加巴喷丁联合玻璃酸钠治疗膝骨关节炎的临床研究

Clinical study of gabapentin combined with sodium hyaluronate in treatment of knee osteoarthritis

目的探讨加巴喷丁联合玻璃酸钠对膝骨关节炎患者疼痛及血清炎症因子的影响。方法选择2018年6月—2020年9月于新乡医学院第三附属医院住院治疗的115例膝骨关节炎患者为观察对象,按照随机数字表法分为对照组(n=57)和治疗组(n=58)。对照组膝关节腔注射玻璃酸钠注射液,2 mL/次,1次/周。治疗组患者在对照组基础上口服加巴喷丁片,300mg/次,3次/d。两组均治疗4周。观察两组的临床疗效,比较两组视觉模拟(VAS)评分、炎症因子水平、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、健康状况调查简表(SF-36)评分。结果治疗后,治疗组总有效率是91.38%,显著高于对照组的73.68%(P<0.05)。与治疗前比较,两组患者治疗1、2、4周VAS评分、WOMAC评分均显著降低,但SF-36评分显著升高(P<0.05);且治疗后治疗组相关评分改善优于对照组同期(P<0.05)。与治疗前比较,两组患者治疗1、2、4周血清白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)水平均较治疗前显著降低(P<0.05);且治疗后,治疗组血清炎症因子水平显著低于对照组同期(P<0.05)。结论加巴喷丁联合玻璃酸钠可显著缓解膝骨关节炎患者疼痛症状,减轻炎症反应,改善膝关节功能,提高生活质量。

Objective To investigate the effect of gabapentin combined with sodium hyaluronate on pain and serum inflammatory factors in patients with knee osteoarthritis. Methods 115 Patients with knee osteoarthritis hospitalized in the Third Affiliated Hospital of Xinxiang Medical University from June 2018 to September 2020 were collected and divided into control group(n=57) and treatment group(n=58) according to random number table method. The control group received Sodium Hyaluronate Injection, 2 mL/time, once a week, 4 weeks as a course of treatment. Patients in the treatment group were po administered with Gabapentin Tablets on the basis of the control group, 300 mg/time, 3 times daily, 4 weeks as a course of treatment. After treatment, the clinical efficacy was evaluated,and VAS score, inflammatory factor levels, WOMAC score and SF-36 score were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 91.38%, significantly higher than that of the control group(73.68%)(P <0.05). Compared with before treatment, VAS score and WOMAC score were significantly decreased at 1, 2, and 4 weeks after treatment, but SF-36 score was significantly increased in two groups(P < 0.05). The improvement of the correlation score in the treatment group was better than that in the control group(P < 0.05). Compared with before treatment, serum interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α) levels in two groups were significantly decreased at 1, 2, and 4 weeks after treatment(P < 0.05).After treatment, the level of serum inflammatory factors in the treatment group was significantly lower than that in the control group(P < 0.05). Conclusion Gabapentin combined with sodium hyaluronate can significantly relieve pain symptoms in patients with knee osteoarthritis, and can reduce inflammation, improve knee function and quality of life.