依托考昔联合透明质酸钠对膝关节骨性关节炎患者疼痛及炎性因子水平的影响

Effects of etoricoxib and sodium hyaluronate on pain and inflammatory factors in patients with knee osteoarthritis

目的:探讨依托考昔联合透明质酸钠对膝关节骨性关节炎(KOA)患者疼痛及炎性因子水平的影响。方法:选取2018年3月至2020年10月南方医科大学珠江医院收治的106例KOA患者为研究对象,采用随机数字表法分为对照组和研究组,每组53例。对照组行透明质酸钠治疗,研究组在对照组的基础上另给予依托考昔治疗,两组均持续治疗4周后观察效果。对比两组临床疗效及治疗前后的膝关节功能、疼痛、炎性因子变化情况,记录治疗期间不良反应发生情况。结果:研究组总有效率高于对照组[92.45%(49/53)比77.36%(41/53)],差异有统计学意义(P<0.05)。两组治疗后的美国膝关节协会评分(AKS)、Lysholm评分均高于治疗前,研究组治疗后的AKS评分、Lysholm评分均高于对照组[(171.84±24.16)分比(159.09±22.21)分、(81.62±14.76)分比(75.41±13.58)分],差异有统计学意义(P<0.05)。两组治疗后的疼痛视觉模拟评分(VAS)均低于治疗前,研究组治疗后的VAS评分低于对照组[(3.01±0.54)分比(3.45±0.64)分],差异有统计学意义(P<0.05)。两组治疗后的白细胞介素-1β(IL-1β)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)水平均低于治疗前,研究组治疗后的TIL-1β、MMP-3、MMP-9均低于对照组[(56.38±9.67)μg/L比(62.19±10.73)μg/L、(91.56±15.18)μg/L比(98.09±16.74)μg/L、(30.46±5.59)μg/L比(35.03±6.27)μg/L],差异有统计学意义(P<0.05)。两组总不良反应发生率比较差异无统计学意义(P>0.05)。结论:托考昔联合透明质酸钠治疗KOA可提高临床疗效,改善膝关节功能,减轻疼痛,降低炎性因子水平,安全性良好。

Objective To explore the effects of etoricoxib combined with sodium hyaluronate on pain and inflammatory factors in patients with knee osteoarthritis(KOA).Methods A total of 106 KOA patients admitted to Zhujiang Hospital of Southern Medical University were selected as the research objects from March 2018 to October 2020,and they were divided into a control group and a study group using a random number table method,with 53 cases in each group.The control group was treated with sodium hyaluronate,and the study group was treated with etoricoxib on the basis of the control group.The effects of both groups were observed after continuous treatment for 4 weeks.The clinical efficacy and changes of knee joint function,pain and inflammatory factors before and after treatment were compared between the two groups,and the occurrence of adverse reactions during the treatment period was recorded.Results The total effective rate of the study group was higher than that of the control group:92.45%(49/53)vs.77.36%(41/53),the difference was statistically significant(P<0.05).The American Knee Association score(AKS)and Lysholm score after treatment in the two groups were higher than before treatment(P<0.05),and the AKS score and Lysholm score in the study group after treatment were higher than control group:(171.84±24.16)scores vs.(159.09±22.21)scores,(81.62±14.76)scores vs.(75.41±13.58)scores,the difference was statistically significant(P<0.05).The visual analogue score(VAS)of pain after treatment in the two groups was lower than before treatment,and the VAS score of the study group after treatment was lower than the control group:(3.01±0.54)scores vs.(3.45±0.64)scores.the difference was statistically significant(P<0.05).The levels of interleukin-1β(IL-1β),matrix metalloproteinase-3(MMP-3)and matrix metalloproteinase-9(MMP-9)after treatment in the two groups were lower than before treatment,TIL-1β,MMP-3,and MMP-9 of the study group after treatment were lower than the control group:(56.38±9.67)μg/L vs.(62.19±10.73)μg/L,(91.56±15.18)μg/L vs.(98.09±16.74)μg/L,(30.46±5.59)μg/L vs.(35.03±6.27)μg/L,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusions Tocoxib combined with sodium hyaluronate in the treatment of KOA can improve the clinical efficacy,improve knee joint function,relieve pain,reduce the level of inflammatory factors,and have good safety.