玻璃酸钠关节腔内注射治疗老年膝骨关节炎的临床疗效

Clinical Efficacy of Articular Injection of Sodium Hyaluronate for the Treatment of Senile Knee Osteoarthritis

【目的】探讨玻璃酸钠关节腔内注射治疗老年膝骨关节炎的临床疗效。【方法】120例老年膝骨关节炎患者随机分为治疗组及对照组各60例。对照组患者给予基本治疗，包括口服盐酸氨基葡萄糖胶囊以及理疗。治疗组在基本治疗基础上行膝关节腔内注射玻璃酸钠，每周1次，5周为一疗程。比较两组患者JOA评分、关节功能、下肢肌力、步态等情况，记录不良反应发生情况。【结果】和治疗前相比，治疗1个月及治疗3个月后两组患者的膝骨关节joA评分均有较大改善，且差异有显著性（P〈O．01），治疗后3个月，治疗组患者膝骨关节JOA评分改善程度均优于时照组，且差异有显著性（81．65±3．96VS60．58±4．38，P〈0．01）；治疗后6个月治疗组患者显效率及总有效率明显高于对照组，且差异有显著性（88．33％VS78．33％，P〈0．01）；和对照组相比，治疗过程中治疗组下肢乏力及血压升高总发生率明显降低，且两组相比较差异有显著性（P〈0．05）。【结论】与常规基本治疗相比，膝关节腔内注射玻璃酸钠治疗老年膝骨关节炎更有效，不良反应减少，用药安全，值得临床推广。

[Objective]To explore the clinical efficacy of articular injection of sodium hyaluronate for the treatment of senile knee osteoarthritis. [Methods] Totally 120 elderly patients with knee osteoarthritis were randomly divided into treatment group and control group with 60 patients in each group. The control group was given only basic treatment including oral glucosamine hydrochloride capsules and physical therapy. The treatment group was given knee articular injection of sodium hyaluronate on the basis of basic treatment. One course were once a week for 5 weeks. The JOA scores, joint function, lower extremity muscle strength and gait were recorded and compared between two groups. The incidence of adverse effect was recorded. [Results] Compared with before treatment, knee osteoarthritis JOA scores in two groups 1 month and 3 months after treatment were greatly improved, and there was significant difference（ P 〈0.01）. The improvement of knee osteoarthritis JOA score in the treat- ment group 1 month and 3 months after treatment was better than the control group, and there was significant difference（ P 〈0.01）. The excellence rate and total effective rate in treatment group 6 months after treatment were obviously higher than those in control group, and there was significant difference（ P 〈0.01）. Compared with the control group, the overall incidence rate of lower extremity weakness and blood pressure elevation in treatment group during treatment was decreased obviously, and there was significant difference（ P〈0.01）. [Conclusion] Compared with conventional basic therapy, knee articular injection of sodium hyaluronate for the treatment of senile knee osteoarthritis is more effective, and reduces the adverse reactions, and the medication is safety. Therefore, it is worthy of clinical promotion.