非甾体类抗炎药物对膝关节骨性关节患者镇痛及膝关节功能的影响观察

The effect observation on analgesia and knee joint function of non-steroidal anti-inflammatory drugs for knee osteoarthritis

目的:探讨关节镜联合塞来昔布治疗膝关节骨性关节炎,观察对患者局部肿痛的减轻程度及膝关节功能的改善作用,并分析其不良反应.方法:随机选择2015年10月~2017年4月在本院治疗的膝骨性关节炎患者120例,随机分为对照组和研究组,两组各60例,对照组关节镜下进行清理;研究组应用关节镜联合塞来昔布进行治疗.评估两组患者临床疗效、治疗前后膝关节疼痛、肿胀状况,检测血清TNF-α和IL-6浓度,并评估患者治疗前和治疗后12个月HSS评分和生活质量.结果:研究组患者总有效率为93.33%(56/60),高于对照组83.33%(56/60),差异具有统计学意义.研究组患儿治疗后VAS评分、关节肿胀评分和血清TNF-α和IL-6浓度分别为(2.20±0.31)分、(0.76±0.20)分和(41.18±9.33)ng/mL、(44.32±6.60)μg/L,均低于对照组(3.63±0.29)分、(1.34±0.21)分和(60.57±9.26)ng/mL、(49.20±6.55)μg/L,差异具有统计学意义.研究组治疗12个月后HSS评分和生活质量评分分别为(80.39±5.37)分和(84.65±6.73)分,均高于对照组(75.05±5.26)分和(77.21±6.34)分,差异具有统计学意义.结论:关节镜下清理术联合口服塞来昔布治疗膝骨性关节炎患者,效果确切,能够有效缓解膝关节清理术后患者疼痛程度,降低血清炎性反应,促进膝关节功能恢复和生活质量的提高,临床应用安全.

Objective To explore the arthroscopy combined with celecoxib in the treatment of osteoarthritis of knee osteoarthritis,observe the degree of relief of local swelling and the improvement of knee function,and analyze the adverse reactions.Methods 120 patients with knee osteoarthritis treated at our hospital from October in 2015 to April in 2017,and they were selected and randomly divided into control group and study group,60 patients in each group.Control group treated underwent arthroscopic clean-up,and study group treated by Arthroscopy combined with celecoxib.Evaluated clinic effect,the pain and swelling of the knee joints before and after treatment,and measured serum TNF-αand IL-6 concentrations,and evaluated HSS score and quality of life before and after the treatment 12 months.Results The total effective rate of the study group was 93.33%(56/60),which was higher than the control group 83.33%(56/60),the difference was statistically significant.VAS score,joint swelling score and serum TNF-αand IL-6 concentrations of the study group were(2.20±0.31)points,(0.76±0.20)points and(41.18±9.33)ng/mL,(44.32±6.60)μg/L,lower than the control group(3.63±0.29)points,(1.34±0.21)points and(60.57±9.26)ng/mL,(49.20±6.55)μg/L,the difference was statistically significant.After 12 months of treatment,HSS score and quality of life score of the study group were(80.39±5.37)points and(84.65±6.73)points respectively,which were higher than those of the control group(75.05±5.26)points and(77.21±6.34)points,the difference was statistically significant.Conclusion Arthroscopic debridement combined with oral celecoxib for the treatment of patients with knee osteoarthritis,the effect is clear,which can effectively relieve pain after knee joint surgery,reduce serum inflammatory response,promote knee function recovery and improvement of the quality of life,and clinical application is safety.