木瓜壳寡糖复合营养素对膝骨关节炎的干预研究

Intervention of papaya chitosan oligosaccharide compound nutrient on knee osteoarthritis

目的探讨木瓜壳寡糖复合营养素对膝骨关节炎患者的干预作用。方法选取2020年5月—2021年12月在河北医科大学第三医院就诊的膝骨关节炎患者95例,按照随机数字表法分为2组,随访过程中试验组脱落1例,最终对照组46例、试验组48例完成研究。对照组患者给予双膝关节腔内注射玻璃酸钠注射液,每周1次,每次20 mg,连续注射5周;试验组患者给予木瓜壳寡糖复合营养素口服,每日2次,每次13 g,连续服用15周。观察2组患者干预前后Lequesne指数评分及膝骨关节滑膜厚度、滑膜积液量和滑膜血流的变化情况。结果2组患者不同时间Lequesne指数评分比较差异有统计学意义(P<0.05);试验组干预第10周、第15周Lequesne指数评分均明显低于对照组(P均<0.05)。2组患者不同时间左、右膝骨关节滑膜厚度比较差异均有统计学意义(P均<0.05);试验组干预第10周、15周右膝骨关节滑膜厚度均明显小于对照组(P均<0.05)。2组患者不同时间左、右膝骨关节滑膜积液量比较差异均有统计学意义(P均<0.05);试验组干预第5周、第10周、第15周右膝骨关节滑膜积液量均明显少于对照组(P均<0.05)。2组患者不同时间膝骨关节滑膜血流比较差异有统计学意义(P<0.05),但2组干预后各时间点膝骨关节滑膜血流比较差异均无统计学意义(P均>0.05)。结论口服木瓜壳寡糖复合营养素与关节腔内注射玻璃酸钠均可改善膝骨关节炎患者病情,但口服木瓜壳寡糖复合营养素改善膝骨关节疼痛、肿胀、功能及减少膝骨关节滑膜厚度、滑膜积液量的效果均优于关节腔内注射玻璃酸钠,且改善患者膝骨关节滑膜血流的情况不弱于关节腔内注射玻璃酸钠。

Objective It is to explore the efficacy of papaya chitosan oligosaccharide compound nutrient in the treatment of patients with knee osteoarthritis.Methods Ninety-five patients with knee osteoarthritis treated in the Third Hospital of Hebei Medical University from May 2020 to December 2021 were selected and divided into 2 groups according to the random number table method,and 1 case was shed in the test group during the follow-up,and finally 46 cases in the control group and 48 cases in the test group completed the study.The patients in the control group were given intraarticular injection of sodium hyaluronate once a week,20 mg each time,for 5 weeks;The patients in the test group were given papaya chitosan oligosaccharide compound nutrient orally,twice a day,131 g each time,for 15 weeks.The changes of Lequesne index score,synovial thickness,synovial effusion and synovial blood flow of knee joint were observed before and after the intervention.Results There were statistically significant differences in Lequesne index scores among different times in the two group(all P<0.05);The scores of Lequesne index in the test group at the 10 th and 15 th week of intervention were significantly lower than those in the control group(all P<0.05).The synovial thickness of the left and right knee joints at different times was significantly different in the two groups(all P<0.05);The synovial thickness of the right knee joint in the test group was significantly thicker than that in the control group at the 10th and 15th week of intervention(all P<0.05).There were significant differences in the amount of synovial effusion of left and right knee joints among different times in the two groups(all P<0.05);The amount of synovial effusion of right knee joint in the test group at the 5 th,10 th and 15 th week of intervention was significantly lower than that in the control group(all P<0.05).There was statistically significant difference in the blood flow of knee joint synovium among different time points in the two groups(all P<0.05),but there was no statistically significant difference in the blood flow of knee joint synovium at different time points between the two groups after intervention(all P>0.05).Conclusion Both oral papaya chitosan complex nutrient and intra-articular injection of sodium vitrate could improve the condition of patients with knee osteoarthritis,but oral papaya chitosan complex nutrient was more effective than intra-articular injection of sodium vitrate in improving knee osteoarthritis pain,swelling,function and reducing knee osteoarthritis synovial thickness and synovial fluid volume,and was not less effective in improving synovial blood flow.