膝关节注射玻璃酸钠治疗骨关节炎疗效分析

Effect of oral drug plus joint injection on treatment of knee osteoarthritis

目的观察膝关节内注射玻璃酸钠对膝关节骨关节炎的疗效。方法总结2002年5月至2006年12月门诊和住院按疗程治疗的膝关节骨关节炎患者556例。根据病人的意愿或经济情况分为口服药组(A组,口服羟乙膦酸钠和美洛昔康组)136例(256个关节)、口服药物加膝关节注药组(B组,口服羟乙膦酸钠和止痛药加膝关节注射玻璃酸钠组)400例(636个关节)和单纯膝关节注药组(C组,膝关节注射玻璃酸钠)20例(34个关节)。三组在年龄及性别等方面无明显差异。对比观察三组患者治疗前和治疗1月、3月、半年、1年时10米步行时间、患者自我评价、下蹲活动及运动疼痛、关节肿胀、关节腔积液、骨摩擦音等临床表现。结果治疗1月后,B组、C组在各项观察指标改善情况,除X线改变外其他各项指标均有明显改善,与A组比较差异具有显著性(P<0.05或0.01)。结论玻璃酸钠关节内注射可明显减轻关节局部的症状,增加关节的活动度,疗效优于单用口服药物,口服药加膝关节注射玻璃酸钠优于单纯口服药物和单纯关节注药。

Objective： To observe the effect after knee injection of sodium hyaluronate and oral medication for patients with knee osteoarthritis.Methods： Summary was made of the 556 out-patient and in-patient cases with therapeutic course of treatment from May 2002 to March 2007.According to the wishes or economic conditions of the patients,556 cases were divided into the 3 groups： 136 cases（group A： oral Etidronate Disodium plus one kind of non-steroidal anti-inflammatory analgesic drugs,256 joints）,400 cases（group B ： oral Etidronate Disodium and knee injection group,636 joints） and 20 cases（group C： simple knee injection,34 joints）.There was no obvious difference in such aspects as age and sex in the three groups.Comparison was made about the clinical performance,such as 10 meters walking time,patient self-appraisal,squat activities and sporting pain,joint swelling,joint effusion and bone friction sound of the three groups of patients before treatment and one months,three months,six months,one year after treatment.Results： After the treatment for one month,observation index of group B and C,in addition to X-ray change,were improved significantly.The difference was significant（P〈0.05 or 0.01） with group A.Conclusion： This study shows that for the patients with osteoarthritis of the knee,intra-articular injection of sodium hyaluronate can significantly reduce the symptoms of joint pain and increase joint activities and the curative effect is superior to the use of the oral medicine separately.Oral medicine plus the sodium hyaluronate injection in knee joint is superior to the single oral medicine and simple joint injection.