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[1]何本祥.潮式關(guān)節(jié)腔沖洗、玻璃酸鈉關(guān)節(jié)內(nèi)注射聯(lián)合運(yùn)動(dòng)療法治療積液型膝骨性關(guān)節(jié)炎[J].中醫(yī)正骨,2012,24(12):23-26.
　HE Ben-xiang*.Curative effect of the method of articular cavity tidal irrigation combined with intra-articular injection of sodium hyaluronate and exercise therapy in the treatment of type fluidify knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(12):23-26.
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潮式關(guān)節(jié)腔沖洗、玻璃酸鈉關(guān)節(jié)內(nèi)注射聯(lián)合運(yùn)動(dòng)療法治療 積液型膝骨性關(guān)節(jié)炎()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期數(shù):
2012年12期
頁碼:
23-26
欄目:
臨床研究
出版日期:
2012-12-20

文章信息/Info

Title:
Curative effect of the method of articular cavity tidal irrigation combined with intra-articular injection of sodium hyaluronate and exercise therapy in the treatment of type fluidify knee osteoarthritis
作者:
何本祥
成都體育學(xué)院附屬體育醫(yī)院,四川 成都 610041
Author(s):
HE Ben-xiang*
*Sport Hospital Attached to Chengdu Sport University,Chengdu 610041,Sichuan,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝 關(guān)節(jié)積水 灌洗 注射; 關(guān)節(jié)內(nèi) 運(yùn)動(dòng)療法 治療; 臨床研究性
Keywords:
Osteoarthritis; knee;  Hydrarthrosis;  Irrigation;  Injections; intra-articular;  Exercise therapy;  Therapies; investigational
摘要:
目的:探討潮式關(guān)節(jié)腔沖洗、玻璃酸鈉關(guān)節(jié)內(nèi)注射聯(lián)合運(yùn)動(dòng)療法治療積液型膝骨性關(guān)節(jié)炎的臨床療效。方法:103例積液型膝骨性關(guān)節(jié)炎患者,男32例,女71例; 年齡41～82歲,中位數(shù)65歲; 病程2個(gè)月至30年,中位數(shù)4年; 左側(cè)37例,右側(cè)49例,雙側(cè)17例。依據(jù)Lequesne-Mery膝骨性關(guān)節(jié)炎嚴(yán)重度評價(jià)指數(shù)評價(jià)臨床嚴(yán)重程度:輕度18例19膝,中度37例46膝,重度48例55膝。按就診順序隨機(jī)分為2組。治療組53例60膝,男15例,女38例; 左側(cè)21例,右側(cè)25例,雙側(cè)7例; 采用潮式關(guān)節(jié)腔沖洗、玻璃酸鈉關(guān)節(jié)內(nèi)注射聯(lián)合運(yùn)動(dòng)療法治療。對照組50例60膝,男17例,女33例; 左側(cè)16例,右側(cè)24例,雙側(cè)10例; 采用關(guān)節(jié)積液抽吸加玻璃酸鈉關(guān)節(jié)內(nèi)注射治療。觀察2組患者患膝疼痛、功能及積液改善情況,并對綜合療效進(jìn)行比較。結(jié)果:治療前2組患者患膝疼痛評分(30.41±8.70,30.83±8.64)、功能評分(25.92±4.83,26.17±4.82)、積液評分(3.42±2.35,3.33±2.38)比較,差異無統(tǒng)計(jì)學(xué)意義(t=-0.263,P=0.793; Z=-0.367,P=0.714; Z=-0.194,P=0.846); 治療3個(gè)月后,2組患者患膝疼痛評分(45.67±8.31,40.58±8.88)、關(guān)節(jié)功能評分(32.33±4.06,30.08±4.46)、積液評分(9.50±1.51,7.83±2.50)比較,差異有統(tǒng)計(jì)學(xué)意義(Z=-3.450,P=0.001; Z=-3.052,P=0.002; Z=-4.111,P=0.000); 且治療組患膝疼痛、功能、積液改善(15.25±3.95,6.42±2.78,6.08±2.08)優(yōu)于對照組(9.75±3.11,3.92±2.62,4.50±1.51),差異有統(tǒng)計(jì)學(xué)意義(Z=-6.851,P=0.000; Z=-4.623,P=0.000; Z=-4.394,P=0.000)。治療組治愈15例15膝,顯效28例32膝,有效7例9膝,無效3例4膝; 對照組治愈5例5膝,顯效12例14膝,有效16例20膝,無效17例21膝; 治療組綜合療效優(yōu)于對照組( 治療組=0.373, 對照組=0.627; Z=-4.819,P=0.000)。103例患者均獲隨訪,隨訪時(shí)間1～3年,中位數(shù)18個(gè)月; 治療組復(fù)發(fā)5例6膝,對照組復(fù)發(fā)32例38膝,治療組復(fù)發(fā)率低于對照組(χ2=36.746,P=0.000)。復(fù)發(fā)患者均再次采用潮式關(guān)節(jié)腔沖洗、玻璃酸鈉關(guān)節(jié)內(nèi)注射聯(lián)合運(yùn)動(dòng)療法治療1～2次(每次間隔6個(gè)月),其中治療組1例2膝、對照組2例3膝輔以糖皮質(zhì)激素關(guān)節(jié)腔注射治療,癥狀均緩解。結(jié)論:潮式關(guān)節(jié)腔沖洗、玻璃酸鈉關(guān)節(jié)內(nèi)注射聯(lián)合運(yùn)動(dòng)療法治療積液型膝骨性關(guān)節(jié)炎可有效緩解癥狀、改善關(guān)節(jié)功能、促進(jìn)關(guān)節(jié)積液的吸收,療效滿意。
Abstract:
Objective:To explore the clinical curative effect of the method of articular cavity tidal irrigation combined with intra-articular injection of sodium hyaluronate and exercise therapy in the treatment of type fluidify knee osteoarthritis(KOA).Methods:One hundred and three type fluidify KOA patients were analyzed,male 32 cases,while female 71 cases; ranging in age from 41 to 82 years with a median of 65 years; ranging in courses of disease from 2 months to 30 years with a median of 4 years; 37 cases on left side,49 cases on right side and 17 cases on both sides.Clinical severity was evaluated according to Lequesne-Mery severity evaluation index of KOA and the results showed mild in 19 knees of 18 cases,medium in 46 knees of 37 cases and severe in 55 knees of 48 cases.The patients were randomly divided into 2 groups according to examining sequence.Fifty-three patients(60 knees)were divided into the treatment group,male 15 cases,while female 38 cases; 21 cases on left side,25 cases on right side and 7 cases on both sides; and they were administrated with the method of articular cavity tidal irrigation combined with intra-articular injection of sodium hyaluronate and exercise therapy.Fifty cases(60 knees)were divided into the control group,male 17 cases,while female 33 cases; 16 cases on left side,24 cases on right side and 10 cases on both sides; and they were administrated with the joint effusion suction combined with intra-articular injection of sodium hyaluronate.The extent of relief of pain,improvement of function and decrease of effusion in the sick knees and the comprehensive curative effects were compared between the 2 groups.Results:There were no statistical differences in pain scores(30.41±8.70,30.83±8.64),function scores(25.92±4.83,26.17±4.82)and effusion scores(3.42±2.35,3.33±2.38)of the sick knees between the 2 groups respectively before the treatment(t=-0.263,P=0.793; Z=-0.367,P=0.714; Z=-0.194,P=0.846).There were statistical differences in pain scores(45.67±8.31,40.58±8.88),function scores(32.33±4.06,30.08±4.46)and effusion scores(9.50±1.51,7.83±2.50)of the sick knees between the 2 groups respectively after treatment of 3 months(Z=-3.450,P=0.001; Z=-3.052,P=0.002; Z=-4.111,P=0.000); and the patients in the treatment group got better outcomes in relief of pain,improvements of function and decrease of effusion in sick knees(15.25±3.95,6.42±2.78,6.08±2.08),compared with those in the control group(9.75±3.11,3.92±2.62,4.50±1.51),and there was statistical difference between them(Z=-6.851,P=0.000; Z=-4.623,P=0.000; Z=-4.394,P=0.000).Fifteen knees of 15 patients got excellent results,32 knees of 28 cases good,9 knees of 7 cases fair and 4 knees of 3 cases invalid in treatment group; while 5 knees of 5 patients got excellent results,14 knees of 12 cases good,20 knees of 16 cases fair and 21 knees of 17 cases invalid in control group; and the comprehensive curative effect of treatment group was better than that of the control group(treatment group=0.373,control group=0.627; Z=-4.819,P=0.000).One hundred and three patients were all followed up of 1-3 years with a median of 18 months.Six knees of 5 cases with relapse were found in the treatment group,while 38 knees of 32 cases with relapse were found in the control group,and the relapse rate of the treatment group was lower than that of the control group(χ2=36.746,P=0.000).All of the patients with relapse obtained further articular cavity tidal irrigation combined with intra-articular injection of sodium hyaluronate and exercise therapy for one or two times(interval of 6 months),and 2 knees of 1 patient in the treatment group and 3 knees of 2 patients in the control group were assistantly administrated with intra-articular injection of glucocorticosteroids,and their symptoms were all released.Conclusion:The method of articular cavity tidal irrigation combined with intra-articular injection of sodium hyaluronate and exercise therapy can effectively release the symptoms,improve the joint functions and promote the suction of joint effusion in the treatment of type fluidify KOA,and it has satisfied curative effect.

參考文獻(xiàn)/References:

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備注/Memo

備注/Memo:
基金項(xiàng)目:四川省科學(xué)技術(shù)廳課題(2008SZ0239)
更新日期/Last Update: 2012-12-20