摘要
目的了解关节腔内注射玻璃酸钠联合药物和功能锻炼对早中期膝骨关节炎(knee osteoarthritis,KOA)的治疗效果。方法选择2015年9月-2018年1月于本院骨科门诊就诊的54例KOA患者,随机分为玻璃酸钠组和对照组。对照组口服硫酸氨基葡萄糖(50 mg,3次/d)并行日常膝关节功能锻炼,持续3个月;玻璃酸钠组在对照组治疗基础上行关节腔内注射玻璃酸钠治疗(4 ml,1次/周),持续4次。分别于治疗前,治疗后3个月、6个月随访患者,使用改良版美国西大略和麦克马斯特大学骨关节炎评分(Western Ontario and Mc Master Universities osteoarthritis index,WOMAC)评估治疗效果。结果两组的性别、年龄、WOMAC评分等基线数据无统计学差异;玻璃酸钠组与对照组的WOMAC评分在3个月时(36.15±10.56 vs34.00±11.23,P=0.54)和6个月时(30.15±11.30 vs 26.50±12.43,P=0.34)均无统计学差异。结论与口服药物联合功能锻炼治疗KOA相比,联合使用口服药物、功能锻炼和关节腔内注射玻璃酸钠并不能取得更好的疗效,我们不推荐使用关节腔内玻璃酸钠联合口服药物及功能锻炼治疗KOA。
Objective To evaluate the effect of intra-articular injection of hyaluronateacid combined with drugs and functional exercise on early and middle- stage knee osteoarthritis （KOA）. Methods Fifty-four patients diagnosed as KOA from September 2015 to January 2018 were randomly divided into hyaluronateacid group and control group. The control group received oral glucosamine sulfate （50 mg, 3/d） and routine exercise for 3 months. Hyaluronateacid group received intra-articular injection of hyaluronate acid （4 ml, 1/week） for 4 times on the basis of treatment for control group. Modified WOMAC （Western Ontario and McMaster Universities osteoar thritis index） score was collected at 3 and 6 months to evaluate the treatment effect. Results There was no statistical difference in baseline data between the two groups. The WOMAC score in the hyaluronateacid group and the control group were 36.15 ± 10.56 vs 34.00± 11.23 （P=0.54） at 3 months, and 30.15 ± 11.30 vs 26.50± 12.43 （P=0.34） at 6 months, without significant difference. Conclusion The combination of oral medication, exercise and intra-articular injection of hyaluronate acid is not superior to oral medication combined with exercise for KOA. We do not recommend intra-articular hyaluronateacid as standard treatment for KOA patients.
作者
苏祥正
李众利
李冀
张浩
刘春晖
SU Xiangzheng;LI Zhongli;LI Ji;ZHANG Hao;LIU Chunhui(Department of Orthopedics, Chinese PLA General Hospital, Beijing 100853, China)
出处
《解放军医学院学报》
CAS
2018年第6期484-486,共3页
Academic Journal of Chinese PLA Medical School
关键词
骨关节炎
玻璃酸钠
硫酸氨基葡萄糖
功能锻炼
osteoarthritis
sodium hyaluronate
glucosamine sulfate
functional exercise
作者简介
苏祥正，男，在读博士，医师。研究方向：运动医学。Email：sxz19891205@163．com;通信作者：李众利，男，博士，主任医师，教授，主任。Email：lizhongli@263．net
