玻璃酸钠和臭氧治疗膝关节创伤性关节炎的临床研究  

Clinical study of sodium hyaluronate and ozone in the treatment of knee traumatic arthritis

作　　者：许小志[1] 邓铭锋[1] XU Xiao-zhi;DENG Ming-feng(Sanshui Hospital of Foshan Traditional Chinese Medicine Hospital,Foshan 528100,Guangdong,China)

机构地区：[1]佛山市中医院三水医院,广东佛山528100

出　　处：《川北医学院学报》2020年第6期1081-1084,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨关节腔内注射玻璃酸钠和臭氧治疗膝关节创伤性关节炎的临床疗效。方法:148例确诊的膝关节创伤性关节炎患者,均为单侧,按照接收治疗的方式分为参照组(n=74)和联合组(n=74)。参照组给予关节腔内注射玻璃酸钠注射治疗,联合组给予关节腔内注射玻璃酸钠和40μg/mL浓度臭氧治疗,1次/周,连续治疗5周,均接受常规康复运动疗法。比较两组关节液炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)]水平和并发症发生率。治疗结束后均随访2个月,比较两组治疗前后以及随访期末视觉模拟疼痛法(VAS)评分、膝关节功能(HSS)评分和膝关节活动范围。结果:所有患者均成功完成治疗及随访,两组治疗后关节液IL-6、TNF-α、CRP水平均较治疗前下降(P<0.05),且联合组治疗后上述关节液水平均低于参照组(t=6.972、5.892、4.708,P<0.05);两组治疗期间均无关节腔内部感染发生,两组不良反应率比较差异无统计学意义(χ2=0.187,P>0.05);两组治疗后和随访2个月VAS评分与治疗前比较下降,膝关节HSS评分升高(P<0.05),且联合组治疗后和随访2个月VAS评分、膝关节HSS评分改善均优于参照组(P<0.05)。结论:关节腔内注射玻璃酸钠和臭氧能有效减轻膝关节创伤性关节炎患者患膝炎性反应,缓解疼痛症状和改善膝关节功能,且安全性较好。Objective:To investigate the clinical effect of intra-articular injection of sodium hyaluronate combined with ozone in the treatment of knee traumatic arthritis.Methods:148 patients with traumatic arthritis of knee joint(all unilateral)were divided into control group(n=74)and combined group(n=74)according to the way of receiving treatment.The control group was treated with intra-articular injection of sodium hyaluronate,while the combined group was treated with intra-articular injection of sodium hyaluronate and 40μg/ml concentration of ozone once a week for 5 weeks,all patients received routine rehabilitation exercise therapy.The levels of IL-6,TNF-α,C-reactive protein(CRP)and the incidence of complications were compared between the two groups.After treatment,the patients were followed up for 2 months.The vas,HSS and range of motion of knee joint were compared before and after treatment and at the end of follow-up.Results:All the patients were successfully treated and followed up.The levels of IL-6,TNF-αand CRP in the joint fluid of the two groups were significantly lower than those before treatment(P<0.05),and the average level of the joint fluid of the combined group was significantly lower than that of the control group(t=6.972,5.892,4.708,P<0.05).There was no intra-articular infection in the two groups during the treatment period.There was no significant difference in the adverse reactions between the two groups(χ2=0.187,P>0.05).According to the follow-up results,after treatment and at the end of 2 months follow-up,the VAS score of the two groups was significantly lower than that before treatment,and the HSS score of the knee joint was significantly higher(P<0.05).And the improvement of VAS score and HSS score of the knee joint in the combined group was better than that in the control group after treatment and at the end of 2 months follow-up(P<0.05).Conclusion:Intra-articular injection of sodium hyaluronate combined with ozone can effectively reduce the knee inflammatory reaction,relieve the pain sympto

关 键 词：膝关节创伤性关节炎 玻璃酸钠 臭氧 疼痛 关节液炎性因子 膝关节功能 

分 类 号：R658.3[医药卫生—外科学]