复方倍他米松联合玻璃酸钠治疗中重度膝关节骨性关节炎的随机对照研究  

Intra-articular injection of compound betamethasone and hyaluronic acid for the treatment of moderate-severe knee osteoarthritis:a randomized controlled trial

作　　者：王善正[1] 郭玉冬[1] 张学军[1] 王宸[1] WANG Shan-zheng;GUO Yu-dong;ZHANG Xue-jun;WANG Chen(不详;Department of Orthopaedics,Zhongda Hospital,Medical School of Southeast University,Nanjing210009,Jiangsu,China)

机构地区：[1]东南大学附属中大医院骨科,江苏南京210009

出　　处：《中国骨伤》2021年第5期424-428,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:比较复方倍他米松与复方倍他米松联合玻璃酸钠治疗中重度膝关节骨性关节炎(knee osteoarthritis,KOA)的临床疗效。方法:采用前瞻性随机对照研究方法将2017年2月至2017年11月收治的116例单侧中重度KOA患者分为观察组和对照组,每组58例。观察组男15例,女43例;年龄45~80(66.45±6.31)岁;骨性关节炎的Kellgren-Lawrence(K-L)分级,Ⅲ级42例,Ⅳ级16例;病程4~8(5.25±2.21)年;予膝关节注射1 ml复方倍他米松治疗。对照组男13例,女45例;年龄45~80(64.89±6.41)岁;K-L分级,Ⅲ级43例,Ⅳ级15例;病程4~10(5.41±2.35)年;予以膝关节联合注射4 ml玻璃酸钠和1 ml复方倍他米松治疗。分别于治疗前和治疗后1周,1、3、6个月采用疼痛视觉模拟评分(visual analogue scale,VAS),西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster University Osteoarthritis Index,WOMAC)评分进行疗效评价。结果:观察组共55例患者获得6个月完整随访,有3例患者因疗效不佳,改用其他治疗方案,于第3个月退出。对照组共56例患者获得6个月完整随访,有2例患者因疗效不佳,改用其他治疗方案,分别于第1、3个月退出。治疗前后各时间点,两组VAS评分、WOMAC评分比较差异无统计学意义(P>0.05),且两组患者治疗后6个月与治疗前VAS评分、WOMAC评分比较差异无统计学意义(P>0.05)。结论:对于中重度KOA患者,复方倍他米松注射治疗与复方倍他米松联合玻璃酸钠注射治疗效果并无明显差异,两者长期疗效均不佳。Objective:To compare clinical effects of compound betamethasone and compound betamethasone with hyaluronic acid in treating moderate-severe knee osteoarthritis(KOA).Methods:A prospective randomized controlled study was conducted in 116 patients with unilateral moderate-severe KOA patients from February 2017 to November 2017 and divided into observation group and control group,58 patients in each group.In observation group,there were 15 males and 43 females aged from 45 to 80 years old with an average of(66.45±6.31)years old;according to Kellgren-Lawrence(K-L)classification,42 patients were typeⅢand 16 patients were typeⅣ;the courses of disease ranged from 4 to 8 years with an average of(5.25±2.21)years;the patients were treated by injecting 1 ml compound betamethasone into knee joint.In control group,there were 13 males and 45 females aged from 45 to 80 years old with an average of(64.89±6.41)years old;according to K-L classification,43 patients were typeⅢand 15 patients were typeⅣ;the courses of disease ranged from 4 to 10 years with an average of(5.41±2.35)years;the patients were treated by knee joint injection of 4 ml hyaluronic acid and 1 ml compound betamethasone.Visual analog scale(VAS),Western Ontario and McMaster University Osteoarthritis Index(WOMAC)were used to evaluate clinical effects before treatment and 1 week,1,month,3 and 6 months after treatment.Results:Totally 55 patients in observation group were followed up for 6 months,and 3 patients were quit at 3 months after treatment for poor efficacy.Totally 56 patients in control group were followed up for 6 months,and 2 patients were withdrew from the follow-up on the first and third month respectively for poor efficacy.There were no statistical difference in VAS and WOMAC between two groups before treatment and different time points after treatment(P>0.05),and no significant difference in VAS and WOMAC before treatment and 6 months after treatment between two groups(P>0.05).Conclusion:For patients with moderate-severe KOA,there is no signi

关 键 词：骨关节炎 玻璃酸钠 复方倍他米松 膝关节 

分 类 号：R684.3[医药卫生—骨科学]