比较关节腔内分别注射臭氧、透明质酸钠及硫酸软骨素治疗膝关节骨性关节炎患者的疗效及安全性  

Comparising the efficacy and safety of intra-articular injection with ozone, sodium hyaluronate or chondroitin sulfate in the knee joint cavity respectively for the treatment of patients with knee osteoarthritis

作　　者：钱黎 陈黔 潘奇 王大寿 段斌武 Qian Li;Chen Qian;Pan Qi;Wang Dashou;Duan Binwu(Department of Pain Medicine,Orthopedic Hospital of Guizhou Province,Guiyang City,Guizhou Province 550002,China)

机构地区：[1]贵州省骨科医院疼痛科,贵阳市550002

出　　处：《实用疼痛学杂志》2019年第4期282-288,共7页Pain Clinic Journal

基　　金：贵阳市科技计划项目(筑科合同[20161001]28号).

摘　　要：目的比较膝关节腔内分别注射臭氧、透明质酸钠及硫酸软骨素对膝关节骨性关节炎患者的疗效及安全性。方法收集2016年1月至2017年12月就诊于贵州省骨科医院疼痛科的膝关节骨性关节炎患者149例,性别不限,年龄≥18岁,采用随机数字表法将其分为3组,臭氧组(A组)、透明质酸钠组(B组)及硫酸软骨素组(C组),其中A组50例,B组49例,C组50例。A组关节腔内注射25μg/ml臭氧5ml,B组注射透明质酸钠20mg/2ml,C组注射硫酸软骨素40mg,以0.9%氯化钠注射液稀释至2ml,每周1次,5次为一个疗程。观察并记录患者注射时出现膝关节酸胀情况;注射前、注射时、注射后1min、注射后5min的心率、血压和脉搏血氧饱和度,及治疗前、治疗1次、治疗5次、治疗完成后1个月、3个月时患者的视觉模拟评分(VAS)和Lysholm功能评分。结果与注射前比较,A组心率在注射时升高[(94±10)比(78±9)次/min](P<0.05)。与A组比较,B组与C组患者在注药时出现强烈酸胀感的例数较少(5比27例,3比27例),心率较低[(85±9)比(94±10),(83±8)比(94±10)次/min](P均<0.05)。与治疗前比较,A组与B组在治疗后各时点Lysholm功能评分升高,VAS评分降低(P均<0.05);C组在治疗5次、治疗完成后1个月时Lysholm功能评分升高,VAS评分降低(P均<0.05)。与A组B组比较,C组在治疗后各时点Lysholm功能评分较低,VAS评分较高(P均<0.05)。结论膝关节腔内注射臭氧、透明质酸钠均可有效治疗膝关节骨性关节炎,注射硫酸软骨素疗效较前两者效果稍差,但注射臭氧时患者会有明显酸胀不适感和短暂心率升高。Objective To investigate the efficacy and safety of intra-articular injection with ozone, sodium hyaluronate or chondroitin sulfate in knee joint cavity respectively for the treatment of patients with knee osteoarthritis. Methods One hundred and forty-nine patients with knee osteoarthritis, both sexes, aged≥18 years, from January 2016 to December 2017 in Department of Pain Medicine, Orthopedic Hospital of Guizhou Province, were randomly divided into three groups. Different medicines were injected into the knee joint cavity, ozone in group A(50 cases), sodium hyaluronate in group B(49 cases) and chondroitin sulfate in group C(50 cases), once a week, five times in a course. The number of cases with discomfort during injection was recorded in three groups. Heart rate, blood pressure and blood oxygen saturation were observed before the injection, and at injection time, 1 minute and 5 minutes after the injection. Visual analogue score (VAS) and Lysholm scores were recorded before the treatment, and at 1 time, 5 times injection, and at 1 month, 3 months after the treatment. Results Compared with pre-injection, heart rate was significantly increased during the injection in group A[(94±10)vs.(78±9)](P<0.05). Compared with group A, the discomfort cases were fewer and heart rate were lower during the injection in group B and group C (5 vs. 27 cases, 3 vs. 27 cases)[(85±9)vs.(94±10),(83±8)vs.(94±10)](all P<0.05). VAS was lower and Lysholm score was higher in group A and group B at each time point after the treatment than those in pre-treatment (all P<0.05), while there were significant differences in VAS and Lysholm score at 5 times injection and 1 month after the treatment in group C(all P<0.05). Compared with group A and group B, VAS was increased and Lysholm score was decreased respectively at each time point after the treatment in group C (all P<0.05). Conclusion Intra-articular injection of ozone or sodium hyaluronate is effective for the treatment of patients with osteoarthritis, while the efficacy is poorer w

关 键 词：臭氧 透明质酸 软骨素 注射 关节内 骨关节炎 膝 

分 类 号：R684.3[医药卫生—骨科学]