医用几丁糖膝关节内注射联合康复训练对中期膝骨关节炎患者的疗效分析

Analysis of the effect of medical chitosan intra-knee injection combined with rehabilitation training on patients with knee osteoarthritis in the middle stage

目的观察医用几丁糖膝关节内注射联合康复训练对中期膝骨关节炎患者的临床疗效,血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平,以及西安大略和麦克马斯特大学骨关节调查量表(WOMAC)评分的影响。方法选择2019年1月至2020年6月该院骨科门诊收治的80例中期膝骨关节炎患者作为研究对象,依据随机数字表法将其分成A组、B组,每组40例。A组采用医用几丁糖膝关节内注射疗法,B组采用医用几丁糖联合康复训练治疗,6周为1疗程。评价2组的疗效,比较2组治疗前、疗程结束时及疗程结束后3个月血清PCT、TNF-α、hs-CRP水平及WOMAC评分。结果B组治疗总有效率为92.5%,高于A组的72.5%(P<0.05)。2组疗程结束时、疗程结束后3个月血清PCT、TNF-α、hs-CRP水平及WOMAC评分均低于治疗前,疗程结束后3个月低于疗程结束时(P<0.05),且疗程结束后3个月B组血清PCT、TNF-α、hs-CRP水平及WOMAC评分均低于A组(P<0.05)。结论医用几丁糖膝关节内注射联合康复训练治疗中期膝骨关节炎具有较好疗效,能降低血清PCT、TNF-α、hs-CRP水平,改善膝关节功能状态,值得临床推广使用。

Objective To observe the clinical efficacy of medical chitosan joint injection combined with rehabilitation training on mid-stage knee osteoarthritis patients and its effect on serum procalcitonin(PCT),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and Western Ontario and McMaster University Bone and Joint Survey Scale(WOMAC)scores.Methods From January 2019 to June 2020,80 patients with mid-stage knee osteoarthritis admitted to the orthopedic clinic of the hospital were selected as the research objects.According to the random number table method,they were divided into group A and group B,with 40 cases in each group.Group A was treated with medical chitosan intra-articular injection therapy,and group B was treated with medical chitosan combined with rehabilitation training,6 weeks as a course of treatment.The efficacy of the two groups was evaluated,and the serum levels of PCT,TNF-α,hs-CRP and WOMAC scores were compared before the treatment,at the end of the treatment course,and 3 months after the end of the treatment course.Results The total effective rate of treatment in group B was 92.5%,which was higher than 72.5%in group A(P<0.05).The serum levels of PCT,TNF-α,hs-CRP and WOMAC scores were lower than before treatment at the end of the treatment course and at 3 months after the treatment course in the two groups,and lower than at the end of the treatment course at 3 months after the treatment course(P<0.05),and the serum levels of PCT,TNF-α,hs-CRP and WOMAC scores of group B were lower than those of group A at 3 months after the end of treatment(P<0.05).Conclusion Medical chitosan intra-knee injection combined with rehabilitation training has a good effect in the treatment of mid-stage knee osteoarthritis.It can reduce serum levels of PCT,TNF-α,hs-CRP and improve the functional status of the knee joint.It is worthy of clinical application.