关节腔注射消炎镇痛液联合臭氧治疗股骨头坏死的临床疗效及安全性评价

Evaluation of the clinical efficacy and the safety of intra-articular injection of anti-inflammatory and analgesic therapy was combined with ozone osteonecrosis

目的探讨关节腔注射消炎镇痛液联合臭氧治疗股骨头坏死(ONFH)的临床疗效及安全性。方法将80例ONFH患者随机分为对照组(n=38)与观察组(n=42)。对照组采用口服双氯芬酸钠联合氨基葡萄糖胶囊治疗,观察组采用关节腔注射消炎镇痛液联合臭氧治疗。比较两组临床疗效、治疗前后骨坏死改善情况评分、治疗前后视觉模拟评分(VAS)、Harris总评分及股骨头坏死体积变化情况、治疗后生活质量评分及不良反应发生情况。结果观察组临床总有效率为85.71%,显著高于对照组(63.16%)(P<0.05);两组治疗后骨坏死改善情况(疼痛、功能、关节活动度、X线片评价及总得分)评分均显著优于治疗前(P<0.05,P<0.01),且观察组治疗后上述评分均显著优于对照组治疗后(P<0.05);两组治疗后VAS评分、Harris总评分及股骨头坏死体积均明显优于治疗前,差异均具有统计学意义(P<0.05),且观察组治疗后上述指标更优于对照组(P<0.05);根据SF-36评分标准,观察组治疗后生活质量评分显著高于对照组(P<0.05);观察组不良反应发生率为4.76%,显著低于对照组(18.42%)(P<0.05)。结论关节腔注射消炎镇痛液联合臭氧治疗股骨头坏死(ONFH)的临床疗效显著,安全性高,值得推广应用。

Objective To investigate the clinical efficacy and the safety of intra-articular injection of anti-inflammatory and analgesic therapy was combined with ozone osteonecrosis. Methods Eighty cases of ONFH were randomly divided into the control group（ n = 38） and the observation group（ n = 42） in accordance with the treating method. The control group was given diclofenac combined with glucosamine capsules for treatment,and the observation group were given intra-articular injection of anti-inflammatory and analgesic solution combined with ozone therapy. The clinical efficacy,osteonecrosis improve scores before and after treatment,VAS scores,Harris osteonecrosis total score and volume changes in quality of life scores after treatment and adverse events before and after the treatment were compared. Results The total effective rate of the observation group was 85. 71%,which was significantly higher than the control group（ 63. 16%）（ P〈0. 05）. The treatment of osteonecrosis of the two groups to improve the situation（ pain,function,range of motion,X-ray evaluation sheet and the total score） scores were significantly higher than before treatment（ P〈0. 05,P〈0. 01）. These scores in the observation group after treatment were significantly higher than after treatment（ P〈0. 05）. The VAS scores before and after treatment,Harris and osteonecrosis volume total score differences were statistically significant（ P〈0. 05,P〈0. 01）,and the difference between the two groups after the treatment of these indicators were also statistically significant（P〈0. 05）. The SF-36 score in after treatment group was significantly higher quality of life scores（ P〈0. 05）. In the observation group,response rate was 4. 76%,which was significantly lower than in the control group（ 18. 42%）（ P〈0. 05）. Conclusion Intra-articular injection of anti-inflammatory and analgesic therapy combined with ozone osteonecrosis（ ONFH） had significant clinical efficacy,safety. The application of this method should be promoted.