目的 探讨臭氧联合玻璃酸钠对膝关节骨性关节炎患者膝关节功能及疼痛症状的改善效果.方法 前瞻性选取自2013年1月到2017年1月期间收治的126例膝关节股性关节炎患者,随机分为A组、B组和C组各42例.A组采用玻璃酸钠膝关节腔内注射治疗,B组采用医用臭氧膝关节腔内注射治疗,C组采用臭氧联合玻璃酸钠膝关节腔内注射治疗.比较三组患者的临床疗效,同时比较三组患者治疗前后的视觉模拟评分法(VAS)、Lequesne评分的评估结果以及肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的检测结果.结果 C组的显效率为66.67％,总有效率为95.24％,均显著高于A组(28.57％、71.43％)和B组(26.19％、64.29％)(P<0.05);三组患者治疗1个月后和治疗2个月后的VAS评分显著低于治疗前,而Lequesne评分显著高于治疗前(P<0.05);C组治疗1个月后的VAS评分为(1.95±0.79)分,显著低于A组[(5.89±1.12)分],而Lequesne评分为(67.42±5.07)分,显著高于A组[(50.31±3.95)分](P<0.05);C组治疗2个月后的VAS评分为(2.17±0.78)分,显著低于A组和B组[(5.89±1.12)分、(2.03±0.91)分],而Lequesne评分为(82.41±5.47)分,显著高于A组和B组[(63.19±5.08)分、(62.21±4.92)分](P<0.05);三组患者治疗后的TNF-α 和IL-6检测结果均显著低于治疗前(P<0.05);C组治疗后的TNF-α 为(24.09±7.29)pg/ml,IL-6为(48.15±11.51)pg/ml,均显著低于A组[(39.58±10.61)pg/ml、(77.85±19.64)pg/ml]和B组[(37.17±8.09)pg/ml、(73.19±16.19)pg/ml](P<0.05).结论 臭氧联合玻璃酸钠可显著减轻膝关节骨性关节炎患者的疼痛症状,减轻炎症反应,改善膝关节的功能,具有良好的临床疗效.%Objective To investigate the effect of ozone combined with sodium hyaluronate on knee joint function and pain symptoms in patients with knee osteoarthritis. Methods 126 patients with knee joint osteoarthritis were selected from January 2013 to January 2017 and ran-domly divided into group A,group B and group C,with 42 cases in each group. Group A was treated with sodium hyaluronate intra articular injec-tion. Group B was treated with ozone intra articular injection. Group C was treated with ozone combined with sodium hyaluronate intra articular in-jection. The clinical efficacy of the three groups was compared. The results of VAS,Lequesne score,and the levels of TNF - α,IL - 6 were com-pared between the three groups before and after treatment. Results The effective rate of group C was 66. 67％,and the total effective rate was 95. 24％,which were significantly higher than those of group A (28. 57％,71. 43％)and group B (26. 19％,64. 29％)(P < 0. 05). After treatment,the scores of VAS in the three groups were significantly lower than those before treatment,and the Lequesne score was higher than those before treatment (P < 0. 05). After 1 month treatment,the VAS score of group C was (1. 95 ± 0. 79)points,which was significantly lower than that in group A [(5. 89 ± 1. 12)points],and the score of Lequesne was (67. 42 ± 5. 07)points,which was significantly higher than that of group A [(50. 31 ± 3. 95)points](P < 0. 05). After 2 months treatment,the VAS score of group C was (2. 17 ± 0. 78)points,which was signifi-cantly lower than those of group A and group B [(5. 89 ± 1. 12)points,(2. 03 ± 0. 91)points],while the Lequesne score was (82. 41 ± 5. 47) points,which was significantly higher than those of group A and group B [(63. 19 ± 5. 08)points,(62. 21 ± 4. 92)points](P < 0. 05). After treatment,the levels of TNF - α and IL - 6 of the three groups were significantly lower than those before treatment (P < 0. 05). After treatment, the levels of TNF - α of group C was (24. 09 ± 7. 29)pg/ ml,and IL - 6 was (48. 15 ± 11. 51)pg/ ml,which were significantly lower than those of group A [(39. 58 ± 10. 61)pg/ ml,(77. 85 ± 19. 64)pg/ ml]and group B [(37. 17 ± 8. 09)pg/ ml,(73. 19 ± 16. 19)pg/ ml](P < 0. 05). Conclusion Ozone combined with sodium hyaluronate can significantly alleviate the pain symptoms of knee osteoarthritis patients,reduce inflam-matory reaction and improve the function of knee joint,and has good clinical efficacy.
展开▼
