关节内注射低浓度臭氧联合玻璃酸钠治疗膝骨关节炎49例
摘要
目的:探讨关节内注射低浓度臭氧联合玻璃酸钠对膝骨关节炎(KOA)患者白介素6(IL-6)、C反应蛋白(CRP)、E-钙粘附蛋白(E-cad)的影响。方法:选取2016年1月至2018年1月本院KOA患者49例,所有患者给予膝关节内注射低浓度(20mg/L)臭氧联合玻璃酸钠治疗。结果:KOA患者治疗后IL-6,hs-CRP及E-cad明显低于治疗前,患者治疗7d,1个月及3个月后疼痛视觉模拟评分法(VAS)得分明显低于治疗前,差异有统计学意义(P<0.05)。KOA患者膝功能优29例,良18例,中2例,差0例,优良率为95.92%;患者发生关节酸软感5例,肿胀3例,发热3例,感染0例,并发症发生率为22.45%.结论:膝关节内注射低浓度臭氧联合玻璃酸钠可有效改善KOA患者IL-6,hs-CRP及E-cad,有利于改善患者膝功能及疼痛,且安全性好,值得临床推广。
引文
[1]CASE R,THOMAS E,CLARKE E,et al.Prodromal symptoms in knee osteoarthritis:a nested case-control study using data from the osteoarthritis initiative[J].Osteoarthritis Cartilage,2015,23(7):1083-1089.
[2]张艺强,滕方舟,陈少清,等.膝骨痹康熏洗剂联合电针、功法治疗膝骨关节炎的疗效观察[J].中国中医骨伤科杂志,2018,26(1):25-28.
[3]魏汉贤,许俊榆,吴海斌,等.臭氧关节腔内注射联合充髓通络汤离子导入治疗膝骨关节炎[J].中医正骨,2014,26(4):70-71.
[4]LIN F,WANG X,LIANG Y,et al.Red blood cell distribution width in rheumatoid arthritis,ankylosing spondylitis and osteoarthritis:true inflammatory index or effect of anemia?[J].Ann Clin Lab Sci,2018,48(3):301-307.
[5]涂容芳,张秀峰,何振华.5-HTR2B、E-cad、α-SMA在博莱霉素致大鼠肺纤维化中的表达变化[J].中国应用生理学杂志,2016,32(4):365-369.
[6]中华中医药学会.骨性关节炎[J].风湿病与关节炎,2013,2(2):71-73.
[7]HART H F,Collins N J,Ackland D C,et al.Gait characteris-tics of people with lateral knee OA after ACL reconstruction[J].Med Sci Sports Exerc,2015,47(11):2406-2415.
[8]ZHAO J,HUANG S,ZHENG J,et al.Changes of rabbit meniscus influenced by hyaline cartilage injury of osteoarthritis[J].Int J Clin Exp Med,2014,7(9):2948-2956.
[9]麻圣达,卢雄,罗利飞.玻璃酸钠对膝骨性关节炎患者关节液中基质金属蛋白酶-3、9水平的影响及疗效观察[J].中国现代医生,2014,52(1):42-44.
[10]WANG S Z,WU D Y,CHANG Q,et al.Intra-articular,single-shot co-injection of hyaluronic acid and corticosteroids in knee osteoarthritis:a randomized controlled trial[J].Exp Ther Med,2018,16(3):1928-1934.
[11]赵宝祥,孙丙银,邹季.复方威灵仙熏洗联合臭氧关节腔内注射治疗老年膝骨关节炎临床疗效研究[J].风湿病与关节炎,2015,4(7):18-21.
[12]MANOTO S L,MAEPA M J,MOTAUNG S K.Medical ozone therapy as a potential treatment modality for regeneration of damaged articular cartilage in osteoarthritis[J].Saudi J Biol Sci,2018,25(4):672-679.
[13]SHADYAB A H,TERKELTAUB R,KOOPERBERG C,et al.Prospective associations of C-reactive protein(CRP)levels and CRP genetic risk scores with risk of total knee and hip replacement for osteoarthritis in a diverse cohort[J].Osteoarthritis Cartilage,2018,26(8):1038-1044.
[14]YOKOGAWA N,TORIBATAKE Y,MURAKAMI H,et al.Differences in gait characteristics of patients with lumbar spinal canal stenosis(L4radiculopathy)and those with osteoarthritis of the hip[J].PLoS One,2015,10(4):e124745.
[15]邵洁琦,曾志江,杨敏,等.右归丸联合隔姜灸治疗阳虚寒凝型膝骨性关节炎的临床效果[J].中国医药导报,2018,15(10):106-109.
[16]MIGITA K,IZUMI Y,JIUCHI Y,et al.Effects of janus kinase inhibitor tofacitinib on circulating serum amyloid a and interleukin-6during treatment for rheumatoid arthritis[J].Clinical&Experimental Immunology,2014,175(2):208-214.
[17]王来亮,罗群,蔡珂丹,等.帕立骨化醇对糖尿病肾病肾小管上皮间充质转化的干预作用研究[J].浙江医学,2015,37(11):925-930.
[18]CI H,XU Z,XU J,et al.Expressions of KAI1and E-cadherin in nonsmall cell lung cancer and their correlation with vasculogenic mimicry[J].Medicine(Baltimore),2018,97(40):e12293.
[2]张艺强,滕方舟,陈少清,等.膝骨痹康熏洗剂联合电针、功法治疗膝骨关节炎的疗效观察[J].中国中医骨伤科杂志,2018,26(1):25-28.
[3]魏汉贤,许俊榆,吴海斌,等.臭氧关节腔内注射联合充髓通络汤离子导入治疗膝骨关节炎[J].中医正骨,2014,26(4):70-71.
[4]LIN F,WANG X,LIANG Y,et al.Red blood cell distribution width in rheumatoid arthritis,ankylosing spondylitis and osteoarthritis:true inflammatory index or effect of anemia?[J].Ann Clin Lab Sci,2018,48(3):301-307.
[5]涂容芳,张秀峰,何振华.5-HTR2B、E-cad、α-SMA在博莱霉素致大鼠肺纤维化中的表达变化[J].中国应用生理学杂志,2016,32(4):365-369.
[6]中华中医药学会.骨性关节炎[J].风湿病与关节炎,2013,2(2):71-73.
[7]HART H F,Collins N J,Ackland D C,et al.Gait characteris-tics of people with lateral knee OA after ACL reconstruction[J].Med Sci Sports Exerc,2015,47(11):2406-2415.
[8]ZHAO J,HUANG S,ZHENG J,et al.Changes of rabbit meniscus influenced by hyaline cartilage injury of osteoarthritis[J].Int J Clin Exp Med,2014,7(9):2948-2956.
[9]麻圣达,卢雄,罗利飞.玻璃酸钠对膝骨性关节炎患者关节液中基质金属蛋白酶-3、9水平的影响及疗效观察[J].中国现代医生,2014,52(1):42-44.
[10]WANG S Z,WU D Y,CHANG Q,et al.Intra-articular,single-shot co-injection of hyaluronic acid and corticosteroids in knee osteoarthritis:a randomized controlled trial[J].Exp Ther Med,2018,16(3):1928-1934.
[11]赵宝祥,孙丙银,邹季.复方威灵仙熏洗联合臭氧关节腔内注射治疗老年膝骨关节炎临床疗效研究[J].风湿病与关节炎,2015,4(7):18-21.
[12]MANOTO S L,MAEPA M J,MOTAUNG S K.Medical ozone therapy as a potential treatment modality for regeneration of damaged articular cartilage in osteoarthritis[J].Saudi J Biol Sci,2018,25(4):672-679.
[13]SHADYAB A H,TERKELTAUB R,KOOPERBERG C,et al.Prospective associations of C-reactive protein(CRP)levels and CRP genetic risk scores with risk of total knee and hip replacement for osteoarthritis in a diverse cohort[J].Osteoarthritis Cartilage,2018,26(8):1038-1044.
[14]YOKOGAWA N,TORIBATAKE Y,MURAKAMI H,et al.Differences in gait characteristics of patients with lumbar spinal canal stenosis(L4radiculopathy)and those with osteoarthritis of the hip[J].PLoS One,2015,10(4):e124745.
[15]邵洁琦,曾志江,杨敏,等.右归丸联合隔姜灸治疗阳虚寒凝型膝骨性关节炎的临床效果[J].中国医药导报,2018,15(10):106-109.
[16]MIGITA K,IZUMI Y,JIUCHI Y,et al.Effects of janus kinase inhibitor tofacitinib on circulating serum amyloid a and interleukin-6during treatment for rheumatoid arthritis[J].Clinical&Experimental Immunology,2014,175(2):208-214.
[17]王来亮,罗群,蔡珂丹,等.帕立骨化醇对糖尿病肾病肾小管上皮间充质转化的干预作用研究[J].浙江医学,2015,37(11):925-930.
[18]CI H,XU Z,XU J,et al.Expressions of KAI1and E-cadherin in nonsmall cell lung cancer and their correlation with vasculogenic mimicry[J].Medicine(Baltimore),2018,97(40):e12293.