和对照组,对照组膝关节Lysholm评分高于空白对照组(P<0.05)。对照组和治疗组治疗后膝关节Lysholm评分均高于治疗前(P<0.05)。结论关节腔内药物注射治疗可减轻KOA患者疼痛,提高膝关节功能活动度,促进关节修复和功能恢复,为临床治疗提供借鉴。
Objective To explore curative effect of intra- articular medicine injection therapy on knee osteoarthritis( KOA). Methods In this retrospective analysis,100 KOA patients who accorded with the inclusion and exclusion criterion and received treatment in the Department of Rehabilitation Medicine of Chinese PLA General Hospital from January 2014 to January 2015 were enrolled. The patients were divided into treatment group( intra- articular medicine injection therapy) and control group( TCM inunction) with 40 cases in each group and blank control group( no treatment) with 20 cases by random number table method. The pain degree of patients was assessed by visual analogue scale( VAS) before treatment and after 1month treatment and the clinical efficacy of KOA was evaluated by criterion relevant with the guiding principles for clinical research of traditional Chinese medicine in the treatment of osteoarthritis. Results The difference of VAS scores among the three groups was not significant before treatment( P > 0. 05). The difference of VAS scores among the three groups was significant after treatment( P < 0. 05). The VAS scores of treatment group were lower than those of blank control group and control group and the VAS scores of control group were lower than those of blank control group after treatment( P < 0. 05). The VAS scores of control group and treatment group after treatment were lower than those before treatment( P < 0. 05). The difference of clinical efficacy of KOA among three groups was significant( P < 0. 05). The difference of Lysholm scores of knee- joint among three groups were not significant before treatment( P > 0. 05). The difference of Lysholm scores of knee- joint among three groups were significant after treatment( P < 0. 05). The Lysholm scores of knee- joint of treatment group were higher than those of blank control group and control group and the Lysholm scores of knee- joint of control group were higher than those of blank control group after treatmnet( P < 0. 05). The Lysholm scores of knee- joint of control group and treatment group after treatment were higher than those before treatment( P < 0. 05). Conclusion Intra- articular medicine injection therapy can alleviate the ache of patients with KOA, enhance the activity function of knee- joint and promote the repair of arthrosis and recovery of function,which can provide reference for clinic treatment.
Objective To explore curative effect of intra- articular medicine injection therapy on knee osteoarthritis( KOA). Methods In this retrospective analysis,100 KOA patients who accorded with the inclusion and exclusion criterion and received treatment in the Department of Rehabilitation Medicine of Chinese PLA General Hospital from January 2014 to January 2015 were enrolled. The patients were divided into treatment group( intra- articular medicine injection therapy) and control group( TCM inunction) with 40 cases in each group and blank control group( no treatment) with 20 cases by random number table method. The pain degree of patients was assessed by visual analogue scale( VAS) before treatment and after 1month treatment and the clinical efficacy of KOA was evaluated by criterion relevant with the guiding principles for clinical research of traditional Chinese medicine in the treatment of osteoarthritis. Results The difference of VAS scores among the three groups was not significant before treatment( P > 0. 05). The difference of VAS scores among the three groups was significant after treatment( P < 0. 05). The VAS scores of treatment group were lower than those of blank control group and control group and the VAS scores of control group were lower than those of blank control group after treatment( P < 0. 05). The VAS scores of control group and treatment group after treatment were lower than those before treatment( P < 0. 05). The difference of clinical efficacy of KOA among three groups was significant( P < 0. 05). The difference of Lysholm scores of knee- joint among three groups were not significant before treatment( P > 0. 05). The difference of Lysholm scores of knee- joint among three groups were significant after treatment( P < 0. 05). The Lysholm scores of knee- joint of treatment group were higher than those of blank control group and control group and the Lysholm scores of knee- joint of control group were higher than those of blank control group after treatmnet( P < 0. 05). The Lysholm scores of knee- joint of control group and treatment group after treatment were higher than those before treatment( P < 0. 05). Conclusion Intra- articular medicine injection therapy can alleviate the ache of patients with KOA, enhance the activity function of knee- joint and promote the repair of arthrosis and recovery of function,which can provide reference for clinic treatment.
引文
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[2]孟彦彬,高晓燕.牛膝中脱皮甾酮的含量测定及促成骨样细胞增殖活性[J].承德医学院学报,2009,26(4):441-442.
[3]中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中华骨科杂志,2007,27(10):793-796.
[4]董秋平.麻黄、附子、桂枝在关节痛治疗中的作用[J].中国当代医药,2011,18(2):89,92.
[5]Harris JD,Siston RA,Pan X,et al.Autologous chondrocyte implantation:a systematic review[J].J Bone Joint Surg Am,2010,92(12):2220-2233.
[6]Yuan XQ,Sun LF.Analgesic effect and mechanism of action of asarum[J].Journal of Liaoning University of Traditional Chinese Medicine,2008,10(10):70-72.(in Chinese)袁晓琴,孙莲芬.细辛的镇痛作用及作用机制[J].辽宁中医药大学学报,2008,10(10):70-72.
[7]Ma YB,Chi G,Liang W,et al.Application of ultrasonic technology in transdermal drug delivery systems[J].Chinese Pharmaceutical Affairs,2011,25(2):180-183.(in Chinese)马艳彬,迟戈,梁文,等.超声波技术在透皮药物传递系统中的应用[J].中国药事,2011,25(2):180-183.
[8]兰由玉,王友强.依托芬那酯凝胶加红外线治疗类风湿关节炎的临床疗效观察[J].风湿病与关节炎,2012,1(6):32-34.
[9]崔宝甲.膝骨性关节炎关节镜清理术时机的选择[D].吉林:吉林大学,2009.
[10]Couchourel D,Aubry I,Delalandre A,et al.Altered mineralization of human osteoarthritic osteoblasts is attributable to abnormal typeⅠcollagen production[J].Arthritis Rheum,2009,60(5):1438-1450.