透明质酸钠联合塞来昔布治疗老年人膝骨关节炎的临床效果观察

Clinical effect of sodium hyaluronate combined with celecoxib in the treatment of osteoarthritis in the elderly patients

目的 探讨透明质酸钠联合塞来昔布治疗老年人膝骨关节炎的治疗效果及应用价值.方法将120例老年膝骨关节炎患者采用随机数字表法分为观察组与对照组,对照组采用曲安奈德膝关节腔注射,观察组采用膝关节腔注射透明质酸钠并口服塞来昔布胶囊治疗,观察两组临床疗效.结果 观察组治疗总有效率为95.00%,对照组治疗总有效率为76.67%,组间对比差异有统计学意义（x2=8.292,P＜0.05）.观察组治疗后一氧化氮浓度（60.11±13.42）μmol/L,诱导型一氧化氮合酶浓度（15.45±4.42）U/mL;对照组治疗后一氧化氮浓度（93.45±20.46）μmol/L,诱导型一氧化氮合酶浓度（23.52±7.76）U/mL;组间差异均有统计学意义（t=10.554、6.999,均P＜0.05）.观察组治疗后Lequesne评分（7.25±2.08）分,VAS评分（2.86±0.95）分;对照组治疗后Lequesne评分（9.89±3.15）分,VAS评分（4.21±1.47）分,组间差异均有统计学意义（t=5.417、5.974,均P＜0.05）.结论 采用透明质酸钠联合塞来昔布治疗老年人膝骨关节炎临床疗效可靠,能够有效改善患者疼痛,降低关节液中的一氧化氮与诱导型一氧化氮合酶浓度,值得在临床上推广应用.

Objective To explore the treatment effect and application value of sodium hyaluronate joint celecoxib in the treatment of senile knee osteoarthritis.Methods According to the digital table,120 elderly patients with knee osteoarthritis were randomly divided into observation group and control group.The control group received injection of triamcinolone acetonide knee joint cavity, the observation group used the knee joint cavity injection of sodium hyaluronate and oral celecoxib capsule treatment.The clinical curative effect was observed in the two groups.Results The total effective rate of the observation group was 95.00%,which of the control group was 76.67%, the difference between the two groups was statistically significant（x2=8.292,P〈0.05）.After treatment, the nitric oxide concentration, induction type concentration of nitric oxide synthase of the observation group were （60.11±13.42）μmol/L, （15.45±4.42）U/mL, which of the control group were （93.45 ±20.46）μmol/L,（23.52±7.76）U/mL, the differences between the two groups were statistically significant（t=10.554,6.999,all P〈0.05）.After treatment, the Lequesne score and VAS score of the observation group were （7.25±2.08）points, （2.86±0.95）points,which of the control group were （9.89±3.15）points, （4.21±1.47） points, the differences between the two groups were statistically significant（t=5.417,5.974,all P〈0.05）.Conclusion The clinical curative effect of sodium hyaluronate combined therapy with celecoxib in the treatment of elderly knee osteoarthritis is reliable, can effectively improve pain in patients with clinical symptoms, reduce joint fluid of induced nitric oxide and the concentration of nitric oxide synthase, it is worthy of popularization and application in clinic.