膝关节腔内注射玻璃酸钠联合复方倍他米松对高原地区膝关节滑膜炎患者疼痛症状及膝关节功能的影响  

Effects of knee intra-articular injection of sodium hyaluronate combined with compound betamethasone on pain symptoms and knee function of patients with knee synovitis in plateau area

作　　者：殷臣竹 杨波 胡浩 向继林 张宇[1] 姚富 张兰[1] Chen-Zhu YIN;Bo YANG;Hao HU;Ji-Lin XIANG;Yu ZHANG;Fu YAO;Lan ZHANG(Department of Pain and Anesthesiology,Sichuan Province Orthopedic Hospital,Chengdu 610041,China;Traditional Chinese Medicine and Tibetan Medicine Hospital of Songpan County,Songpan 623301,Sichuan Province,China)

机构地区：[1]四川省骨科医院疼痛科麻醉科,成都610041 [2]四川省松潘县中臧医院,四川松潘623301

出　　处：《药物流行病学杂志》2023年第1期36-43,共8页Chinese Journal of Pharmacoepidemiology

摘　　要：目的观察膝关节腔内注射玻璃酸钠联合复方倍他米松对高原地区膝关节滑膜炎患者的疼痛症状及膝关节功能的影响。方法高原地区膝关节滑膜炎患者118例随机分为观察组(n=59)和对照组(n=59)。对照组膝关节腔内注射复方倍他米松1 mL+0.9%氯化钠注射液2 mL,观察组用相同方法注射复方倍他米松1 mL+玻璃酸钠注射液2 mL。两组均为1周1次,共治疗4周。分别于治疗前、治疗第2、第4周用视觉模拟评分法(VAS)评估患者膝关节疼痛情况,对膝关节功能情况进行Lysholm评分,测定滑膜厚度和关节腔积液量;比较两组临床疗效,以及治疗前后两组患者膝关节积液中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的水平变化,观察药品不良反应发生情况。结果观察组治疗总有效率为91.53%,明显优于对照组(P<0.05)。治疗后第2、第4周,两组患者膝关节VAS评分、滑膜厚度和关节腔积液量均较前明显降低,Lysholm评分则较前明显升高(P<0.01);且观察组上述指标均优于同时点的对照组(P<0.01)。治疗后,两组患者膝关节积液中TNF-α、IL-1β、IL-6水平均较前明显降低(P<0.01),且观察组上述指标均明显低于对照组(P<0.01)。治疗期间两组患者均未见明显药品不良反应发生。结论膝关节腔内注射玻璃酸钠联合复方倍他米松能有效缓解高原地区膝关节滑膜炎疼痛症状,减轻关节炎症,抑制滑膜肥厚,促进膝关节功能恢复,且安全性高。Objective To observe the effects of knee intra-articular injection of sodium hyaluronate combined with compound betamethasone on the pain symptoms and knee function of patients with knee synovitis in plateau area.Methods A total of 118 patients with knee synovitis in plateau area were selected and divided into observation group(n=59)and control group(n=59)by random number table method.The control group was given knee intra-articular injection of1mL compound betamethasone+2mL 0.9%sodium chloride injection,while the observation group was injected with 1mL compound betamethasone+2mL sodium hyaluronate injection in the same way,and both groups were treated once a week for 4 weeks.Before treatment and on the 2nd week and the 4th week of treatment,the knee pain of patients was evaluated by Visual Analogue Scale(VAS),and the Lysholm score was used to determine the knee function,and the synovial thickness and joint cavity effusion were measured.The clinical efficacy,as well as the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in knee effusion before and after treatment were compared between the two groups of patients.Adverse drug reactions were observed in the two groups.Results The effective rate of observation group was 91.53%,which was significantly better than that in control group(P<0.05).On the 2nd week and 4th week after treatment,the knee VAS score,synovial thickness and joint cavity effusion volume in the two groups of patients were significantly decreased compared with those before treatment while the Lysholm score was significantly increased(P<0.01),and the above indicators were better in observation group than those in control group at the same time point(P<0.01).The levels of TNF-α,IL-1βand IL-6 in knee effusion after treatment were significantly reduced in both groups compared with those before treatment(P<0.01),and the above levels in observation group were significantly lower compared to control group(P<0.01).No obvious adverse drug reactions were observed in b

关 键 词：玻璃酸钠 复方倍他米松 膝关节滑膜炎 疼痛症状 膝关节功能 炎症因子 

分 类 号：R686.7[医药卫生—骨科学]