降钙素联合透明质酸钠治疗绝经后女性膝关节骨性关节炎的疗效分析

Efficacy comparison of calcitonin combined with sodium hyaluronate in treatment of knee osteoarthritis in postmenopause women

目的分析降钙素联合关节腔注射透明质酸钠对绝经后女性膝关节骨性关节炎的远期治疗效果。方法 72例绝经后女性膝骨性关节炎随机分为实验组和对照组,各36例。实验组采用肌肉注射降钙素联合关节腔内注射透明质酸钠治疗。对照组采用关节腔内注射透明质酸钠联合口服氨基硫酸葡萄糖胶囊治疗。2组疗程均为6周。应用Lequesne指数及疼痛视觉模拟评分(VAS)分别于治疗前及治疗后1、6、12个月进行疗效评估。结果 72例均未出现明显降钙素、透明质酸钠注射不良反应,均获得12个月随访。联合治疗1个月,实验组和对照组的Lequesne指数分别为(5.58±1.44)、(6.50±1.31)分,差异无统计学意义(P=0.118)。联合治疗6个月,实验组与对照组Lequesne指数分别为(3.17±1.03)、(4.75±1.22)分;治疗后12个月,实验组与对照组的Lequesne指数分别为(1.42±0.67)、(2.50±1.09)分;实验组Lequesne指数均明显低于对照组(6个月:P=0.002;12个月:P=0.008)。实验组治疗1、6、12个月膝关节VAS疼痛评分分别为(3.08±1.44)、(1.75±0.97)、(1.75±0.75)分,对照组分别为(4.67±1.50)、(3.17±1.34)、(2.58±0.79)分,实验组VAS评分均明显低于对照组(1个月:P=0.015;6个月:P=0.007;12个月:P=0.015)。结论肌肉注射降钙素联合关节腔注射透明质酸钠可以短期内有效改善膝关节骨性关节炎所引起的膝关节疼痛,并能改善膝关节远期功能。

Objective To evaluate the effect of calcitonin combined with intraarticular injection of sodium hyaluronate on knee osteoarthritis in postmenopause women patients. Methods Seventy two women with knee otseoarthritis were randomly divided into test group and control group, with 36 cases each group. The test group were applied with ealcitonin injection （mucle） combined with sodium hyaluronate intraarticular injection, whereas control group were treated with Glucosamine sulfate oral administration combined with sodium hyaluronate intraarticular injection, all patients were treated for 6 weeks. Lequesne index was used for knee function evaluation. Visual Analogue Scale was employed to examine the joint pain management. Results No calcitonin and sodium hyaluronate treatment related adverse effect was reported in 72 patients; all patients were followed up for at least one year in outpatients department by senior physician. Patients in test group exhibited better knee function compared with control group in the six month and twelve month follow-up visit, the mean Lequesne index of test group was significantly lower than control group （6th month： 3.17±1.03 vs 4.75±1.22,P =0.002; 12th month： 1.42±0.67 vs 2.50±1.09, P =0.008）, while the test group patients also presented better pain control, the mean VAS score was significantly lower than control group （lst month： 3.08±1.44 vs 4.67±1.50,P =0.015; 6th month： 1.75±0.97 vs 3.17±1.34,P =0.007; 12th month： 1.75 ±0.75 vs 2.58±0.79,P =0,015）. Conclusion Calcitonin combined with intraarticular injection of sodium hyaluronate can effectively attenuate knee joint pain of postmenopause women with osteoarthritis in a short period time, and also contribute to the knee functional improvement in the long run.