摘要
目的:探讨臭氧联合玻璃酸钠关节腔注射治疗膝骨性关节炎的临床疗效及对患者炎症因子和血液流变学指标的影响。方法:选取2016年10月至2019年2月于本院接受治疗的膝骨性关节炎患者146例,按随机数字表法分为观察组和对照组,每组73例。观察组采用臭氧联合玻璃酸钠关节腔内注射,对照组常规服用盐酸氨基葡萄糖片,同时关节腔内注射玻璃酸钠,两组患者均每周治疗1次,连续5周为1个疗程。分析两组患者的一般资料,比较两组患者的疗效,治疗前后VAS评分和美国纽约特种外科医院膝关节功能评分(HSS)、炎症因子水平以及血液流变学指标变化。结果:治疗前,两组患者VAS评分和HSS评分的差异均无统计学意义(P>0.05);治疗后,两组患者VAS评分和HSS评分分别显著降低和升高(P<0.05);与对照组相比,治疗后观察组VAS评分显著降低,HSS评分显著升高(P<0.05)。观察组患者治疗后总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者关节液中炎症因子血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、IL-1β、IL-6、hs-CRP及基质金属蛋白酶13(MMP-13)水平差异均无统计学意义(P>0.05);两组患者治疗后关节液中炎症因子水平分别与各自治疗前相比均降低,差异具有统计学意义(P<0.05),且观察组均显著低于对照组(P<0.05)。两组患者治疗前的血液流变学指标差异均无统计学意义(P>0.05),治疗后两组均明显改善,且观察组改善程度显著优于对照组(P<0.05)。结论:臭氧联合玻璃酸钠关节腔内注射治疗膝骨性关节炎疗效更加显著,可有效降低炎症因子水平,减轻炎症反应,改善血液流变学,进而减轻患者疼痛程度,提高膝关节功能。
Objective To investigate the clinical effect of ozone combined with sodium hyaluronate injection in the treatment of knee osteoarthritis and its effect on inflammatory factors and hemorheology in patients.Methods 146 patients with knee osteoarthritis who received treatment in our hospital from October 2016 to February 2019 were selected and divided into observation group and control group according to the random number table method,73 cases in each group.In the experimental group,intra-articular injection of sodium hyaluronate combined with ozone was used,while in the control group,glucosamine hydrochloride tablets were routinely taken and intra-articular injection of sodium hyaluronate was performed.Patients in both groups were treated once a week for 5 consecutive weeks for a course of treatment.General data of patients in the two groups were analyzed,and the efficacy,visual analogue scale(VAS)score and hospital for special surgery knee score(HSS)before and after treatment,levels of inflammatory factors and changes in hemorheology indexes were compared between the two groups.Results There was no significant difference in general data between the two groups(P>0.05).Before treatment,there was no significant difference in VAS score and HSS score between the two groups(P>0.05).After treatment,VAS score and HSS score in the two groups were significantly decreased and increased respectively(P<0.05).Compared with the control group,VAS score was significantly decreased and HSS score was significantly increased in the observation group after treatment(P<0.05).The total effective rate in the observation group was higher than that in the control group,and the difference between the two groups was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of inflammatory factors vascular endothelial growth factor(VEGF),tumor necrosis factor(TNF-α),interleukin(IL)-1β,IL-6,hypersensitive C-reactive protein(hs-CRP)and matrix metalloproteinase(MMP)-13 in the articular fluid between the two groups(P>0.05).After treatment,the above indexs in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of inflammatory cytokines in the articular fluid of the two groups were lower than before(P<0.05).There was no significant difference in hemorheology indexes between the two groups before treatment(P>0.05),and the two groups were significantly improved after treatment,and the degree of improvement in the observation group was significantly better than that in the control group(P<0.05).Conclusions Ozone combined with sodium hyaluronate intra-articular injection is more effective in the treatment of knee osteoarthritis,which can effectively reduce the level of inflammatory factors and inflammatory response,improve hemorheology,and then reduce the pain of patients,improve the knee joint function.
作者
李宝
刘燕平
杜开兴
黄晓
王旭松
Li Bao;Liu Yanping;Du Kaixing;Huang Xiao;Wang Xusong(Department of Traditional Chinese Medicine Rehabilitation,Meishan People′s Hospital,Meishan 620010,China)
出处
《中国医师杂志》
CAS
2020年第6期886-890,895,共6页
Journal of Chinese Physician
关键词
臭氧
玻璃酸钠
骨关节炎
膝
炎症因子
血液流变学
注射
关节内
Ozone
Sodium hyaluronate
Osteoarthritis
knee
Inflammatory factors
Hemorheology
Injections
intra-articular
