膝关节灌洗后注射臭氧及富血小板血浆治疗膝关节骨性炎的疗法对比

Comparison of the efficacy of after knee lavage ozone injection and platelet-rich plasma in the treatment ofknee osteoarthritis

目的观察并比较关节灌洗联合富血小板血浆(Platelet-rich plasma,PRP)及关节灌洗联合注射臭氧(Sodium Hyaluronate Injection)治疗膝关节骨关节炎的疗效。方法某医院疼痛科就诊的膝关节骨性关节炎患者且经Kellgren Lawrence(K-L)分级量表评估级别Ⅱ-Ⅲ级患者123例,随机分为两组,治疗组给予膝关节灌洗后行自体富血小板血浆治疗,对照组给予膝关节灌洗后注射臭氧。于治疗前、治疗后1d、1、3、6、9个月采用视觉模拟评分法(VAS)评估关节疼痛程度,采用骨关节炎指数(WOMAC)评分评估关节功能。结果两组一般资料对比P>0.05,差异无统计学意义;两组治疗后VAS评分均较治疗前低,且随时间呈下降趋势。对照组治疗结束后3个月VAS评分回升,且治疗后第9个月其评分接近于治疗前。治疗组治疗后3、6、9个月VAS评分基本稳定,不随时间延长而升高,两组治疗后VAS评分对比差异有统计学意义,P<0.001;两组治疗结束即时WOMAC评分较治疗前降低,^(a)P<0.01,差异有统计学意义;对照组治疗结束后6个月WOMAC评分回升,且治疗后第9个月其评分接近于治疗前。治疗组治疗后3个月WOMAC评分较低,6及9个月保持稳定,不随时间延长而升高,两组治疗后6及9个月WOMAC评分差异有统计学意义,^(b)P<0.01;两组治疗后白细胞介素均较治疗前降低,治疗组治疗后1、3、6个月测定结果随时间呈下降趋势。对照组治疗结束后3个月白细胞介素水平回升,第6个月其浓度水平接近于治疗前。两组治疗后1个月开始白细胞介素水平差异对比有统计学意义,P<0.001。结论膝关节灌洗后注射富血小板血浆可有效改善膝关节骨性炎患者疼痛症状、功能及降低白细胞介素水平,优于臭氧注射疗法。

Objective To observe the effect of Platelet-rich plasma combined with Knee lavage combined and local ozone injection with Knee lavage external application of on knee osteoarthritis.Methods A total of 123 patients with knee osteoarthritis admitted to the department of pain in a hospital and assessed by Kellgren-Lawrence(K-L)scale levelⅡ-Ⅲwere randomly divided into two groups.Treatment group were treated with Platelet-rich plasma combined with after Knee lavage combined,control group was given ozone injection after knee lavage.Before treatment,1day,1,3,6 and 9months after treatment,the visual analogue scale(VAS)was used to assess the degree of joint pain,and the osteoarthritis Index(WOMAC)was used to assess joint function.Results The difference in comparison of general data between two groups was no statistical significance,P>0.05;VAS scores in both groups were lower after treatment than before treatment,and showed a downward trend over time.The VAS scores of the control group recovered at 3 months after treatment,and at 9 months after treatment,the scores were close to those before treatment,P<0.001.The VAS score of the treatment group was basically stable at 3,6 and 9 months after treatment,and did not increase with the extension of time,and the difference of VAS score between the two groups was statistically significant(P<0.001).At the end of treatment,WOMAC score of the two groups was lower than before treatment,^(a)P<0.01,and the difference was statistically significant;In the control group,WOMAC scores recovered at 6 months after treatment and were close to those before treatment at 9 months after treatment.The WOMAC score of the treatment group was lower at 3 months after treatment,and remained stable at 6 and 9 months after treatment,but did not increase with the extension of time;The difference of WOMAC score at 6 and 9 months after treatment between the two groups was statistically significant,^(b)P<0.01.Interleukin decreased after treatment in both groups compared with before treatment,and the results in the treatment group showed a decreasing trend with time at 1,3 and 6 months after treatment.Interleukin levels in the control group recovered at 3 months after treatment,and at 6 months the concentration level was close to that before treatment.The difference of interleukin level between the two groups from 1 month after treatment was statistically significant,P<0.001.Conclusion Injection of platelet-rich plasma after knee lavage can effectively improve the pain symptoms,function and reduce the level of interleukin in patients with knee osteoarthritis,which is superior to ozone injection therapy.