不同剂量阿魏酸钠治疗膝关节骨性关节炎疗效观察

Effect of Different Doses of Sodium Ferulate in the Treatment of Knee Osteoarthritis

目的观察采用不同剂量阿魏酸钠关节腔注射治疗膝关节骨性关节炎(KOA)的临床效果。方法选择2015-2018年沈阳中大骨科医院收治的KOA患者160例,随机分为对照组、低剂量组、中剂量组和高剂量组各40例。对照组采用玻璃酸钠注射液膝关节关节腔注射治疗,20mg/次;其余治疗组在对照组基础上加用阿魏酸钠注射液,剂量分别为25mg/次、50mg/次和75mg/次;每周膝关节关节腔注射治疗1次,疗程共计5周,比较治疗前后各组间超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)水平和膝关节奎森功能演算指数(Lequesne评分)。结果各组治疗前SOD、MDA、TNF-α和Lequesne评分差异均无统计学意义(P〉0.05)。治疗后,SOD呈上升趋势,MDA、TNF-α和Lequesne评分呈下降趋势,各组组内比较差异均有统计学意义(P<0.05)。而中剂量组和高剂量组指标优于低剂量组和对照组,差异有统计学意义(P<0.05);中剂量组和高剂量组之间,低剂量组和对照组之间差异均无统计学意义(P>0.05)。结论在玻璃酸钠基础上,联合应用阿魏酸钠关节腔注射治疗KOA疗效确切,且呈一定程度的剂量依赖性。

Objective To observe the clinical effect of different doses of sodium ferulate intra-articular injection on knee osteoarthritis(KOA).Methods A total of 160 patients with KOA admitted to our hospital from 2015 to 2018 were randomly divided into control group,low dose group,medium dose group and high dose group,40 cases in each group.The control group was treated with sodium hyaluronate injection into the articular cavity of the knee joint,20 mg/time.The other treatment groups were treated with sodium ferulate injection on the basis of the control group,dosage at 25 mg/time,50 mg/time and 75 mg/time,respectively;once a week,the treatment course was 5 weeks.The levels of superoxide dismutase(SOD),malondialdehyde(MDA)and tumor necrosis alpha(TNF-alpha),and Lequesne score of knee joint function were compared before and after treatment.Results There was no significant differences in SOD,MDA,TNF-alpha and Lequesne scores before treatment in all groups(P>0.05).After treatment,SOD showed an upward trend,while MDA,TNF-alpha and Lequesne scores showed a downward trend.There were significant differences among the intra-groups(P<0.05).The indexes of middle dose group and high dose group were significantly better than those of low dose group and control group(P<0.05);there was no statistical differences between middle dose group and high dose group,and between low dose group and control group(P>0.05).Conclusion The sodium hyaluronate,combined with intra-articular injection of sodium ferulate for KOA is effective and dose-dependent.