草乌甲素联合玻璃酸钠关节腔内注射治疗膝关节骨性关节炎的疗效

Effect of oral Bulleyacinitine A combined with intra-articular injection of sodium hyaluronate on knee osteoarthritis

目的观察口服草乌甲素联合玻璃酸钠关节腔内注射治疗膝关节骨性关节炎(KOA)的疗效和安全性。方法 90例KOA患者随机分入联合治疗组和局部治疗组,每组45例。联合治疗组在玻璃酸钠关节腔内注射的基础上口服草乌甲素片,局部治疗组仅予玻璃酸钠关节腔内注射治疗。采用疼痛视觉模拟评分(VAS评分)评估疼痛情况,Lenquesne和Lysholm膝关节评分总指数评估治疗效果。结果两组治疗后1、2、4、8周的疼痛VAS评分及Lenquesne和Lysholm膝关节评分总指数均显著低于同组治疗前(P值均<0.05),联合治疗组治疗后各时间点的3项评分均显著低于局部治疗组同时间点(P值均<0.05)。治疗6个月后,联合治疗组复发2例(4.4%),局部治疗组复发8例(17.8%),联合治疗组的复发率显著低于局部治疗组(P值均<0.05)。结论草乌甲素联合玻璃酸钠关节腔内注射治疗KOA的疗效持续时间长,不良反应少,复发率低。

Objective To observe the efficacy and safety of oral Bulleyacinitine A combined with intraarticular injection of sodium hyaluronate on knee osteoarthritis. Methods Ninety knee osteoarthritis patients were randomly divided into combined treatment group （oral Bulleyaconitine A and intra-articular injection of sodium hyaluronate） and local treatment group （intra-articular injection of sodium hyaluronate only）, with 45 cases in each group. Visual analogue scale （VAS） score, Lenquesne index and Lyshotm knee scores were used to evaluate the clinical outcomes. Results The VAS scores, Lenquesne index and Lysholm knee scores of two groups at 1, 2, 4 and 8 weeks after treatment were significantly lower than those before treatment （all P〈0.05）, and the three parameters at each time point after treatment in combined treatment group were significantly lower than those in local treatment group （P〈 0. 05）. The recurrence rate in combined treatment group （2 cases, 4.4%） was significantly lower than that in local treatment group （8 cases, 17.8%） 6 months after treatment （P〈0.05）. Conclusion Bulleyacinitine A combined with intra-articular injection of sodium hyaluronate can reduce adverse reaction and recurrence rate for knee osteoarthritis, and the clinical efficacy can last for at least 6 months.