小剂量复方倍他米松关节腔注射治疗轻度膝骨关节炎的临床观察

Efficacy and safety of low dose compound betamethasone in the treatment of mild knee osteoarthritis

目的:探讨采用关节腔注射小剂量复方倍他米松治疗轻度膝骨关节炎的效果及安全性。方法:2018年9月~2019年12月期间治疗轻度膝骨关节炎患者90例,按治疗顺序分为完全剂量组和小剂量组,每组45例。完全剂量组采用关节腔注射1 mL复方倍他米松注射液和2 mL玻璃酸钠注射液,每周1次,3次为1个疗程;小剂量组关节腔注射0.3 mL复方倍他米松注射液和2 mL玻璃酸钠注射液,每周1次,3次为1个疗程。比较两组患者治疗前后Lysholm评分、美国西安大略与麦克马斯特大学骨关节炎指数评分(The Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)和视觉模拟疼痛评分(visual analogue scale,VAS),评估两种方案的疗效和安全性。结果:80例患者获得随访,随访时间3~8(4.96±1.50)个月,共脱落10例(11.11%),其中完全剂量组5例,小剂量组5例。两组治疗后3、6、12周Lysholm评分、WOMAC评分和VAS评分较治疗前均有明显改善(P<0.001)。治疗后3、6、12周小剂量组Lysholm评分分别为(78.10±2.16)、(86.78±2.55)、(80.90±2.26)分,WOMAC评分分别为(61.00±1.38)、(39.03±1.98)、(45.76±1.66)分,VAS评分分别为(2.23±0.89)、(0.78±0.73)、(1.05±0.85)分,与完全剂量组同一时间点各项评分比较差异均无统计学意义(P均>0.05)。两组均未发生与药物相关的不良反应。结论:使用小剂量复方倍他米松关节腔注射治疗轻度膝骨关节炎的疗效与完全剂量复方倍他米松相当,能改善膝关节功能及症状,且安全性较高,是一种安全有效的治疗方法。

Objective:To investigate the efficacy and safety of intra-articular injection of low-dose compound betamethasone in the treatment of mild knee osteoarthritis.Methods:A total of 90 patients with mild knee osteoarthritis treated in our hospital from September 2018 to December 2019 were divided into complete dose group and low dose group according to the tenrollment sequence with 45 cases in each group.The complete dose group was treated with intra-artiular injection of betamethasone(1 mL)and sodium hyaluronate(2 mL),once a week,three times of treatment was considered as a course of treatment.The low dose group was treated with intra-artiular injection of betamethasone(0.3 mL)and sodium hyaluronate(2 mL),once a week,three times of treatment was considered as a course of treatment.Lysholm scores,the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)as well as visual analogue scale(VAS)were evaluated and compared between the two groups before and after treatment.Efficacy and safety were observed and compared too.Results:The follow-up was conducted for 80 patients for an average of(4.96±1.50)months ranging from 3 to 8 months.Ten cases(11.11%)were lost to follow-up including 5 cases in the complete dose group and 5 cases in the low dose group.Lysholm scores were significantly improved,WOMAC scores and VAS scores were significantly decreased in the both groups 3 weeks,6 weeks and 12 weeks after the treatment comparing with those scores before the treatment(all P<0.001).The Lysholm scores of low dose group were 78.10±2.16,86.78±2.55,80.90±2.26,WOMAC scores were 61.00±1.38,39.03±1.98,45.76±1.66 and VAS scores were 2.23±0.89,0.78±0.73 and 1.05±0.85 in low dose group at 3 weeks,6 weeks and 12 weeks after treatment.No significant difference in the scores at any time points were observed between the two groups(P>0.05).Drug-related adverse reactions were observed in neither of the two groups.Conclusion:Low dose compound betamethasone intra-articular injection improves the function of knee joint and alleviate symptoms in mild knee osteoarthritis,and its efficacy is equivalent to that of complete dose compound betamethasone.