艾瑞昔布联合玻璃酸钠治疗膝骨关节炎的早期疗效分析

Early efficacy of imrecoxib combined with hyaluronic acid sodium in treatment of knee osteoarthritis

背景:选择性环氧合酶-2抑制剂应用于膝骨关节炎越来越广泛,而关节内注射黏多糖类药物可促进关节软骨的修复,缓解疼痛和延缓病情的发展。目的:比较艾瑞昔布、玻璃酸钠、艾瑞昔布联合玻璃酸钠治疗膝骨关节炎的疗效。方法:选取2017年1月至2018年1月膝骨关节炎患者150例,随机分为艾瑞昔布组、玻璃酸钠组、艾瑞昔布联合玻璃酸钠组,每组各50例。单盲给药,艾瑞昔布100 mg,餐后用药,每日2次,连续8周为1个疗程;玻璃酸钠注射液2.5ml膝关节腔内注射,每周1次,连续5周为1个疗程。记录患者在治疗前和治疗后1个月、3个月及6个月的膝关节功能评分(WOMAC)、Lysholm评分、疼痛视觉模拟评分(VAS)。结果:治疗前3组患者WOMAC评分、Lysholm评分、VAS评分差异无统计学意义(P>0.05)。治疗后1个月、3个月、6个月联合组患者WOMAC评分、Lysholm评分、VAS评分均优于艾瑞昔布组和玻璃酸钠组(P<0.05)。仅在治疗后1个月患者WOMAC评分、Lysholm评分、VAS评分艾瑞昔布组优于玻璃酸钠组(P<0.05)。治疗后3个月和6个月WOMAC评分、Lysholm评分、VAS评分艾瑞昔布组与玻璃酸钠组比较差异均无统计学意义(P>0.05)。结论:艾瑞昔布、玻璃酸钠、艾瑞昔布联合玻璃酸钠对膝骨关节炎均有良好的治疗效果,艾瑞昔布比玻璃酸钠起效快,但以艾瑞昔布联合玻璃酸钠的治疗效果最佳,值得临床推广。

Background:Selected cyclooxygenase-2 inhibitor has been widely used for knee osteoarthritis.While intra-articu-lar injection of mucopolysaccharide can promote the repair of articular cartilage,relieve pain and delay the progresion of thedisease.Objective:To investigate the clinical effect of imrecoxib combined with intra-articular hyaluronic acid sodium injec-tion in the treatment of knee osteoarthritis.Methods:A total of 150 patients with knee osteoarthritis were recruited from Janu-ary 2017 to January 2018 in our hospital,and randomly divided into three groups as the imrecoxib group given oral imrecoxib(100 mg/d,Bid,for eight weeks),the hyaluronic acid sodium group given intra-articular hyaluronic acid sodium injection(once per week,for five weeks),and the combined treatment group given oral imrecoxib combining with the intra-articular hy-aluronic acid sodium injection with 50 patients in each group.The clinical effects were evaluated before the treatment andone,three and six months after the treatment by WOMAC,Lysholm score and the visual analogue scale(VAS).Results:Therewas no significant difference in WOMAC score,Lysholm score and VAS score among the three groups before treatment(P>0.05).The WOMAC score,Lysholm score and VAS score were all lower in the combined group than in the imrecoxib groupand in the hyaluronic acid sodium group at 1 month,3 and 6 months after treatment(P<0.05).The WOMAC score,Lysholmscore and VAS score were lower in the imrecoxib group than in the hyaluronic acid sodium group at 1 month after treatment(P<0.05).However,there was no significant difference in WOMAC score,Lysholm score and VAS score between the imrecoxibgroup and the hyaluronic acid sodium group at 3 and 6 months after treatment(P>0.05).Conclusions:Imrecoxib,hyaluronic ac-id sodium and imrecoxib combined with hyaluronic acid sodium all have a good therapeutic effect on knee osteoarthritis,andimrecoxib has a faster effect than hyaluronic acid sodium,but the imrecoxib combined with hyaluronic acid sodium has thebest therapeutic effect which is worthy of clinical promotion.