关节镜下有限清理术联合塞来昔布治疗膝骨性关节炎临床效果分析

Analysis of the efficacy of limited cleaning under arthroscopy operation combined with celecoxib for knee osteoarthritis

目的分析关节镜下有限清理术联合塞来昔布治疗膝骨性关节炎的临床效果。方法选取2014年9月至2015年8月本院收治的66例膝骨性关节炎患者为研究对象,根据投硬币法将入选患者分为观察组和对照组,每组各33例。对照组患者采取关节镜下有限清理术治疗,观察组患者在对照组治疗基础上口服塞来昔布。比较两组患者治疗前后关节功能评分、炎性因子水平变化、临床疗效及不良反应发生情况。结果观察组患者治疗优良率显著高于对照组(P<0.05)。治疗后两组患者疼痛评分、日常活动评分、关节僵硬评分均较治疗前显著降低(P<0.05),观察组患者各WOMAC评分均显著低于对照组(P<0.05)。治疗后两组患者金属蛋白酶组织抑制因子-1(TIMP-1)、基质金属蛋白酶(MMP)-1、MMP-3、白细胞介素1β(IL-1β)水平均较治疗前显著降低(P<0.05),观察组患者TIMP-1、MMP-1、MMP-3、IL-1β水平均显著低于对照组(P<0.05)。两组患者不良反应发生率比较差异无显著性(χ2=0.0000,P>0.05)。结论关节镜下有限清理术联合塞来昔布治疗膝骨性关节炎,能有效降低患者炎性因子水平,有利于患者膝关节功能的改善,临床疗效良好,安全性高。

Objective To study the efficacy of limited cleaning under arthroscopy operation combined with celecoxib for knee osteoarthritis. Method From September 2014 to August 2015, selected 66 cases of patients with knee osteoarthritis in our hospital according to the coin method, they were divided into observation group and control group, 33 cases in each group. Control group patients were taken limited under arthroscopy cleaning, observation group patients were treated with celecoxib on the basis of control group. The joint function scores and inflammatory factor changes before and after treatment, clinical ecacy and adverse reactions were compared between the two groups. Result Observation group of patients with excellent and good rates was significantly higher than control group （P 〈 0.05）. After treatmen, two groups＇ patients with pain scores, daily activity grading, joint stiffness scores were significantly lower than before treatment （P 〈 0.05）, the WOMAC scores of observation group patients were significantly lower than control group （P 〈 0.05）. After treatment, observation group patients with tissue inhibitor of metalloproteinase-1 （TIMP-1）, matrix metalloproteinase （MMP）-1 and MMP-3, interleukin-1β （IL-1β） inflammatory factor were significantly lower than control group （P 〈 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （χ^2 = 0.0000, P 〉 0.05）. Conclusion Limited cleaning under arthroscopy operation combined with celecoxib can effectively reduce the levels of inflammatory factors in patients with knee osteoarthritis and is helpful for the improvement of the patients with knee joint function, with additional benefits of good clinical curative effect and high safety.