玻璃酸钠关节腔注射联合运动疗法对膝关节创伤性关节炎的临床观察

Clinical effect of sodium hyaluronate joint cavity filling combined with exercise therapy on patients with post-traumatic knee arthritis

目的:观察并记录在关节腔内注射玻璃酸钠的基础上给予运动疗法(下肢推蹬运动控制与训练系统)对膝关节创伤性关节炎患者疼痛程度及关节功能的影响,并测量关节液中炎性因子水平。方法:收集100例膝关节创伤性关节炎患者,按照入组先后顺序分为对照组和观察组,每组均为50例,对照组给予口服氨基葡萄糖胶囊+关节腔内注射玻璃酸钠,观察组在对照组的基础上给予下肢推蹬运动控制与训练系统进行视觉反馈下腿部推蹬运动治疗,连续进行4周的治疗。治疗前后采用视觉模拟评分法(visual analogue scale,VAS)评估患者的疼痛程度,同时采用美国特种骨科医院膝关节评分(hospital for special surgery knee score,HSS)对患者膝关节功能进行评定,并检测关节液炎性因子(TNF-α、IL-6、CRP)的变化。结果:治疗后两组VAS评分均低于治疗前(P<0.05),且观察组低于对照组(P<0.05);治疗后两组HSS评分均高于治疗前(P<0.05),且观察组高于对照组(P<0.05);治疗后两组关节液中炎性因子(TNF-α、IL-6、IL-8)均低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。结论:创伤性膝关节炎患者给予关节腔内注射玻璃酸钠的联合运动疗法能改善患者的临床症状。

Objective:To research the sodium hyaluronate joint cavity filling combined with exercise therapy on the indicator of pain,motor function,and levels of inflammatory factors in joint fluid in patients with post-traumatic knee arthritis.Methods:Selecting 100 patients(Department of Orthopaedics,the Second Affiliated Hospital to Liaoning University of Chinese Medicine,2013.10-2018.8)with post-traumatic knee arthritis,then they were divided into the observation group(n=50)and the control group(n=50).The control group was given glucosamine sulfate and sodium hyaluronate joint cavity filling,and the observation group was given leg press with visual feedback,and they were treated 4 weeks.Assessing the pain degree through visual analog scale(VAS),hospital for special surgery knee score(HSS)as the indicator of motor function,inflammatory factor(TNF-α,IL-6,and IL-8)in the joint fluid.Results:The score of VAS were lower than pre-therapy(P<0.05),and the degree of VAS of the observation group were lower than that of the control group(P<0.05).The score of HSS were higher than pre-therapy(P<0.05),and the degree of VAS of the observation group were higher than that of the control group(P<0.05).The inflammatory factor(TNF-α,IL-6,and CRP)in the joint fluid were lower than pre-therapy(P<0.05),and the observation group were lower than the control group(P<0.05).Conclusions:Sodium hyaluronate joint cavity filling combined with exercise therapy can improve the function of joint.