关节腔注射玻璃酸钠对肩周炎患者血清TNF-α、COX-2表达及VAS评分的影响  

Effect of Intra-articular Injection of Sodium Hyaluronate on Serum TNF-α、COX-2 expression and VAS scorein Patients with Scapulohumeral Periarthritis

作　　者：蔺广生 杨王李 LIN Guang-sheng;YANG Wang-Li(Deptment of Orthopaedics,Yan'an People's Hospital,Yan'an 716000)

机构地区：[1]延安市人民医院骨三科,陕西延安716000 [2]陕西省咸阳市三原县医院骨一科,陕西咸阳713800

出　　处：《医学临床研究》2021年第8期1152-1155,共4页Journal of Clinical Research

摘　　要：【目的】探讨关节腔注射玻璃酸钠对肩周炎患者血清肿瘤坏死因子-α(TNF-α)、环氧合酶(COX-2)表达及疼痛视觉模拟评分(VAS)的影响。【方法】将2017年3月至2020年3月于本院疼痛科就诊的160例肩周炎患者按随机数表法分为对照组(n=80)、观察组(n=80)。对照组施以常规治疗,观察组在对照组基础上加行关节腔内玻璃酸钠注射治疗。治疗1个月后,比较两组临床疗效(有效率),治疗前后的TNF-α、COX-2、VAS评分及肩关节主动关节活动度(Active Range Of Motion,AROM)的变化。【结果】观察组临床有效率优于对照组(85.00%vs 62.50%,χ^(2)=10.460,P<0.05),观察组COX-2水平、VAS评分较对照组改善明显[(12.47±2.33)pg/mL vs(16.67±3.43)pg/mL、(1.42±1.10)分vs(2.34±1.31)分,P<0.05];观察组肩关节前咸、后伸、外展的AR0M较对照组改善明显[(161.14±18.33)°vs(145.67±14.45)°、(50.25士6.57)°vs(38.64±7.40)°、(133.20±14.37)°vs(124.36±14.07)°,P<0.05]。两组TNF-α水平比较差异无显著性[(29.32±10.10)pg/mL vs(31.64±9.31)pg/mL,P>0.05]。【结论】关节腔内玻璃酸钠注射治疗可有效抑制肩周炎患者的炎症反应,改善其疼痛症状及关节活动功能障碍。【Objective】To investigate the effect of intra-articular injection of sodium hyaluronate on serum tumor necrosis factor in patients with scapulohumeral periarthritis-α(TNF-α),Cyclooxygenase-2(COX-2)expression and pain visual analogue scale(VAS).【Methods】A total of 160 patients with Scapulohumeral Periarthritis treated in the pain department of our hospital from March 2017 to March 2020 was randomly divided into control group(n=80)and observation group(n=80).The control group was treated with routine treatment,and the observation group was treated with intra-articular sodium hyaluronate injection,on the basis of the control group;After one month of treatment,the clinical efficacy(effective rate)arid TNF-α,COX-2,VAS score and active range of motion(AROM)of shoulder jointbefore and after treatment were compared between the two groups.【Results】The clinical effective rate of the observation group was better than that of the control group(85.00%vs 62.50%,χ^(2)=10.460,P<0.05),the scores of COX-2 and VAS in the observation group were significantly improved compared with those in the control group[(12.47±2.33)pg/mL vs(16.67±3.43)pg/mL,(1.42±1.10)score vs(2.34±1.31)score,P<10.05];The AROM of shoulder flexion,extension and abduction in the observation group was significantly improved compared with that in the control group[(161.14±18.33)°vs(145.67±14.45)°,(50.25±6.57)°vs(38.64±7.40)°,(133.20±14.37)°vs(124.36+14.07)°,P<0.05].There was no significant difference TNF-αof two groups[(29.32±10.10)pg/mL vs(31.64±9.31)pg/mL,P>0.05].【Conclusion】Intaarticular sodium hyaluronate injection can effectively in-hibit the inflammatory responsc,improve the pain symptoms and joint activity dysfunction in patients withscapalohumeral periarthritis.

关 键 词：肩凝症/治疗 透明质酸/治疗应用 封闭疗法 肿瘤坏死因子α/血清 氧化还原酶类/血清 

分 类 号：R684.73[医药卫生—骨科学]