隐神经脉冲射频联合透明质酸钠关节内注射对保守治无效的膝骨关节炎患者氧化应激和炎症疼痛介质的影响

Effects of Saphenous Nerve Pulsed Radiofrequency Combined with Intra-Articular Injection of Sodium Hyaluronate on Oxidative Stress and Inflammatory Pain Mediators in Patients with Knee Osteoarthritis Who are Ineffective in Conservative Treatment

目的:观察隐神经脉冲射频联合透明质酸钠关节内注射对保守治无效的膝骨关节炎(KOA)患者氧化应激和炎症疼痛介质的影响。方法:选取2021年7月~2022年12月期间我院收治的经保守治无效的127例KOA患者,根据随机数字表法,将患者分为对照组(n=63,接受透明质酸钠关节内注射)和联合组(n=64,接受隐神经脉冲射频联合透明质酸钠关节内注射)。对比两组膝关节疼痛视觉模拟(VAS)评分、Lysholm膝关节功能评分(Lysholm评分)、炎症介质[白介素-1β(IL-1β)、白介素-1(IL-1)、肿瘤坏死因子α(TNF-α)、疼痛介质[P物质(SP)、5-羟色胺(5-HT)、前列腺素E2(PGE2)]、氧化应激指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)]、不良反应。结果:联合组治疗后VAS评分较对照组更低,Lysholm评分较对照组更高(P<0.05)。联合组治疗后MDA较对照组更低,GSH-Px、SOD较对照组更高(P<0.05)。联合组治疗后IL-1β、IL-1、TNF-α较对照组更低(P<0.05)。联合组治疗后SP、5-HT、PGE2较对照组更低(P<0.05)。两组不良反应发生率对比未见差异(P>0.05)。结论:隐神经脉冲射频联合透明质酸钠关节内注射对保守治无效的KOA患者,可缓解疼痛,降低氧化应激和炎症疼痛介质水平,促进膝关节功能恢复,且安全性较好。

Objective: To observe the effects of saphenous nerve pulsed radiofrequency combine with intra-articular injection of sodium hyaluronate on oxidative stress and inflammatory pain mediators in patients with knee osteoarthritis(KOA) who are ineffective in conservative treatment. Methods: 127 KOA patients who were ineffective in conservative treatment in our hospital from July 2021 to December 2022 were selected, according to the random number table method, the patients were divided into control group(n=63, received intra-articular injection of sodium hyaluronate) and combination group(n=64, received saphenous nerve pulsed radiofrequency combine with intra-articular injection of sodium hyaluronate). The knee pain visual analogue(VAS) score, Lysholm knee function score(Lysholm score), inflammatory mediators [interleukin-1β(IL-1β), interleukin-1(IL-1), tumor necrosis factor-α(TNF-α), pain mediators [substance P(SP), 5-hydroxytryptamine(5-HT), prostaglandin E_2(PGE_2)], oxidative stress indexes [superoxide dismutase(SOD), glutathione peroxidase(GSH-Px), malondialdehyde(MDA)] and adverse reactions were compared between two groups. Results: The VAS score in combination group was lower than that in control group post-treatment, and the Lysholm score was higher than that in control group(P<0.05).MDA in combination group was lower than that in control group post-treatment, GSH-Px and SOD were higher than those in control group(P<0.05). IL-1β, IL-1 and TNF-α in combination group were lower than those in control group post-treatment(P<0.05). SP, 5-HT and PGE2in combination group were lower than control group post-treatment(P<0.05). There was no difference in the incidence of adverse reactions between two groups(P>0.05). Conclusion: Saphenous nerve pulsed radiofrequency combined with intra-articular injection of sodium hyaluronate can relieve pain, reduce the levels of oxidative stress and inflammatory pain mediators, and promote the recovery of knee joint function in KOA patients with ineffective conservative treatment, and has good safety.