伤筋擦剂外用联合关节腔注射透明质酸钠治疗膝骨关节炎的临床疗效

Knee Osteoarthritis: Clinical Effect of Topical Shangjin Liniment Combined with Injection of Sodium Hyaluronate into Articular Cavity

目的：观察伤筋擦剂外用联合关节腔注射透明质酸钠治疗膝骨关节炎（KOA）的临床疗效及安全性。方法：选择2012年2月~2014年2月我院收治的KOA患者114例,随机分为研究组与对照组各57例。对照组于关节腔内注射透明质酸钠治疗,研究组在此基础上应用伤筋擦剂治疗,疗程均为5周。观察两组临床疗效,不良反应及治疗前后血清白细胞介素1β（IL-1β）及一氧化氮（NO）变化。结果：研究组的总有效率为96.49%,显著高于对照组的84.21%（P〈0.05）;研究组治疗后血清IL-1β及NO水平显著低于治疗前且低于对照组（均P〈0.05）;两组不良反应对比无明显差异（P〉0.05）。结论：伤筋擦剂外用联合关节腔注射透明质酸钠治疗KOA疗效显著,两药优势互补,可以有效降低关节内炎症因子水平且安全可靠,适于临床应用与推广。

Objective： To observe the clinical effect and safety of topical shangjin liniment combined with injection of sodium hyaluronate into articular cavity in the treatment of patients with knee osteoarthritis（KOA）. Methods： A total of 114 patients with KOA,who were treated in Baoji Traditional Chinese Medicine Hospital from February 2012 to February 2014, were selected and randomly divided into study group（n=57） and control group（n=57）. The control group was treated by injecting sodium hyaluronate into articular cavity, while the study group was treated with topical shangjin liniment based on the therapy of the control group, the courses of treatment of the two groups were 5 weeks. Then the clinical effect, adverse reactions and the changes of serum interleukin 1β（IL-1β） and nitric oxide（NO） in the two groups before and after treatment were observed. Results： The total effective rate（96.49%） of the study group was significantly higher than that（84.21%） of the control group（P〈0.05）. The levels of serum IL-1β and NO in the study group after treatment were significantly lower than before treatment and also lower than the control group（P〈0.05）. There was no significant difference in adverse reactions between the two groups（P〈0.05）. Conclusion： Topical shangjin liniment combined with injection of sodium hyaluronate into articular cavity has a remarkable effect in the treatment of patients with KOA. It can effectively reduce the levels of inflammatory factors in the joints, with the advantages of safety and reliability, which is suitable for clinical application and promotion.