潮式关节腔冲洗、玻璃酸钠关节内注射联合运动疗法治疗积液型膝骨性关节炎  

Curative effect of the method of articular cavity tidal irrigation combined with intra-articular injection of sodium hyaluronate and exercise therapy in the treatment of type fluidify knee osteoarthritis

作　　者：何本祥[1] 

机构地区：[1]成都体育学院附属体育医院,四川成都610041

出　　处：《中医正骨》2012年第12期23-26,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：四川省科学技术厅课题(2008SZ0239)

摘　　要：目的:探讨潮式关节腔冲洗、玻璃酸钠关节内注射联合运动疗法治疗积液型膝骨性关节炎的临床疗效。方法:103例积液型膝骨性关节炎患者,男32例,女71例;年龄41～82岁,中位数65岁;病程2个月至30年,中位数4年;左侧37例,右侧49例,双侧17例。依据Lequesne-Mery膝骨性关节炎严重度评价指数评价临床严重程度:轻度18例19膝,中度37例46膝,重度48例55膝。按就诊顺序随机分为2组。治疗组53例60膝,男15例,女38例;左侧21例,右侧25例,双侧7例;采用潮式关节腔冲洗、玻璃酸钠关节内注射联合运动疗法治疗。对照组50例60膝,男17例,女33例;左侧16例,右侧24例,双侧10例;采用关节积液抽吸加玻璃酸钠关节内注射治疗。观察2组患者患膝疼痛、功能及积液改善情况,并对综合疗效进行比较。结果:治疗前2组患者患膝疼痛评分(30.41±8.70,30.83±8.64)、功能评分(25.92±4.83,26.17±4.82)、积液评分(3.42±2.35,3.33±2.38)比较,差异无统计学意义(t=-0.263,P=0.793;Z=-0.367,P=0.714;Z=-0.194,P=0.846);治疗3个月后,2组患者患膝疼痛评分(45.67±8.31,40.58±8.88)、关节功能评分(32.33±4.06,30.08±4.46)、积液评分(9.50±1.51,7.83±2.50)比较,差异有统计学意义(Z=-3.450,P=0.001;Z=-3.052,P=0.002;Z=-4.111,P=0.000);且治疗组患膝疼痛、功能、积液改善(15.25±3.95,6.42±2.78,6.08±2.08)优于对照组(9.75±3.11,3.92±2.62,4.50±1.51),差异有统计学意义(Z=-6.851,P=0.000;Z=-4.623,P=0.000;Z=-4.394,P=0.000)。治疗组治愈15例15膝,显效28例32膝,有效7例9膝,无效3例4膝;对照组治愈5例5膝,显效12例14膝,有效16例20膝,无效17例21膝;治疗组综合疗效优于对照组(治疗组=0.373,对照组=0.627;Z=-4.819,P=0.000)。103例患者均获随访,随访时间1～3年,中位数18个月;治疗组复发5例6膝,对照组复发32例38膝,治疗组复发率低于对照组(χ2=36.746,P=0.000)。复发患者均再次采用潮式关节腔冲洗、玻璃酸钠关节内注射联合运动疗法治�Objective ： To explore the clinical curative effect of the method of articular cavity tidal irrigation combined with intra-articulat injection of sodium hyaluronate and exercise therapy in the treatment of type fluidify knee osteoarthritis （KOA）. Methods：One hundred and three type fluidify KOA patients were analyzed, male 32 cases, while female 71 cases;ranging in age from 41 to 82 years with a median of 65 years;ranging in courses of disease from 2 months to 30 years with a median of 4 years;37 cases on left side,49 cases on right side and 17 cases on both sides. Clinical severity was evaluated according to Lequesne-Mery severity evaluation index of KOA and the results showed mild in 19 knees of 18 cases, medium in 46 knees of 37 cases and severe in 55 knees of 48 cases. The patients were randomly divid- ed into 2 groups according to examining sequence. Fifty-three patients （60 knees）were divided into the treatment group, male 15 cases, while female 38 cases;21 cases on left side,25 cases on fight side and 7 cases on both sides;and they were administrated with the method of articular cavity tidal irrigation combined with intra-articular injection of sodium hyaluronate and exercise therapy. Fifty cases（60 knees）were divided into the control group,male 17 cases,while female 33 cases; 16 cases on left side,24 cases on fight side and 10 cases on both sides ; and they were administrated with the joint effusion suction combined with intra-articular injection of sodium hyaluronate. The extent of relief of pain, improvement of function and decrease of effusion in the sick knees and the comprehensive curative effects were compared between the 2 groups. Results ： There were no statistical differences in pain scores （ 30.41 ± 8.70,30.83 ± 8.64 ） , fhnction scores （ 25.92 ± 4.83,26.17 ± 4.82）and effusion scores（3.42 ± 2.35,3.33± 2.38 ）of the sick knees between the 2 groups respectively before lhe l reatment （ t = - 0. 263, P = 0. 793 ;Z = - 0. 367,P = 0. 714 ;Z = - 0. 194, P = 0. 846 �

关 键 词：骨关节炎 膝 关节积水 灌洗 注射 关节内 运动疗法 治疗 临床研究性 

分 类 号：R684.3[医药卫生—骨科学]