关节内注射复方双氯芬酸钠治疗中重度骨关节炎的临床研究

Clinical Study of Intra-articular Injection of Compound Diclofenac Sodium in the Treatment of Moderate and Severe Osteoarthritis

目的:探究关节内注射复方双氯芬酸钠治疗中重度骨关节炎的临床应用价值。方法:选取2017年3月至2018年3月本院收治的中重度骨关节炎患者94例,采用随机字母表法随机分为2组,对照组及观察组各47例,对照组采用双氯芬酸钠利多卡因注射液治疗,观察组关节内注射复方双氯芬酸钠,对比两组患者总有效率、骨关节炎指数、生存质量及不良反应发生率,检测白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、前列腺素E2(PGE2)水平。结果:观察组经治疗后总有效率为95.74%明显较对照组78.72%高,差异有统计学意义(P<0.05);两组经治疗后疼痛、僵硬、生理功能及总分均显著低于治疗前,且观察组较对照组低,差异有统计学意义(P<0.05);两组经治疗后IL-1,TNF-ɑ及PGE2均显著低于治疗前,且观察组较对照组低,差异有统计学意义(P<0.05);两组经治疗后世界卫生组织生存质量测定量表简表(WHOQOL-BREF)各项评分均显著高于治疗前,且观察组较对照组高,差异有统计学意义(P<0.05);观察组不良反应发生率为10.64%,明显较对照组29.79%低,差异有统计学意义(P<0.05)。结论:中重度骨关节炎患者采用关节内注射复方双氯芬酸钠治疗效果显著,达到抗炎镇痛作用,明显缓解临床症状,提高生存质量,安全性更高,值得临床推广应用。

Objective:To explore the clinical application value of intra-articular injection of compound diclofenac sodium in the treatment of moderate and severe osteoarthritis.Methods:94 patients with moderate and severe osteoarthritis were selected from March 2017 to March 2018,random alphabet method was used to divide them into two groups randomly,47 cases in control group and 47 cases in observation group,the control group was treated with diclofenac sodium lidocaine injection,while the observation group was treated with compound diclofenac sodium intra-articular injection,the total effective rate,osteoarthritis index,quality of life and incidence of adverse reactions were compared between the two groups,the levels of interleukin-1(IL-1),tumor necrosis factor-α(TNF-α) and prostaglandin E2(PGE2) were measured.Results: After treatment,the total effective rate of the observation group was 95.74%,which was significantly higher than 78.72% of the control group(P<0.05).The pain,stiffness,physiological function and total scores of the two groups after treatment were significantly lower than those before treatment,and the observation group was lower than the control group(P<0.05).After treatment,the levels of IL-1,TNF-α and PGE2 in the two groups were significantly lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05);the scores of World Health Organization quality of life scale(WHOQOL-BREF) in the two groups after treatment were significantly higher than those before treatment,and the observation group were higher than the control group(P<0.05).The incidence of adverse reactions in the observation group was 10.64%,which was significantly lower than 29.79% in the control group(P<0.05).Conclusion:Intra-articular injection of compound diclofenac sodium is effective for moderate and severe osteoarthritis,it can achieve anti-inflammatory and analgesic effects,relieve clinical symptoms,improve the quality of life,and have higher safety,it is worthy of clinical application.