隐神经射频热凝联合臭氧关节腔注射治疗膝关节骨性关节炎疼痛的疗效分析

Analysis about the Efficacy of Saphenous Nerve Radiofrequency Thermocoagulation Combined with Ozone Intra-articular Injection in the treatment of knee osteoarthritis pain

目的 观察隐神经射频热凝联合臭氧局部注射治疗膝骨关节炎疼痛的效果。方法 收集某医院疼痛科就诊的经Kellgren-Lawrence(K-L)分级量表评估级别2级及以上患者,治疗组给予射频热凝联合臭氧注射治疗,并外涂雪山金罗汉止痛涂膜剂,对照组仅给予射频热凝联合臭氧注射治疗。治疗时间1个月。于治疗前、治疗后1 d、1、3、6个月采用视觉模拟评分法(VAS)评估关节疼痛状况,及日本膝关节骨关节炎功能评估量表(JKOM)评估关节功能;治疗后6个月评价治疗效果。结果 两组一般资料对比差异无统计学意义,P> 0.05;两组治疗前VAS及JKOM评分对比早期患者情况优于晚期患者P <0.05;治疗前后VAS及JKOM评分对比差异有统计学意义,P <0.05;治疗后不同时间段VAS及JKOM评分对比差异无统计学意义,P> 0.05;治疗效果对比治疗组早期及不耐受药物者优效8/13(61.5%),良效5/13(38.8%),优良率13/13(100%);晚期及不耐受手术者优效7/32(21.9%),良效20/32(62.5%),可效5/32(15.6%),优良率27/32(84.4%);对照组早期及不耐受药物者优效8/14(57.1%),良效6/14(42.8%),优良率14/14(100%);晚期及不耐受手术者优效5/30(16.7%),良效18/30(60.0%),可效7/30(23.3%),优良率23/30(76.7%)。早期及不耐受药物疗效优于晚期及不耐受手术者。结论 隐神经射频热凝联合臭氧局部注射加雪山金罗汉止痛涂膜剂对膝骨性关节炎患者疼痛及关节功能具有较好改善的效果。

Objective To observe the effect of radiofrequency thermocoagulation of saphenous nerve combined with local ozone injection on knee osteoarthritis pain. Methods Patients who were evaluated by the Kellgren-Lawrence(KL)and diagnosed as Grade 2and more at the department of pain were selected. Treatment group were treated with radiofrequency thermocoagulation combined with intra-articular injection and external application of Xueshan Jinluohan odynolysis film for one month. Control group were treated with radiofrequency thermocoagulation combined with intra-articular injection. Before treatment, and 1 d, 1, 3, and 6 months after treatment,the visual analogue scale(VAS)was used to assess joint pain, and the Japanese Knee Osteoarthritis Function Assessment Scale(JKOM)was used to assess joint function. 6 months after treatment, the therapeutic effect was evaluated based on the joint function score and the therapeutic effects at different disease stages were also evaluated. Results There were no significant difference between the two groups(P>0.05). VAS and JKOM scores between the two groups before treatment in the early stage patients were better than those in the late stage patients,(P < 0.05). There were statistically significant differences in VAS and JKOM scores before and after treatment(P < 0.05).There was no statistically significant difference in VAS and JKOM scores at different time after treatment,(P > 0.05). The patients in early stage and patients having drug intolerance had the excellent effect with 8/13(61.5%), the good effect with 5/13(38.8%). The excellent and good rate was 13/13(100%). In the patients with late stage and intolerant surgery, the excellent effect was 7/32(21.9%), the good effect was 20/32(62.5%), and the fair effect was 5/32(15.6%), and the excellent and good rate was 27/32(84.4%). In the control group during the early stage, the excellent effect was 8/14(57.1%), the good effect was 6/14(42.8%), and the excellent and good rate was 14/14(100%). In the patients in late stage and having intolerant surgery, the excellent effect was 5/30(16.7%), the good effect was 18/30(60.0%), and the fair effect was 7/30(23.3%), and the excellent and good rate was 23/30(76.7%). The efficacy in patients with early stage and intolerant drugs was better than that of patients with late stage and intolerant surgery. Conclusion The saphenous nerve radiofrequency thermocoagulation combined with ozone local injection and Xueshan Jinluohan odynolysis film has a good effect on the pain and joint function of patients with knee osteoarthritis, especially in the patients in early stage and patients having intolerant drugs.