玻璃酸钠关节内注射联合中药外洗治疗膝骨性关节炎的临床研究

Clinical study on the curative effect of intra-articular injection of hyaluronic acid combined with external wash of traditional Chinese medicine on knee osteoarthritis

目的:观察玻璃酸钠关节内注射联合中药外洗治疗膝骨性关节炎的临床疗效。方法:将129例膝骨性关节炎患者随机分为3组,分别采用玻璃酸钠关节内注射(HA)、中药外洗(TCM)、玻璃酸钠关节内注射+中药外洗(HA+TCM)治疗。临床观察膝关节疼痛和肿胀情况,并进行评分,两类评分累加为症状体征积分,以此评价疗效。结果:各组患者从治疗开始后第1周起,症状体征积分均有所降低。随时间延长,症状体征积分逐渐下降。治疗第8周结束后,各组症状体征积分均较治疗前降低(t=10.070,P=0.002;t=20.801,P=0.001;t=55.176,P=0.000);3组间症状体征积分差异有统计学意义(F=8.693,P=0.001);组间两两比较,TCM组症状体征积分高于与HA组和HA+TCM组(q=3.004,P=0.034;q=5.896,P=0.001),HA组症状体征积分高于HA+TCM组(q=2.854,P=0.043)。结论:玻璃酸钠关节内注射联合中药外洗治疗骨性膝关节炎效果良好,起效快且有较长的疗效持续时间,对快速改善患者症状和缩短疗程有非常积极的意义。

Objective：To observe the clinical curative effect of intra-articular injection of hyaluronic acid（HA）combined with external wash of traditional Chinese medicine（TCM）on knee osteoarthritis（KOA）.Methods：129 KOA patients were randomly divided into 3 groups and were administrated with intra-articular injection of hyaluronic acid（HA group）,external wash of TCM（TCM group） and intra-articular injection of HA combined with external wash of TCM（HA＋TCM group）respectively.Pain and swelling situations of knee joint for the patients were observed and scored,and 2 kinds of scores were accumulated as symptom-sign scores which were used to evaluate the curative effect.Results：Symptom-sign scores of the patients in the 3 groups all decreased from the 1st week after the start of the treatment,and the scores gradually decreased with the prolongation of time.At the end of the 8th week after the start of the treatment,symptom-sign scores of the patients were lower than those before the treatment（t=10.070,P=0.002;t=20.801,P=0.001;t=55.176,P=0.000）.There was statistical difference in the symptom-sign scores among the 3 groups（F=8.693,P=0.001）.Symptom-sign scores of TCM group were higher than those of HA group and HA＋TCM group respectively（q=3.004,P=0.034;q=5.896,P=0.001）,while symptom-sign scores of HA group were higher than those of HA＋TCM group（q=2.854,P=0.043）.Conclusion：The method of intra-articular injection of HA combined with external wash of TCM performs well on the treatment of KOA,and its fast action and long term efficacy have positive meanings to rapidly improve the symptoms and shorten the course of treatment for the patients.