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[1]李騰輝,陳民.玻璃酸鈉膝關節(jié)腔注射聯(lián)合骨瓜提取物穴位注射治療Kellgren- Lawrence Ⅲ、Ⅳ級膝骨關節(jié)炎的臨床研究[J].中醫(yī)正骨,2016,28(04):12-15.
　LI Tenghui,CHEN Min.Clinical study on intra-articular injection of sodium hyaluronate combined with acupoint injection of Gugua extracts for treatment of Kellgren-Lawrence gradeⅢandⅣknee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(04):12-15.
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玻璃酸鈉膝關節(jié)腔注射聯(lián)合骨瓜提取物穴位注射治療Kellgren- Lawrence Ⅲ、Ⅳ級膝骨關節(jié)炎的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年04期
頁碼:
12-15
欄目:
臨床研究
出版日期:
2016-04-20

文章信息/Info

Title:
Clinical study on intra-articular injection of sodium hyaluronate combined with acupoint injection of Gugua extracts for treatment of Kellgren-Lawrence gradeⅢandⅣknee osteoarthritis
作者:
李騰輝; 陳民
廣東省人民醫(yī)院,廣東 廣州 510080
Author(s):
LI Tenghui; CHEN Min
Guangdong Provincial People's Hospital,Guangzhou 510080,Guangdong,China
關鍵詞:
骨關節(jié)炎; 膝;  注射; 關節(jié)內(nèi);  透明質(zhì)酸;  骨瓜提取物;  水針;  臨床試驗
Keywords:
osteoarthritis; knee;  injections; intra-articular;  hyaluronic acid;  Gugua extracts;  hydro-acupuncture;  clinical trial
摘要:
目的:觀察玻璃酸鈉膝關節(jié)腔注射聯(lián)合骨瓜提取物穴位注射治療Kellgren-Lawrence Ⅲ、Ⅳ級膝骨關節(jié)炎(knee osteoarthritis,KOA)的臨床療效及安全性。方法:將80例Kellgren-Lawrence Ⅲ、Ⅳ級單側(cè)KOA患者隨機分為聯(lián)合治療組和玻璃酸鈉組,每組40例。2組患者均行膝關節(jié)腔玻璃酸鈉注射治療,聯(lián)合治療組在此基礎上行骨瓜提取物穴位注射治療。玻璃酸鈉膝關節(jié)腔注射和骨瓜提取物穴位注射治療均每周1次,連續(xù)治療5次。采用KOA治療效果判定標準(JOA)從步行能力、上下樓梯能力、膝關節(jié)活動情況、膝關節(jié)腫脹情況4個方面評定臨床療效,并觀察治療期間2組患者不良反應的發(fā)生情況。結(jié)果:所有患者均順利完成治療,均未發(fā)生嚴重不良反應。治療前2組患者的步行能力、上下樓梯能力、膝關節(jié)活動情況、膝關節(jié)腫脹情況評分比較,組間差異均無統(tǒng)計學意義[(19.000±5.570)分,(18.500±5.454)分,t=0.539,P=0.593;(11.000±5.089)分,(10.875±5.417)分,t=0.374,P=0.711;(21.375±6.404)分,(20.875±5.534)分,t=1.160,P=0.253;(5.250±2.762)分,(5.625±2.579)分,t=-1.356,P=0.183]。治療結(jié)束后2組患者的步行能力評分和上下樓梯能力評分均提高(t=-9.844,P=0.000; t=-11.590,P=0.000; t=-14.811,P=0.000; t=-13.432,P=0.000),聯(lián)合治療組的評分均高于玻璃酸鈉組[(24.625±4.986)分,(22.375±4.934)分,t=3.635,P=0.002;(18.500±4.696)分,(17.000±4.777)分,t=3.122,P=0.003]。治療結(jié)束后2組患者的膝關節(jié)活動情況均無明顯改善(t=-1.862,P=0.070; t=-0.710,P=0.482); 2組治療結(jié)束后的膝關節(jié)活動評分比較,差異無統(tǒng)計學意義[(22.250±6.883)分,(21.500±5.905)分,t=0.813,P=0.421]。治療結(jié)束后2組患者的膝關節(jié)腫脹評分均較治療前提高(t=-3.122,P=0.003; t=-2.082,P=0.044); 2組治療結(jié)束后的膝關節(jié)腫脹評分比較,差異無統(tǒng)計學意義[(6.250±2.193)分,(6.125±2.399)分,t=0.443,P=0.660]。結(jié)論:玻璃酸鈉膝關節(jié)腔注射聯(lián)合骨瓜提取物穴位注射可有效減輕Kellgren-Lawrence Ⅲ、Ⅳ級KOA患者的膝關節(jié)腫脹和日常活動時的疼痛程度,改善日常活動能力,具有較高的安全性,但對于患者的膝關節(jié)活動度改善無明顯作用,在減輕患者日常活動時疼痛方面的療效優(yōu)于單純玻璃酸鈉膝關節(jié)腔注射治療。
Abstract:
Objective:To observe the clinical curative effect and safety of intra-articular injection of sodium hyaluronate combined with acupoint injection of Gugua(骨瓜)extracts for treatment of Kellgren-Lawrence gradeⅢandⅣknee osteoarthritis(KOA).Methods:Eighty patients with Kellgren-Lawrence gradeⅢorⅣunilateral KOA were randomly divided into combination therapy group and sodium hyaluronate group,40 cases in each group.The sodium hyaluronate were injected into the knee joint cavity of patients in both of the 2 groups,meanwhile,the Gugua extracts were injected into acupuncture points of patients in combination therapy group.The intra-articular injection of sodium hyaluronate and acupoint injection of Gugua extracts were performed once a week for consecutive 5 times.Walking ability,stair ambulation ability,knee joint motion and knee swelling were evaluated and used as the measure of curative effects according to therapeutic effect criterion of KOA made by Japanese orthopaedic association,and the adverse reactions were observed during the treatment period.Results:The treatment were finished successfully in all the patients and no severe adverse reactions were found.There was no statistical difference in walking ability,stair ambulation ability,knee joint motion and knee swelling between the 2 groups before the treatment(19.000+/-5.570 vs 18.500+/-5.454 points,t=0.539,P=0.593; 11.000+/-5.089 vs 10.875+/-5.417 points,t=0.374,P=0.711; 21.375+/-6.404 vs 20.875+/-5.534 points,t=1.160,P=0.253; 5.250+/-2.762 vs 5.625+/-2.579 points,t=-1.356 P=0.183).The scores of walking ability and stair ambulation ability increased in both of the 2 groups after the end of the treatment(t=-9.844,P=0.000; t=-11.590,P=0.000; t=-14.811,P=0.000; t=-13.432,P=0.000),and the scores were higher in combination therapy group compared to sodium hyaluronate group(24.625+/-4.986 vs 22.375+/-4.934 points,t=3.635,P=0.002; 18.500+/-4.696 vs 17.000+/-4.777 points,t=3.122,P=0.003).No significant improvement were found in the knee joint motion in both of the 2 groups after the end of the treatment(t=-1.862,P=0.070; t=-0.710,P=0.482).There was no statistical difference in the scores of knee joint motion between the 2 groups after the end of the treatment(22.250+/-6.883 vs 21.500+/-5.905 points,t=0.813,P=0.421).The knee joint swelling scores increased in both of the 2 groups after the end of the treatment(t=-3.122,P=0.003; t=-2.082,P=0.044)and there was no statistical difference in the knee joint swelling scores between the 2 groups(6.250+/-2.193 vs 6.125+/-2.399 points,t=0.443,P=0.660).Conclusion:In treatment of Kellgren-Lawrence gradeⅢandⅣKOA,the therapy of intra-articular injection of sodium hyaluronate combined with acupoint injection of Gugua extracts can effectively reduce knee swelling and knee pain during daily activities,and improve daily locomotor activity with high safety,however,it has no significant effect on improvement of knee joint motion.It surpasses the monotherapy of knee intra-articular injection of sodium hyaluronate in relieving the knee pain during daily activities.

參考文獻/References:

[1] Kellgren JH,Lawrence JS.Radiological assessment of osteo-arthrosis[J].Ann Rheum Dis,1957,16(4):494-502.
[2] Wilder E,Flanagan R,Strauss E,et al.BMI,age,radiographic severity and ultrasound guidance impact the response to hyaluronic acid injections in knee osteoarthritis[J].Osteoarthritis & Cartilage,2015,23:A405-A406.
[3] Altman R,Asch E,Bloch D,et al.Development of criteria for the classification and reporting of osteoarthritis.Classification of osteoarthritis of the knee.Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association[J].Arthritis Rheum,1986,29(8):1039-1049.
[4] 蔣協(xié)遠,王大偉.骨科臨床療效評價標準[M].北京:人民衛(wèi)生出版社,2005:203-204.
[5] 張董喆.玻璃酸鈉結(jié)合功能鍛煉對膝關節(jié)骨性關節(jié)炎的療效[J].實用醫(yī)學雜志,2013,29(18):2994-2995.
[6] 陳民,李騰輝,李嘉,等.鹿瓜多肽注射液穴位注射治療老年膝關節(jié)骨關節(jié)炎臨床療效觀察[J].實用醫(yī)學雜志,2009,25(8):1291-1292.
[7] 李藝彬,吳昭克,朱勇.針灸治療膝骨性關節(jié)炎臨床研究現(xiàn)狀[J].中醫(yī)正骨,2013,25(2):74-75.
[8] 蘇泉,魯光錢.針刺配合關節(jié)腔注射和中藥內(nèi)服治療膝骨關節(jié)炎53例[J].中醫(yī)正骨,2014,26(5):35-36.
[9] 張蓉,李峰,李珩,等.膝關節(jié)骨性關節(jié)炎針灸治療選穴特點及分析[J].中國康復醫(yī)學雜志,2007,22(4):357-358.
[10] 薛玲.骨瓜提取物注射液臨床療效觀察[J].西北藥學雜志,2008,23(3):174.
[11] 陳曉波,李麗.骨瓜提取物注射液促進骨折愈合的療效觀察[J].中國藥業(yè),2011,20(3):73-74.
[12] 蔡志琴,周福永,陳晨.60例骨瓜提取物注射劑不良反應文獻分析[J].中國藥房,2014,25(15):1419-1421.

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備注/Memo:
通訊作者:李騰輝 E-mail:[email protected]
更新日期/Last Update: 2016-08-30