臭氧疗法在膝关节骨性关节炎慢性疼痛患者治疗中的效果及作用机制

Effect and mechanism of ozone therapy in the treatment of patients with chronic pain of knee osteoarthritis

目的探讨臭氧疗法治疗膝关节骨性关节炎(KOA)慢性疼痛患者的临床效果及可能的作用机制。方法将2017年1月至2019年1月在西安市长安医院疼痛科接受诊治的82例KOA慢性疼痛患者采用简单随机化分组法分为对照组和观察组,各41例。对照组接受关节腔内注射玻璃酸钠治疗,观察组在对照组基础上注射医用臭氧。比较两组治疗前、后疼痛症状、Lysholm膝关节功能评分及血清白细胞介素-1β(IL-1β)、基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)和一氧化氮(NO)变化情况。结果治疗后,观察组NRS评分和血清IL-1β、MMP-9、TNF-α、NO水平均明显低于对照组,Lysholm膝关节功能评分和血清TGF-β1水平明显高于对照组(P<0.05)。结论关节腔内注射医用臭氧可有效缓解KOA慢性疼痛患者关节疼痛,改善膝关节功能,这可能与其显著下调关节腔内炎症介质合成释放有关。

Objective To explore the clinical effect and possible mechanism of ozone therapy in the treatment of patients with chronic pain of knee osteoarthritis(KOA).Methods A total of 82 patients with KOA chronic pain who were treated in the pain department of Xi'an chang'an hospital from January 2017 to January 2019 were divided into control group and observation group by the simple randomized grouping method,with 41 cases in each group.The control group received intra-articular injection of sodium hyaluronate treatment,the observation group was injected medical ozone on the basis of the control group.Pain symptom,Lysholm knee function scores and serum interleukin-1β(IL-1β),matrix metalloproteinase-9(MMP-9),tumor necrosis factor-α(TNF-α),transforming growth factor-β1(TGF-β1)and nitric oxide(NO)were compared between the two groups before and after treatment.Results After treatment,the NRS score and serum IL-1β,MMP-9,TNF-α,and NO levels in the observation group were significantly lower than those in the control group,the Lysholm knee function score and serum TGF-β1 level were significantly higher than those in the control group(P<0.05).Conclusion Intra-articular injection of medical ozone can effectively alleviate joint pain and improve knee function in patients with KOA chronic pain,which may be related to its significant down-regulation of the release of inflammatory mediators in the joint cavity.