膏摩联合玻璃酸钠注射治疗膝骨关节炎的临床研究

目的 探讨膏摩联合玻璃酸钠关节内注射治疗膝骨关节炎的临床疗效。 方法 将2017年1月—2018年12月安徽中医药大学第二附属医院骨伤科收治的符合纳入标准的90例患者经过随机数字表法随机分为治疗组(膏摩联合玻璃酸钠治疗)和对照组(玻璃酸钠治疗),每组45例。治疗组每日行膝关节膏摩治疗1次,20 min/次,每周行玻璃酸钠关节腔注射治疗1次;对照组每周行玻璃酸钠关节腔注射治疗1次,两组疗程均为5周。所有纳入研究患者住院期间同时接受基础运动康复治疗,包括每日针刺治疗1次,20 min/次,每日推拿治疗1次,20 min/次。2组患者均在治疗前和治疗后1、3、6个月时进行膝关节WOMAC评分和膝关节屈伸活动度测量。比较两组评分和关节活动度改变情况,对比临床疗效,同时观察有无不良反应。 结果 通过WOMAC各亚量表评分的比较,2组KOA患者的疼痛、僵硬和功能均有改善(P<0.05),治疗组疗效优于对照组(P<0.05)。通过对膝关节活动度的测量,两组膝关节屈曲活动度均有改善(P<0.05),伸直活动度变化无统计学意义(P>0.05),组间对比差异无统计学意义(P>0.05)。 结论 膏摩联合玻璃酸钠关节内注射治疗KOA,能明显改善患者的关节疼痛、僵硬和功能状态,并且能改善患者的关节屈曲活动度,长期疗效稳定,且未见明显不良反应。 

Clinical study on ointment rubbing combined with intra-articular sodium hyaluronate injection in the treatment of knee osteoarthritis

Objective To investigate the clinical effect of ointment rubbing combined with intra-articular sodium hyaluronate injection in the treatment of knee osteoarthritis. Methods Total 90 patients met the inclusion criteria were randomly divided into treatment group(ointment rubbing combined with intra-articular sodium hyaluronate injection) and control group(intra-articular sodium hyaluronate injection), with 45 cases each group. The treatment group was treated with knee ointment rubbing once a day for 20 minutes. Both groups were treated with intra-articular sodium hyaluronate injection, once a week for five times. The course of treatment in both groups was 5 weeks. All the patients received rehabilitation treatment at the same time during hospitalization, including acupuncture treatment once a day for 20 minutes and massage treatment once a day for 20 minutes. WOMAC score and knee flexion and extension activity were observed before and 1, 3 and 6 months after treatment. The changes of scores and joint mobility of the two groups were compared. The clinical effects were compared, and the adverse reactions were observed at the same time. Results The WOMAC for pain, stiffness and function were improved in both groups(P<0.05), and the WOMAC of treatment group were better than that of control group(P<0.05). Through the measurement of knee joint activity, the flexion activity of knee joint in both groups was improved(P<0.05), and there was no statistical significance in the change of extension activity(P>0.05). There were no difference between the two groups(P>0.05). Conclusion The ointment rubbing combined with intra-articular sodium hyaluronate injection in the treatment of knee osteoarthritis can improve the joint pain, stiffness and functional state, and improve the flexion activity of the patients' joints. The long-term effect is stable, and there is no obvious adverse reaction.