本文選題：倍他米松　切入點(diǎn)：玻璃酸　出處：《中國(guó)藥房》2017年26期 　論文類型：期刊論文

【摘要】：目的:觀察關(guān)節(jié)腔內(nèi)注射倍他米松和玻璃酸治療老年膝骨關(guān)節(jié)炎的臨床療效及安全性。方法:選取我院2012年7月-2015年7月收治的老年膝骨關(guān)節(jié)炎患者76例,以隨機(jī)數(shù)字表法分為對(duì)照組和觀察組,各38例。對(duì)照組患者給予關(guān)節(jié)腔內(nèi)注射玻璃酸鈉注射液2 mL,每周1次,連用3周;觀察組患者第1周給予復(fù)方倍他米松注射液1 mL,后兩周給予玻璃酸鈉注射液,每次2mL,每周1次。比較兩組患者的臨床療效和不良反應(yīng)發(fā)生情況,以及治療前后的視覺(jué)模擬評(píng)分法(VAS)評(píng)分、西安大略和麥克馬斯特大學(xué)骨關(guān)節(jié)炎量表(WOMAC)評(píng)分、生活質(zhì)量綜合評(píng)定問(wèn)卷(GQOLI-74)評(píng)分和基質(zhì)金屬蛋白酶(MMP)水平。結(jié)果:觀察組患者的總有效率為92.11%,顯著高于對(duì)照組的73.68%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療前,兩組患者的VAS、WOMAC、GQOLI-74評(píng)分和MMP-1、MMP-3水平比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療后,兩組患者的VAS、關(guān)節(jié)僵硬、關(guān)節(jié)疼痛和日�；顒�(dòng)受限評(píng)分,以及MMP-1、MMP-3水平均較治療前顯著下降,軀體疼痛、生理功能、生理職能、活力、社會(huì)功能、情感職能、精神健康及GQOLI-74總評(píng)分均較治療前顯著升高,且觀察組各指標(biāo)顯著優(yōu)于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者在治療過(guò)程中均未見嚴(yán)重的不良反應(yīng)發(fā)生。結(jié)論:關(guān)節(jié)腔內(nèi)注射倍他米松和玻璃酸治療老年膝骨關(guān)節(jié)炎可有效降低疼痛程度、改善膝關(guān)節(jié)功能、提高患者生活質(zhì)量,臨床療效較好且安全性較高,其機(jī)制有可能是降低了患者膝關(guān)節(jié)的MMP水平而獲益。
[Abstract]:Objective: to observe the efficacy and safety of intra articular injection of betamethasone and hyaluronic acid in the treatment of senile knee osteoarthritis. The patients in the control group were given intraarticular injection of sodium hyaluronate 2 mL once a week for 3 weeks. Patients in the observation group were treated with compound betamethasone injection (1 mL) in the first week and sodium hyaluronate injection (2 mL per week) in the following two weeks. The clinical efficacy and adverse reactions were compared between the two groups. The visual analogue score before and after treatment and the WOMAC score of the Osteoarthritis scale at the University of Western Ontario and the University of McMaster. Results: the total effective rate of the patients in the observation group was 92.11, which was significantly higher than that in the control group (73.68%). The difference was statistically significant (P 0.05). Before treatment, the VAS-WOMACI-74 score and the MMP-3 level were compared between the two groups. After treatment, VAS, joint stiffness, joint pain, joint pain and limited daily activities, as well as MMP-1 MMP-3 level, decreased significantly after treatment, body pain, physiological function, physiological function, vitality and social function. The scores of affective function, mental health and GQOLI-74 were significantly higher than those before treatment, and the indexes of the observation group were significantly better than those of the control group. The difference was statistically significant (P 0.05). No serious adverse reactions occurred in the two groups. Conclusion: intra articular injection of betamethasone and hyaluronic acid in the treatment of senile knee osteoarthritis can effectively reduce the degree of pain and improve the function of knee joint. To improve the quality of life, the clinical efficacy is better and the safety is higher. The mechanism may be to reduce the MMP level of the knee joint and benefit.
【作者單位】： �？谑腥嗣襻t(yī)院骨科;
【分類號(hào)】：R684.3

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本文編號(hào)：1608174