玻璃酸钠和医用几丁糖对膝骨性关节炎患者临床疗效及关节功能恢复的作用比较  

Comparison of the effects of sodium hyaluronate and medical chitins on clinical efficacy and joint function recovery in patients with knee osteoarthritis

作　　者：陈益果 王威 徐西东 赵智君 黄晓华 魏兵 金宏亮 潘启源 苏瑶 CHEN Yi-guo;WANG Wei;XU Xi-dong(Department of Orthopedics,Chongqing Yubei District People's Hospital,Chongqing 401120,China)

机构地区：[1]重庆市渝北区人民医院骨科,重庆401120 [2]重庆市渝北区人民医院心血管内科,重庆401120

出　　处：《临床和实验医学杂志》2025年第5期490-494,共5页Journal of Clinical and Experimental Medicine

基　　金：重庆市科卫联合医学科研项目(编号:2022QNXM066);重庆市渝北区人民医院科研项目(编号:ybyk2023-20)。

摘　　要：目的比较玻璃酸钠和医用几丁糖对膝骨性关节炎(KOA)患者临床疗效及关节功能恢复的作用。方法收集2023年9月至2024年7月就诊于重庆市渝北区人民医院的KOA患者60例进行前瞻性研究,按照随机数字表法将患者分为两组:前30个编号纳入玻璃酸钠组,后30个编号纳入几丁糖组。纳入玻璃酸钠组接收玻璃酸钠治疗,几丁糖组接受几丁糖治疗。治疗6周后对两组患者的临床总体疗效进行评估,比较两组患者治疗前及治疗6周后的视觉模拟评分法(VAS)评分、西安大略和麦马斯特大学骨性关节炎指数量表(WOMAC)评分、Lysholm膝关节评分、X射线生物学指标,并比较其相关炎症因子[白细胞介素(IL)-6、肿瘤坏死因子α(TNF-α)、IL-1β、一氧化氮]水平及不良反应发生情况。结果几丁糖组的临床总有效率为96.67%,高于玻璃酸钠组(73.33%),差异有统计学意义(P<0.05)。治疗6周后,两组的VAS评分和WOMAC评分均较治疗前显著降低,Lysholm膝关节评分均较治疗前显著升高,且几丁糖组的VAS评分和WOMAC评分分别为(1.11±0.26)、(21.22±4.12)分,均显著低于玻璃酸钠组[(2.44±0.31)、(28.89±3.44)分],几丁糖组Lysholm膝关节评分为(78.66±7.88)分,显著高于玻璃酸钠组[(71.13±6.89)分],差异均有统计学意义(P<0.05)。治疗6周后,两组的胫骨角、股骨远端外侧角及外侧关节间隙均较治疗前增大,差异均有统计学意义(P<0.05),但组间治疗6周后比较,差异均无统计学意义(P>0.05)。治疗6周后,两组的各项炎症因子水平均较治疗前显著降低,且几丁糖组的IL-6、TNF-α、IL-1β、一氧化氮水平分别为(60.11±5.11)pg/mL、(27.15±3.68)pg/mL、(80.12±9.11)pg/mL、(31.66±4.56)ppb,均显著低于玻璃酸钠组[(65.45±4.10)pg/mL、(33.16±3.11)pg/mL、(103.66±8.47)pg/mL、(46.98±3.16)ppb],差异均有统计学意义(P<0.05)。两组间的不良反应发生率比较,差异无统计学意义(P>0.05)。结论医用几丁糖在治�Objective To compare the effects of sodium hyaluronate and medical chitin on the clinical efficacy and joint function recovery of patients with knee osteoarthritis(KOA).Methods A prospective study was conducted on 60 patients with KOA who were admitted to Chongqing Yubei District People's Hospital from September 2023 to July 2024.The patients were divided into two groups according to the random number table method:the first 30 numbers were included in the sodium hyaluronate group,and the last 30 numbers were included in the chitosan group.The sodium hyaluronate group received sodium hyaluronate treatment,and the chitosan group received chitosan treatment.After 6 weeks of treatment,the overall clinical efficacy of the two groups was evaluated.The visual analogue scale(VAS)pain score,Western Ontario McMaster University Osteoarthritis Index Scale(WOMAC)score,Lysholm knee score,X-ray biological indicators,the levels of related inflammatory factors[interleukin(IL)-6,tumor necrosis factorα(TNF-α),IL-1β,nitric oxide]before and after 6 weeks of treatment,and adverse reactions were compared between the two groups.Results The total clinical effective rate of the chitosan group was 96.67%,which was higher than that of the sodium hyaluronate group(73.33%),and the difference was statistically significant(P<0.05).After 6 weeks of treatment,the VAS score and WOMAC score of the two groups were significantly lower than those before treatment,and the Lysholm knee score was significantly higher than that before treatment,the VAS score and WOMAC score of the chitosan group were(1.11±0.26)and(21.22±4.12)points,which were significantly lower than those of the sodium hyaluronate group[(2.44±0.31)and(28.89±3.44)points],the Lysholm knee score was(78.66±7.88)points,which was significantly higher than that of the sodium hyaluronate group[(71.13±6.89)points],the differences were statistically significant(P<0.05).After 6 weeks of treatment,the levels of inflammatory factors in the two groups were significantly lower than those befor

关 键 词：玻璃酸钠 医用几丁糖 膝骨性关节炎 临床疗效 关节功能 炎症因子 

分 类 号：R684.3[医药卫生—骨科学]