度洛西汀口服联合关节腔内脉冲射频对膝骨关节炎的近期疗效

The short-term efficacy of intra-articular pulsed radiofrequency combined with oral duloxetine for the treatment of patient with knee osteoarthritis

目的观察度洛西汀口服联合关节腔内脉冲射频治疗膝骨性关节炎的临床疗效。方法收集2019年1月至2021年1月佛山市第一人民医院疼痛科和康复科确诊为膝骨关节的炎住院患者48例,采用随机数字表法将其分为脉冲射频治疗组(C组)和度洛西汀联合治疗组(D组),每组24例。C组仅行关节腔脉冲射频治疗,参数设置为电压45 V、频率2 Hz、脉宽20 ms、温度42℃,时间15 min;D组在C组治疗基础上联合口服度洛西汀(30 mg/次,2次/d,连续8周)。分别于治疗前、治疗后1、4和8周时记录并比较两组患者视觉模拟评分(VAS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)。结果治疗后1、4、8周时VAS评分C组分别为[(5.4±1.8)、(3.2±1.2)和(3.3±1.8)]分;WOMAC评分C组分别为[(43±6)、(38±4)和(36±4)]。与C组比较,D组治疗后4、8周时的VAS评分和WOMAC评分均降低更明显(P均<0.05),两组患者疼痛症状缓解,膝关节功能改善。结论度洛西汀口服联合关节腔内脉冲射频治疗和关节腔内单纯脉冲射频治疗两种方法治疗膝骨关节炎,均能有效缓解患者疼痛及改善膝关节功能,但前者效果更佳。

Objective To observe the efficacy of intra-articular pulsed radiofrequency combined with oral duloxetine for the treatment of knee osteoarthritis.Methods Forty-eight patients with knee osteoarthritis in the Painology Department and Rehabilitation Department of Foshan First People's Hospital from January 2019 to January 2021 were collected.The patients were divided into pulsed radiofrequency therapy group(group C)and duloxetine combined therapy group(group D)by the random number table,with 24 patients in each group.Patients were only treated with pulsed radiofrequency(voltage 45 V,frequency 2 Hz,pulse width 20 ms,temperature 42℃,15 minutes)in the group C,while patients were treated by pulsed radiofrequency and oral duloxetine(30 mg/time,2 times/d,a total of 8 weeks)in the group D.The visual analogue scale(VAS)and Western Ontario and McMaster University Osteoarthritis Index(WOMAC)were recored before and at 1 week,4 weeks,and 8 weeks after the treatment respectively.Results The VAS were[(5.4±1.8),(3.2±1.2),(3.3±1.8)]at 1 week,4 weeks,and 8 weeks after the treatment respectively in group C,which were all decreased compared with those before the treatment(all P<0.05).WOMAC were[(43±6),(38±4),(36±4)]at 1 week,4,and 8 weeks after the treatment in the group D,which were all decreased compared with those before the treatment(all P<0.05).Compared with the group C,the VAS and WOMAC were better at 4 weeks and 8 weeks after the treatment in the group D(P<0.05).Conclusion Both oral duloxetine combined with intra-articular pulsed radiofrequency and intra-articular pulsed radiofrequency are effective in short-term to treat the knee joint osteoarthritis,but the oral duloxetine combined with intra-articular pulsed radiofrequency is better.