透明质酸钠联合塞来昔布治疗膝关节骨关节炎疗效观察  

Clinical Efficacy of Sodium Hyaluronate Versus Sodium Hyaluronate Plus Celecoxib for Knee osteoarthritis

作　　者：黄天志[1] 郭卫春[1] 

机构地区：[1]武汉大学人民医院,湖北武汉430060

出　　处：《医学临床研究》2015年第6期1115-1117,共3页Journal of Clinical Research

摘　　要：【目的】探讨透明质酸钠联合塞来昔布治疗膝关节骨关节炎临床疗效。【方法】选取2012年2月至2013年12月来本院治疗的96例膝关节骨关节炎患者作为研究对象，随机分为对照组和观察组，每组各48例。对照组采用透明质酸钠膝关节腔注射2 mL ，每周1次；观察组在对照组基础上采用塞来昔布胶囊200 mg／d ，每日1次，5周为一个疗程。治疗 5周后，比较两组患者临床指标变化及总有效率，记录不良反应发生情况，并再随访4周，记录患者临床症状的变化情况，随访期间无失访者。【结果】观察组总有效率为83．33％，对照组总有效率为64．58％，两组比较具有统计学差异（ P ＜0．05）；两组患者治疗后 C 反应蛋白（CRP）、白介素‐1β（IL‐1β）、肿瘤坏死因子α（TNF‐α）、Lequesne 评分均较治疗前明显降低，观察组较对照组降低更显著；两组患者治疗后临床症状均有显著改善（ P ＜0．05），但两组随访期与治疗后比较均无显著性变化；观察组不良反应发生情况与对照组比较无统计学差异（ P ＞0．05）。【结论】透明质酸钠联合应用塞来昔布在改善膝关节骨关节炎患者临床症状、降低炎性因子水平、抑制骨关节炎免疫损伤等方面优于单一用药，两者具有协同作用。[Objective] To explore the efficacy of sodium hyaluronate versus sodium hyaluronate plus cele‐coxib therapy for patients with knee osteoarthritis .[Methods] A total of 96 knee osteoarthritis patients from February 2012 to December 2013 were selected as research subjects .They were randomly divided into control and observation groups （ n = 48 each） .The control group had a weekly injection of 2 ml sodium hyaluronate into knee joint cavity .The observation group received additionally celecoxib capsules 200 mg daily for 5 weeks for a course of treatment .After treatment ,the overall efficacies ,changes of clinical parameters and adverse e‐vents were recorded .During a follow‐up period of 4 weeks ,the changes in clinical symptoms were recorded . None of them was lost during follow‐ups .[Results] After treatment ,the overall effective rate was higher in observation group than that in control group （83 .33% vs 64 .58% ） .And there was significant inter‐group difference （ P 〈 0 .05） .And the levels of C‐reactive protein （CRP） ,interleukin‐1β （IL‐1β） and tumor necrosis factor‐alpha （TNF‐α） and Lequesne score were significantly lower than those pre‐treatment .Both groups showed statistically significant improvements in clinical symptoms （ P 〈 0 .05） .Neither group showed any sig‐nificant change during the follow‐up period .There was no significant inter‐group difference in adverse reac‐tions （ P 〉 0 .05） .[Conclusion] Combined use of sodium hyaluronate and celecoxib is superior to sodium hya‐luronate alone in improving clinical symptoms of knee osteoarthritis patients ,reducing inflammatory cytokines and inhibiting immune injuries .

关 键 词：透明质酸/治疗应用 消炎药  非甾类/治疗应用 骨关节炎  膝/药物疗法 治疗结果 

分 类 号：R684.3[医药卫生—骨科学]