三联疗法治疗膝关节骨性关节炎的临床研究

目的 探讨盐酸氨基葡萄糖、透明质酸钠联合臭氧治疗膝关节骨性关节炎患者的临床疗效。方法 回顾性分析在笔者医院骨科就诊的膝关节骨性关节炎患者120例,根据治疗方法不同,分为对照组（口服盐酸氨基葡萄糖＋透明质酸钠膝关节腔注射）和观察组（口服盐酸氨基葡萄糖＋透明质酸钠结合臭氧膝关节腔注射）,每组60例。治疗期8周,治疗前后观察指标：WOMAC评分,透明质酸（HA）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）水平,关节肿胀、压痛评分,并进行临床疗效评定。结果 治疗后,观察组患者WOMAC疼痛、僵硬和日常生活受限各维度评分及总分均明显下降,且明显优于对照组,差异有统计学意义（P＜0.05）;观察组患者膝关节肿胀和压痛评分均明显下降,且明显优于对照组,差异有统计学意义（P＜0.05）;观察组患者关节液中HA水平升高,TNF-α和IL-1β水平下降,且观察组患者关节液中HA水平高于对照组,TNF-α和IL-1β水平低于对照组,差异有统计学意义（P＜0.05）;观察组总有效率95。00％,对照组总有效率为81.67％,两组比较差异有统计学意义（P＜0.01）。结论 三联疗法治疗膝骨性关节炎可取得较好的临床疗效,在改善患者膝关节肿胀、压痛、疼痛、僵硬和日常生活方面明显优于单独单独用药或二联疗法。

Clinical Studies of Triple Therapy for Knee Joint Osteoarthritis

Objective Discussion on the clinical etficacy of glucosamine hydrochlonde,sodium hyaluronate combined with ozone therapy in patients with knee joint osteoarthritis.Methods Retrospectively analyzing the treatment of 120 knee joint osteoarthritis patients in our hospital,these 120 cases were divided into two groups,a control group （oral glucosamine hydrochloride and injection of sodium hyaluronate knee） and an observation group （oral Hydrochloride glucose and binding sodium hyaluronate injection of ozone knee） according to different methods of treatment,60 cases in each.The treatment period lasted for 8 weeks,the items observed before and after treatment are as follows：WOMAC score,hyaluronic acid （HA）,tumor necrosis factor-α （TNF-α）,interleukin-1β （IL-1β） levels,joint swelling,tenderness score; and all these factors are engaged in the assessment of clinical efficacy.Results After treatment,the scores of WOMAC pain,stiffness and limited activities in everyday life in observation group and the total score were significantly decreased,whichwere significantly better than those in the control group,the difference was statistically significant （P ＜ 0.05） ; the scores of knee joint swelling and knee tenderness in observation group were significantly decreased,which were significantly better than those in the control group,the difference was statistically significant （P ＜ 0.05） ; the HA level in the joint fluid in observation group got higher,and TNF-α and IL-1β levels decreased,and the HA level in the joint fluid in the observation group higher were higher in the control group,TNF -α and IL-1β levels were lower than those in the control group,the difference was statistically significant （P ＜ 0.05） ; the total effective rate of observation group was 95.00％,the total effective rate of the control group was 81.67％,the comparison difference between two groups was statistically significant （P ＜ 0.01）.Conclusion Triple therapy （oral glucosamine tablets,sodium hyalurona