威伐光联合高压氧治疗SLE股骨头缺血坏死的临床研究

Clinical study on water-filtered infrared-A (wIRA) combined with hyperbaric oxygen in the treatment of SLE complicated with avascular necrosis of femoral head

目的评估wIRA联合高压氧(HBO)治疗系统性红斑狼疮(SLE)患者股骨头缺血性坏死(ANFH)的安全性和临床疗效。方法以随机数字表法将56例SLE并ANFH的患者分为HBO治疗组(A组)和wIRA联合HBO治疗组(B组)。A组28例患者接受HBO治疗(10 d为一个疗程,间隔5 d后进行下个疗程),B组28例患者接受wIRA(每天1次,每次30 min)联合HBO治疗。经过25 d治疗后,比较两组的临床治疗效果。结果在疼痛评分、功能评分、活动评分、Harris总分、旋股内动脉血流速、RI和疼痛VAS评分方面,A组治疗前后相比,差异具有统计学意义(P均<0.001),B组具有相同的结果。相较于A组,B组有更高的疼痛评分、功能评分、活动评分和总分(P值分别为0.016,0.004,0.011和0.003)。治疗后,B组较A组有更低RI、疼痛VAS评分和更高的旋股内动脉血流速度(P值均<0.05)。结论 wIRA联合HBO治疗能改善SLE患者ANFH的功能状态和缓解疼痛,较单独应用HBO治疗更有效,wIRA可安全、有效的用于ANFH治疗。

Objective To evaluate the safety and clinical efficacy of wIRA combined with hyperbaric oxygen（HBO） in the treatment of patients with systemic lupus erythematosus（SLE） complicated with avascular necrosis of femoral head（ANFH）. Methods 56 patients with SLE and ANFH were randomly divided into HBO treatment group （group A） and wIRA combined with HBO treatment group （group B） according to the random number table method. 28 patients in group A were given HBO treatment（10 days for a course of treatment, followed by a subsequent course of treatment with an interval of 5 days）. 28 patients in group B were given wlRA（once daily for 30 minutes） combined with HBO. After 25 days of treatment, the clinical effects were compared between the two groups. Results The pain scores, function scores, activity scores, Harris scores, intra-articular arterial blood flow velocity, RI and pain VAS in group A were compared before and after the treatment, and the differences were significantly significant（all P〈0.001）. Group B showed the same results. Group B had higher pain scores, function scores, activity scores and total scores compared to Group A （P values were 0.016, 0.004, 0.011 and 0.003 respectively）. After treatment, group B had lower RI, pain VAS, and higher intra-articular arterial blood flow velocity than group A（all P〈0.05）. Conclusion wlRA combined with HBO can improve functional status and relieve pain for the patients with SLE complicated with ANFH, which is more effective than HBO alone. wlRA is safe and effective in the treatment Of ANFH.