二联药物辅助治疗对膝关节退行性病变患者的影响  

The effect of dual-drug adjuvant therapy on patients with knee degenerative diseases

作　　者：孙龙 何成文[1] 龚有兵[1] 李军[2] 王猛[3] SUN Long;HE Cheng-wen;GONG You-bing;LI Jun;WANG Meng(Xuancheng City Central Hospital, Xuancheng 242000, China;Xuancheng City People′ s Hospital, Xuancheng 242000, China;The Affiliated Hospital of Medical School, Ningbo University, Ningbo 315000, China)

机构地区：[1]安徽省宣城市中心医院,安徽宣城242000 [2]安徽省宣城市人民医院,安徽宣城242000 [3]宁波大学医学院附属医院,浙江宁波315000

出　　处：《实用医院临床杂志》2022年第1期31-34,共4页Practical Journal of Clinical Medicine

基　　金：安徽省自然科学基金资助项目(编号:812148)。

摘　　要：目的探讨二联药物辅助治疗对膝关节退行性病变患者的影响。方法91例膝关节退行性病变患者,按照随机数字表法分为双药组(n=46)和单药组(n=45),单药组采用膝关节镜下病灶清理术,并于术后向膝关节腔内注射玻璃酸钠(2.5 ml),双药组在单药组基础上追用复方倍他米松(1 ml),比较两组连续治疗5周后的临床疗效优良率、炎症因子水平、疼痛程度、膝关节活动度和膝关节功能并进行安全性分析。结果治疗后,双药组优良率高于单药组(P<0.05);两组肿瘤坏死因子-α、白细胞介素-6、C反应蛋白水平及VAS评分均较治疗前降低,膝关节伸直度、屈伸度和屈伸弧度均较治疗前增加,Lysholm膝关节各项评分及总分均较治疗前升高(P<0.05),且两组间比较,差异均有统计学意义(P<0.05)。结论关节腔注射复方倍他米松+玻璃酸钠辅助膝关节镜下病灶清理疗效更优,可有效抑制膝关节退行性病变患者炎症反应并减轻疼痛感,进而改善膝关节活动度提高功能,值得推广应用。Objective To explore the effect of dual-drug adjuvant therapy on patients with knee degenerative diseases.Methods Ninety-one patients with knee degenerative diseases were divided into a dual-drug group(n=46)and a single-drug group(n=45)according to the random number table method.The single-drug group was given lesion debridement under knee arthroscopy,and then injected with sodium hyaluronate(2.5 ml)into the knee articular cavity after surgery.The dual-drug group was additionally treated with compound betamethasone(1 ml)on the basis of the single-drug group.The excellent and good rate of clinical curative effect,levels of inflammatory factors,pain degree,knee joint range of motion and knee function of both groups after 5 weeks of continuous treatment were compared.The safety analysis was also conducted.Results After treatment,the excellent and good rate in the dual-drug group was higher than that in the single-drug group(P<0.05).Compared to before treatment,the levels of interleukin 6,tumor necrosis factorαand C-reactive protein and VAS score in the two groups were decreased while the knee extension,flexion and extension,and arc of flexion and extension were increased,and the scores of various aspects and total scores of Lysholm knee joint scale were enhanced(P<0.05).There were statistical differences in the above indicators between the two groups(P<0.05).Conclusion Intra-articular injection of compound betamethasone+sodium hyaluronate supplemented with lesion debridement under knee arthroscopy has a better efficacy on knee degenerative diseases.It can effectively suppress the inflammatory response and alleviate the pain degree of the patients,thus improving the range of motion and the function of knee joint.It is worth promoting and applying.

关 键 词：复方倍他米松 玻璃酸钠 膝关节镜下病灶清理 膝关节退行性病变 疼痛 关节活动度 

分 类 号：R473.6[医药卫生—护理学]