关节腔内注射倍他米松和玻璃酸治疗老年膝骨关节炎的临床观察

发布时间：2018-03-13 21:21

本文选题：倍他米松　切入点：玻璃酸　出处：《中国药房》2017年26期 　论文类型：期刊论文

【摘要】：目的:观察关节腔内注射倍他米松和玻璃酸治疗老年膝骨关节炎的临床疗效及安全性。方法:选取我院2012年7月-2015年7月收治的老年膝骨关节炎患者76例,以随机数字表法分为对照组和观察组,各38例。对照组患者给予关节腔内注射玻璃酸钠注射液2 mL,每周1次,连用3周;观察组患者第1周给予复方倍他米松注射液1 mL,后两周给予玻璃酸钠注射液,每次2mL,每周1次。比较两组患者的临床疗效和不良反应发生情况,以及治疗前后的视觉模拟评分法(VAS)评分、西安大略和麦克马斯特大学骨关节炎量表(WOMAC)评分、生活质量综合评定问卷(GQOLI-74)评分和基质金属蛋白酶(MMP)水平。结果:观察组患者的总有效率为92.11%,显著高于对照组的73.68%,差异有统计学意义(P0.05)。治疗前,两组患者的VAS、WOMAC、GQOLI-74评分和MMP-1、MMP-3水平比较,差异均无统计学意义(P0.05);治疗后,两组患者的VAS、关节僵硬、关节疼痛和日常活动受限评分,以及MMP-1、MMP-3水平均较治疗前显著下降,躯体疼痛、生理功能、生理职能、活力、社会功能、情感职能、精神健康及GQOLI-74总评分均较治疗前显著升高,且观察组各指标显著优于对照组,差异均有统计学意义(P0.05)。两组患者在治疗过程中均未见严重的不良反应发生。结论:关节腔内注射倍他米松和玻璃酸治疗老年膝骨关节炎可有效降低疼痛程度、改善膝关节功能、提高患者生活质量,临床疗效较好且安全性较高,其机制有可能是降低了患者膝关节的MMP水平而获益。
[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.
【作者单位】：海口市人民医院骨科;
【分类号】：R684.3

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