臭氧配合玻璃酸钠关节腔注射治疗对膝骨关节炎患者关节功能、疼痛程度及前列腺素E_2、白细胞介素-1β、肿瘤坏死因子-α的影响

Effect of Ozone Combined with Sodium Hyaluronate Intra-articular Injection on Joint Function,Pain Degree and PGE_2, IL-1β, TNF-α in Patients with Knee Osteoarthritis

目的探讨臭氧配合玻璃酸钠关节腔注射治疗对膝骨关节炎患者关节功能、疼痛程度及前列腺素E_2(PGE_2)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)的影响。方法选取2016年2月至2018年3月大连大学附属中山医院收治的膝骨关节炎患者92例作为研究对象,按随机数字表法分为对照组和观察组,每组46例。对照组患者采用玻璃酸钠关节腔注射治疗,观察组患者在对照组的基础上加用臭氧治疗,观察两组患者治疗前后关节功能、疼痛程度、PGE_2、IL-1β、TNF-α的变化。结果治疗前,两组患者膝关节功能评分量表(Lysholm)评分比较,差异无统计学意义(P>0.05);观察组患者治疗后1个月、3个月Lysholm评分明显高于同期对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患者视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);观察组患者治疗后1个月、3个月VAS评分明显低于同期对照组,差异均有统计学意义(均P<0.05);治疗前,两组患者血清PGE_2、IL-1β、TNF-α水平比较,差异均无统计学意义(P>0.05);观察组患者治疗后上述血清因子水平均低于对照组,差异均有统计学意义(均P<0.05)。结论臭氧配合玻璃酸钠关节腔注射可以提高患者的关节功能,减轻疼痛程度,也能抑制PGE_2、IL-1β、TNF-α的表达。

Objective To investigate the effects of ozone combined with sodium hyaluronate intra-articular injection on joint function, pain degree, prostaglandin E2(PGE2), interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α) in patients with knee osteoarthritis. Methods A total of 92 patients with knee osteoarthritis admitted in Affiliated Zhongshan Hospital of Dalian University from Feb 2016 to Mar 2018 were randomly divided into the control group(46 cases) and the observation group(46 cases). The control group was treated with sodium hyaluronate intra-articular injection, and the observation group was treated with ozone combined with sodium hyaluronate intra-articular injection. The joint function, pain degree, PGE2, IL-1β and TNF-α of the 2 groups were observed before and after treatment. Results Before the treatment, there was no significant difference in the knee function scores(Lysholm) between the 2 groups(P>0.05). The Lysholm scores of the observation group after 1-month and3-month treatment were significantly higher than those in the control group over the same time(P<0.05). Before the treatment,there was no significant difference in visual analog scale(VAS) scores between the 2 groups(P>0.05). The VAS scores of the observation group after 1-month and 3-month treatment were significantly lower than those in the control group over the same time(P<0.05). Before the treatment, there was no significant difference in serum PGE2, IL-1β and TNF-α levels between the 2 groups(P>0.05). After the treatment, the serum factor levels in the observation group were lower than those in the control group, where there were significant differences(P<0.05). Conclusion Ozone combined with sodium hyaluronate intra-articular injection can improve joint function, reduce pain and inhibit the expression of PGE2, IL-1β and TNF-α.