玻璃酸钠合用塞来昔布治疗膝关节骨性关节炎的疗效

Effect of combination of sodium hyaluronate and celecoxib on knee osteoarthritis

目的探讨玻璃酸钠注射液合用塞来昔布治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的疗效。方法选取2017-05至2019-07武警北京总队医院收治的168例KOA患者为研究对象,随机将其分为塞来昔布组、玻璃酸钠组和联合组,每组56例。塞来昔布组,口服塞来昔布;玻璃酸钠组,关节腔内给予玻璃酸钠注射液;联合组,塞来昔布口服+玻璃酸钠注射。治疗4周后,评价三组患者总体有效率、膝关节功能、生活能力、血清软骨寡聚基质蛋白(cartilage oligomeric matrix protein,COMP)和骨桥蛋白(osteopontin,OPN)表达及不良反应等变化情况。结果治疗后,3组患者总有效率存在明显差异,且联合组(94.64%)显著高于塞来昔布组(82.14%)或玻璃酸钠组(78.57%),差异有统计学意义(P<0.05)。治疗后,3组患者膝关节功能评分较治疗前明显升高,且联合组各功能指标均高于塞来昔布或玻璃酸钠单用组(P<0.05);治疗后,3组患者生活能力评分较治疗前明显降低,且联合组各功能指标均低于塞来昔布或玻璃酸钠单用组(P<0.05)。治疗后3组血清COMP及OPN水平较治疗前均明显减低,与塞来昔布或玻璃酸钠单用组比较,联合组血清COMP及OPN水平降低,组间差异有统计学意义(P<0.05)。3组患者不良反应无明显差异。结论玻璃酸钠注射液合用塞来昔布治疗膝关节炎具有更好疗效,可改善膝关节功能及患者生活能力,可能与降低患者COMP及OPN表达有关。

Objective To investigate the effect of sodium hyaluronate combined with celecoxib(CSC)on knee osteoarthritis(KOA)and on expressions of cartilage oligomeric matrix protein(COMP)and osteopontin(OPN).Methods A total of 168 patients with KOA treated in Beijing Municipal Corps Hospital between May 2017 and July 2019 were randomly divided into three groups:celecoxib group(oral administration of celecoxib),sodium hyaluronate group(intra-articular injection of sodium hyaluronate)and CSC group(oral administration of celecoxib and intra-articular injection of sodium hyaluronate),with 56 cases in each group.After four weeks of treatment,the differences in overall efficiency,knee joint function,daily life ability(DLA),serum COM and OPN expressions and adverse reactions were evaluated.Results The total effective rate was significantly different between the three groups(P<0.05).It was significantly higher in the CSC group(94.64%)than in the celecoxib group(82.14%)or in the sodium hyaluronate group(78.57%).After four weeks of treatment,the knee functional scores in each of the three groups were significantly higher,especially in the CSC group(P<0.05).After four weeks of treatment,the DLA scores in the three groups were significantly reduced,especially in the CSC group(P<0.05).The levels of serum COMP and OPN in the three groups were significantly reduced after treatment,particularly in the CSC group(P<0.05).There was no significant difference in the incidence of adverse reactions between the three groups(P>0.05).Conclusions The combination of sodium hyaluronate and celecoxib has better curative effect against KOA,which can improve knee function and daily life ability.Its efficacy may be related to the inhibition of serum COMP and OPN expressions.