复方骨肽注射液联合玻璃酸钠治疗膝关节骨性关节炎的临床研究

Clinical study on Compound Ossotide Injection combined with sodium hyaluronate in treatment of knee osteoarthritis

目的探讨复方骨肽注射液联合玻璃酸钠注射液治疗膝关节骨性关节炎的临床疗效。方法选取2013年6月—2015年6月榆林市第一医院收治的膝关节骨性关节炎患者192例,随机分为玻璃酸钠组、骨肽组和联合组,每组各64例。玻璃酸钠组清除关节积液后关节腔内注射玻璃酸钠注射液,25 mg/次,1次/周,治疗5周;骨肽组静脉滴注复方骨肽注射液,4~10 m L加入生理盐水250 m L中,1次/d,治疗20 d。联合组采用玻璃酸钠注射液和复方骨肽注射液联合治疗,用法用量、疗程同玻璃酸钠组和骨肽组。观察3组的临床疗效,比较血清学指标和视觉模拟评分(VAS)情况。结果治疗后,玻璃酸钠组、骨肽组和联合组总有效率分别为73.44%、75.00%、90.63%,联合组总有效率明显优于玻璃酸钠组和骨肽组,3组比较差异有统计学意义(P<0.05)。治疗后,3组基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶抑制剂-1(TIMP-1)和肿瘤坏死因子-α(TNF-α)水平均明显下降,同组治疗前后比较差异有统计学意义(P<0.05);且联合组这些指标下降程度明显优于玻璃酸钠组和骨肽组,3组比较差异具有统计学意义(P<0.05)。治疗后,3组VAS评分均明显下降,同组治疗前后比较差异有统计学意义(P<0.05);且联合组VAS评分下降程度明显优于玻璃酸钠组和骨肽组,3组比较差异具有统计学意义(P<0.05)。结论静脉滴注复方骨肽注射液联合关节腔注射玻璃酸钠注射液治疗膝关节骨性关节炎具有较好的临床疗效,能改善临床症状,调节血清学指标,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Compound Ossotide Injection combined with Sodium Hyaluronate Injection in treatment of knee osteoarthritis. Methods Patients（192 cases） with knee osteoarthritis in the First Hospital of Yulin from June 2013 to June 2015 were randomly divided into sodium hyaluronate, ossotide and combined treatment groups, and each group had 64 cases. Patients in the sodium hyaluronate group were intra articular injection administered with Sodium Hyaluronate Injection, 25 mg/time, once weekly, and treated for 5 weeks. Patients in the ossotide group were iv administered with Compound Ossotide Injection, 4 — 10 m L added into normal saline 250 m L, once daily, treated for 20 d. Patients in the combined treatment group were given Sodium Hyaluronate Injection and Compound Ossotide Injection, usage, dosage and course as above. After treatment, the clinical efficacies were evaluated, and serological indexes and VAS scores in three groups were compared. Results After treatment, the clinical efficacies in the sodium hyaluronate, ossotide and combined treatment groups were 73.44%, 75.00%, and 90.63%, respectively, and the clinical efficacies in the combined treatment group were significantly better than those in the sodium hyaluronate and ossotide groups（P〈 0.05）. After treatment, the levels of MMP-3, TIMP-1, and TNF-α in three groups were significantly decreased, and the differences were statistically significant in the same group（P〈 0.05）. And the observational indexes in the combined treatment group were significantly lower than those in sodium hyaluronate and ossotide groups, with significant difference among three groups（P〈 0.05）. After treatment, the VAS scores in three groups were significantly decreased, and the differences were statistically significant in the same group（P〈 0.05）. And the VAS scores in the combined treatment group were significantly lower than those in sodium hyaluronate and ossotide groups, with significant difference among three groups（P〈 0.05）. Conclusion Compound Ossotide Injection combined with Sodium Hyaluronate Injection has clinical curative effect in treatment of knee osteoarthritis, can improve clinical symptoms, and regulate serological indexes, which has a certain clinical application value.