自体富血小板血浆与糖皮质激素关节腔内注射治疗晚期膝骨关节炎疼痛的疗效比较

Comparison of Efficacy of Platelet-rich Plasma vs. Corticosteroid Intra-articular Injection on Advanced Knee Osteoarthritis

目的评价富血小板血浆(PRP)关节腔内注射治疗晚期膝骨关节炎(KOA)的临床疗效。方法选取2014年1月—2016年6月金华市中心医院65例晚期KOA患者,随机分为治疗组(PRP组,30例)和对照组(糖皮质激素混合局部麻醉药,CSA组,35例),两组患者治疗前及治疗1,3,6个月后分别进行疼痛视觉模拟评分(VAS)评估临床表现及临床疗效差异。结果两组患者治疗前VAS评分差异无统计学意义(P>0.05),治疗后1,3,6个月两组患者症状均有所改善,VAS都有所降低,评分差异有统计学意义(P<0.05),但两组间疗效比较差异无统计学意义(P>0.05)。结论PRP关节腔内注射在晚期KOA的患者中能显著减轻疼痛,改善关节功能,提高生活质量,但对晚期KOA的患者,PRP的临床疗效与CSA比较没有明显差别。

Objective To evaluate the clinical efficacy of platelet-rich plasma injection（ PRP） in the treatment of advanced knee osteoarthritis（ KOA） by intra-articular injection. Methods A total of 65 patients with symptomatic KOA（ Kellgren-Lawrence grade Ⅲ to Ⅳ） were enrolled in this study between January 2014 and June 2016. The patients were randomized to treatment group（ group PRP,30 cases） and corticosteroid group（ treated with local anesthetic intra-articular injection,group CSA,35 cases）. All the patients were evaluated respectively before the treatment and 1,3,6 months after the treatment by visual analog scale（ VAS） score. Results Before the treatment,VAS score was not significantly different between the two groups（ P〉0. 05）. One,three,six months after the treatment,symptoms in both groups were improved,and VAS score was significantly decreased（ P〈0.05）,but there were no significant differences between the two groups（ P〉0.05）.Conclusion PRP intra-articular injection is effective for relieving pain,improving function of joint activities and living quality.But for the patients with late-stage KOA,there was no significant difference in clinical efficacy between PRP and CSA.