【摘要】：目的觀察洛索洛芬鈉聯(lián)合玻璃酸鈉關節(jié)腔內注射治療骨關節(jié)炎(OA)的臨床療效。方法將90例OA患者隨機分為試驗組和對照組,各45例。對照組給予玻璃酸鈉注射液,每次25 mg,每周1次,關節(jié)腔內注射,連續(xù)注射5次為1個療程,共治療2個療程,療程之間間隔2周;試驗組在對照組的基礎上加用洛索洛芬鈉片,每次60 mg,每天3次,口服,持續(xù)治療12周。比較2組患者的臨床療效,分析治療前后2組患者關節(jié)滑液中炎癥因子[白細胞介素(IL)~(-1)β、IL-6、腫瘤壞死因子(TNF)-α]水平,用視覺模擬評分法(VAS)和西大略湖和麥克馬斯特大學(WOMAC)骨關節(jié)炎指數(shù)評價2組患者疼痛程度和膝關節(jié)功能,記錄治療過程中藥物不良反應發(fā)生情況。結果治療后,試驗組和對照組的總有效率分別為97.78%(44/45例)和82.22%(37/45例),差異有統(tǒng)計學意義(P0.05)。治療后,試驗組IL~(-1)β,IL-6,TNF-α分別為(34.27±5.88),(7.71±2.45),(12.71±3.08)μg·m L~(-1),對照組分別為(45.29±6.18),(11.55±3.00),(16.30±4.13)μg·m L~(-1)(均P0.05)。治療后,試驗組和對照組的VAS評分分別為(2.75±1.01),(3.63±0.94)分(P0.05);WOMAC骨關節(jié)炎指數(shù)評分分別為(31.51±6.37),(33.85±7.45)分,差異無統(tǒng)計學意義(P0.05)。試驗組主要藥物不良發(fā)應為胃腸道癥狀和輕微皮疹,藥物不良反應發(fā)生率為6.67%(3/45例);對照組主要不良發(fā)應為胃腸道癥狀和關節(jié)紅腫,藥物不良發(fā)應發(fā)生率為11.11%(5/45例),差異無統(tǒng)計學意義(P0.05)。結論洛索洛芬鈉聯(lián)合關節(jié)腔內注射玻璃酸鈉具有較好的抗炎、鎮(zhèn)痛及改善膝關節(jié)功能的作用,對骨關節(jié)炎具有良好的療效和安全性。
[Abstract]:Objective To observe the clinical effect of Loxoprofen sodium combined with sodium hyaluronate in the treatment of osteoarthritis (OA). Methods 90 patients with OA were randomly divided into test group and control group. The control group received the sodium hyaluronate injection, each time of 25 mg, once a week, the joint cavity was injected, the continuous injection of 5 times was 1 treatment course, the treatment course was 2 weeks, the course of treatment was 2 weeks, the test group was added with the loxoprofen sodium tablet in addition to the control group, each time of 60 mg,3 times a day, Oral, lasting for 12 weeks. The clinical effect of group 2 patients was compared, and the levels of the inflammatory factors[interleukin (IL) ~ (-1), IL-6, tumor necrosis factor (TNF)-1] in the synovial fluid of the two groups were analyzed. The degree of pain and the function of the knee in the 2 groups were evaluated by the visual analogue scale (VAS) and the University of the West and the McMaster's University (WOMAC) osteoarthritis index in order to record the occurrence of adverse drug reactions in the course of the treatment. Results The total effective rate of the test group and the control group was 97.78% (44/45) and 82.22% (37/45), respectively. After treatment, IL-1, IL-6 and TNF-1 in the test group were (34.27-5.88), (7.71-2.45), (12.71-3.08) & mu; g 路 m-L-(-1), respectively (45.29-6.18), (11.55-3.00), (16.30-4.13). mu.g 路 m-L-(-1) (all P0.05). After the treatment, the VAS scores of the test group and the control group were (2.75-1.01), (3.63-0.94) (P0.05), and the scores of the WOMAC-osteoarthritis index were (31.51-6.37), (33.85-7.45), and the difference was not significant (P0.05). The main drug adverse effects of the test group should be gastrointestinal symptoms and mild rash, and the incidence of adverse drug reactions was 6.67% (3/45); the main adverse effects of the control group should be gastrointestinal symptoms and joint swelling, and the incidence of adverse drug delivery should be 11.11% (5/45), and the difference was not statistically significant (P0.05). Conclusion The injection of sodium hyaluronate in the joint cavity of Loxoprofen sodium has good anti-inflammatory, analgesic and function of improving the function of the knee joint, and has good curative effect and safety for osteoarthritis.
【作者單位】： 青海紅十字醫(yī)院疼痛科;
【分類號】：R684.3

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