局部与关节腔内注射治疗膝骨关节炎临床观察

Clinical observation of trigger point injection combined with intra-articular injection in the treatment of knee osteoarthritis

目的探讨局部痛点联合关节腔内注射治疗膝骨关节炎的临床疗效及不良反应。方法将膝骨关节炎患者96例随机分成3组：A组予膝关节周围压痛点注射配制药液治疗；B组予膝关节腔内注射透明质酸钠治疗；C组予局部痛点注射联合透明质酸钠关节腔内注射治疗，3组均为每周1次，连续4次。结果4周后，c组HSS评分明显高于A、B组（P〈0．05），C组VAS评分明显低于A、B组（P〈0．05）；A、B、C组膝关节AROM度数均高于治疗前（P〈0．05）。结论曲安奈德局部注射联合透明质酸钠关节腔内注射治疗能更有效地缓解膝骨关节炎疼痛，但在改善关节活动度方面并无明显优势。

Objective To investigate the clinical efficacy and adverse reactions of trigger point injection combined with intra-articular cavity injection in the treatment of knee osteoarthritis. Meth- ods Ninety-six patients with knee osteoarthritis were randomly divided into three groups. Prepara- tion of drug solution with triamcinolone acetonide and lidocaine was injected into the trigger point of the knee in group A, and sodium hyaluronate into knee joint cavity in group B. The two methods in groups A and B were combined in group C, once a week, four times per a treatment course. Results After 4 weeks, HSS score in group C was significantly higher than that in group A and group B （P 〈0.05）, VAS in group C was significantly lower than that in group A and group B （P〈0.01） ; The degrees of knee AROM were improved in all the three groups after treatment, but no significant difference was found among the three groups （P〉0.05）. Conclusion Trigger point injection of tri- amcinolone acetonide combined with intra-articular cavity injection of sodium hyaluronate is more effective in relieving knee joint pain, but no obvious advantage in improving joint mobility.