腔内玻璃酸钠注射联合股四头肌训练治疗骨关节炎的效果研究

Effect of cavity sodium hyaluronate injection and quadriceps training on patients with osteoarthritis

目的分析腔内玻璃酸钠注射联合股四头肌训练治疗骨关节炎（OA）的临床疗效。方法选择2012年9月～2013年9月存江两省九江市第三人民医院接受治疗的膝关节OA患者102例作为研究对象，按照随机数表法分为对照组和观察组，每组各51例。观察组患者给予腔内玻璃酸钠注射联合股四头肌训练治疗，对照组患者仅给予单纯腔内玻璃酸钠注射治疗，检测WOMACOA指数及OA严重程度指数、关节液白细胞介素-1β（IL-1β）、肿瘤坏死因子（TNF-α）水平及膝关节活动范围。结果①治疗后，两组患者WOMACOA指数及OA严重程度指数水平均低于治疗前，且观察组WOMACOA指数及OA严重程度指数[（23．19±5．23）、（3．74±0．65）]均低于对照组[（45．37±9．11）、（6．21±1．02）]，两组各指数相比，差异均有统计学意义（均P〈0．05）；②治疗后，两组患者炎症因子水平均低于治疗前，且观察组患者的IL-1β和TNF-α含量[（65．32±7．16）、（31．38±8．21）pg／mL]均低于对照组[（87．39±9．23）、（47．27±9．35）pg／mL]，差异均有统计学意义（均P〈0．05）；③治疗后，两组患者膝关节活动范围水平均高于治疗前，且观察组患者的背伸、屈曲、内收、外展水平均高于对照组（P〈0．05）。结论腔内玻璃酸钠注射联合股四头肌训练可以有效减轻膝关节OA患者的病情，降低关节腔内的炎症因子水平，增加膝关节活动范围。

Objective To analyze the effect of cavity sodium hyaluronate injection and quadrieeps training on patients with osteoarthritis. Methods 102 patients with knee osteoarthritis from September 2012 to September 2013 in the Third People＇s Hospital of Jiujiang City in Jiangxi Province were selected as research subjects and randomly divided into ob- servation group and control group, with 55 patients in each group. Patients in the observation group were given cavity injection of sodium hyaluronate combined with quadriceps training and patients in the control group were given only cav- ity injection of sodium hyaluronate according to random number table, every group had 51 cases. Then WOMAC os- teoarthritis index, OA severity index, synovial fluid IL-1β, TNF-α levels and knee range were detected. Results ①After treatment, WOMAC osteoarthritis index and OA severity index was lower than those before treatment, and WOMAC os teoarthritis index and OA severity index of observation group [（23.19±5.23）,（3.74±0.65）] were lower than those of control group [（45.37±9.11）,（6.21±1.02）], two index in two groups were found statistieally significant difference （all P 〈 0.05）; ②after treatment, inflammatory eytokines levels were lower than those before treatmen, and IL-1β and TNF-α levels of the observation group [（65.32±7.16）,（31.38±8.21） pg/mL] were lower than those of control group[（87.39±9.23）,（47.27± 9.35） pg/mL], the differences were statistically significant （all P 〈 0.05）; ③after treatment, patients knee range was high- er than before, and dorsiflexion, flexion, adduction, abduction levels of the observation groups were higher （P 〈 0.05）. Conclusion Endovascular injection of sodium hyaluronate and quadrieeps training can effectively reduce the knee os- teoarthritis patients condition and reduce intra-articular inflammatory cytokine levels, increased knee range.