老年性骨关节炎合并骨质疏松症性膝痛的临床治疗研究  

Clinical study of the treatment for knee pain in patients with senile osteoarthritis and osteoporosis

作　　者：邹春平[1] 黄涛[1] 李修成[1] 钱浩[1] 

机构地区：[1]中国医科大学附属第一医院骨科,沈阳110001

出　　处：《中国骨质疏松杂志》2013年第2期170-172,共3页Chinese Journal of Osteoporosis

摘　　要：目的观察透明质酸钠联合鲑鱼降钙素对老年性骨关节炎伴骨质疏松性膝痛的疗效。方法76例确诊为骨关节炎伴骨质疏松并有膝关节疼痛症状的患者随机分成两组,A组40例单纯给予膝关节腔内注射透明质酸钠2.5 mL,每周1次,5周为一个疗程,同时口服盖尔奇D每天1片,疗程3个月;B组为实验组36例,在采用透明质酸钠和盖尔奇D的同时,加用鲑鱼降钙素鼻喷剂,每日200IU,持续3个月。两组治疗前后均进行Lysholm膝关节评分,关节疼痛强度评价(VAS法),以及腰椎骨密度的测量,同时记录临床其他症状改善情况。结果两组患者治疗后Lysholm评分均有明显提高(P<0.05),两组间无明显差异(P>0.05),膝关节痛治疗前后均有改善(P<0.05),但B组效果优于A组(P<0.05),同时B组腰椎骨密度明显增高(P<0.05),且腰痛等全身骨质疏松症状获得较大改善,而A组骨密度无明显变化,整体治疗患者满意程度差于B组。结论透明质酸钠联合鲑鱼降钙素对老年骨关节炎伴骨质疏松性膝痛能获得较好的疗效,其在获得较好的功能改善的同时,也能较快较好地改善老年人膝关节疼痛症状及腰痛的其他骨质疏松症状,能更加全面的提高患者的生活。Objective To observe the treatment of sodium hyaluronate combined with salmon ealeitonin for knee pain in patients with senile osteoarthritis and osteoporosis. Methods A total of 76 patients, who were diagnosed as osteoarthritis with osteoporosis and had knee pain syndrome, were randomly divided into 2 groups. Forty patients in group A were given intraartieular injection of 2.5 ml sodium hyaluronate to the knee, once a week for 5 weeks. Meanwhile they also received an oral administration of 1 Cahrate D tablet per day for 3 months. Thirty-six patients in group B were given a nasal spray of salmon ealeitonin, 200IU per day for 3 months. They received the same treatment of both sodium hyaluronate and Caltrate D. Lysholm knee scoring, joint pain intensity evaluation （VAS）, and bone mineral density （BMD） detection of the lumbar vertebrae of patients in both groups were performed before and after the treatment. Improvement of other clinical symptoms was recorded. Results Lysholm score of patients in both groups after treatment was significantly improved （P 〈 0.05 ） , but there was no significant difference between the two groups （P 〉 0. 05）. The situation of knee pain in both groups was improved after the treatment （P 〈 0.05）. The effect in group B was better than that in group A （ P 〈 0.05 ）. BMD of the lumbar vertebrae in group B increased obviously （ P 〈 0.05 ）. Low back pain and other symptoms of systemic osteoporosis alleviated. BMD in group A did not change significantly. The overall patients＇ satisfaction to the treatment was worse than that in group B. Conclusion The treatment of sodium hyaluronate combined with salmon calcitonin for knee pain in patients with osteoarthritis and osteoporosis can obtain good effect. With a better function improvement, itcan also alleviate knee pain, low back pain, other symptoms of osteoporosis, and can improve the patients＇ life comprehensively.

关 键 词：骨关节炎 骨质疏松 膝关节疼痛 鲑鱼降钙素 透明质酸钠 

分 类 号：R684.3[医药卫生—骨科学]