玻璃酸钠关节腔内注射联合伤柏膏外敷对膝骨性关节炎的临床疗效分析  

Clinical Effect of Intra-articular Injection of Sodium Hyaluronate Combined with External Application of Shangbai Ointment for Treatment of Knee Osteoarthritis

作　　者：刘永裕[1] 陈国涛[1] 冯宗权[1] 潘国铨[1] 邱华耀[1] 李逸群[1] 

机构地区：[1]佛山市中医院骨科,广东佛山528000

出　　处：《广州中医药大学学报》2014年第1期11-14,19,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：佛山市卫生局医学科研立项课题(编号:2013127)

摘　　要：【目的】探讨玻璃酸钠关节腔内注射联合伤柏膏外敷治疗膝骨性关节炎(knee osteoarthritis,KOA)的临床疗效。【方法】将60例单侧膝骨性关节炎病例随机分为治疗组和对照组各30例,分别给予玻璃酸钠关节腔内注射联合伤柏膏外敷及单纯使用玻璃酸钠关节腔内注射治疗,观察2组治疗前后膝骨性关节炎临床疼痛指标WOMAC量表评分、关节肿胀度、活动度改变、Lysholm膝关节功能评分结果以及膝关节液中白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平的变化情况。【结果】全部患者均完成5周治疗。治疗后,治疗组与对照组的WOMAC疼痛指标、膝关节活动度、肿胀度及Lysholm功能评分均显著改善,与治疗前比较差异均有统计学意义(P<0.05),但治疗组的改善作用均优于对照组(P<0.01)。治疗后,2组的膝关节液IL-1、IL-6、TNF-α水平均较治疗前有所下降(P<0.05),但治疗组的下降作用更为显著,与对照组比较差异均有统计学意义(P<0.05)。【结论】运用玻璃酸钠关节腔内注射联合伤柏膏外敷治疗膝骨性关节炎,具有中西医结合疗效优势,临床效果满意,并发症少。Objective To explore the clinical effect of intra-articular injection of sodium hyaluronate combined with external application of Shangbai Ointment for the treatment of knee osteoarthritis. Methods Sixty adult patients with unilateral knee osteoarthritis were equally randomized into two groups. The treatment group was given intra-articular injection of sodium hyaluronate combined with external application of Shangbai Ointment, and the control group received only intra-articular injection of sodium hyaluronate. Before and after treatment, we recorded WOMAC osteoarthritis scores of pain, knee motion range, affected knee circumference, Lysholm knee function scores, and interleukin-1 （IL-1）, interleukin-6 （IL-6） and tumor necrosis factor alpha （TNF-or） levels in knee synovial fluid. Results All of the 60 patients finished the 5-week treatment. After treatment, WOMAC osteoarthritis scores, knee motion range, affected knee circumference and Lysholm knee function scores were decreased significantly in both groups （P 〈0.05 compared with those before treatment） , and the decrease in the treatment group was superior to that in the control group （P〈0.01） . The levels of IL-1, IL-6 and TNF-α in the knee synovial fluid were decreased in both groups （P〈0.05）, and the decrease was more obvious in the treatment group （P〈0.05） . Conclusion Intra-artieular injection of sodium hyaluronate combined with external application of Shanghai Ointment is effective and safe for the treatment of knee osteoarthritis, which shows the advantage of integrated Chinese and western medicine.

关 键 词：膝骨性关节炎 中西医结合疗法 伤柏膏 治疗应用 玻璃酸钠 治疗应用 关节腔注射 

分 类 号：R274.9[医药卫生—中西医结合]