| 关节腔注射帕瑞昔布治疗早期膝骨关节炎的临床疗效分析 |
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投稿时间：2019-03-11
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| 作者 | Author | 单位 | Address | E-Mail |
| 鲁璐 |
LU Lu |
南京中医药大学附属医院 江苏省中医院, 江苏 南京 210029 |
Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 黄晓文 |
HUANG Xiao-wen |
南京医科大学第一附属医院, 江苏 南京 210029 |
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| 谢榆 |
XIE Yu |
南京中医药大学附属医院 江苏省中医院, 江苏 南京 210029 |
Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 汪悦 |
WANG Yue |
南京中医药大学附属医院 江苏省中医院, 江苏 南京 210029 |
Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu, China |
wangyuephd@126.com |
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| 期刊信息：《中国骨伤》2019年，第32卷，第5期，第418-422页 |
| DOI：10.3969/j.issn.1003-0034.2019.05.006 |
| 基金项目:国家自然科学基金（编号：81774274） |
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中文摘要:
目的：观察并评价早期膝骨关节炎患者进行关节腔注射帕瑞昔布的临床效果。
方法：自2016年9月至2017年8月治疗早期膝骨关节炎患者107例，男50例，女57例；年龄45~64（51.9±4.2）岁；分为基础治疗+口服氨基葡萄糖组（A组）36例，口服塞来昔布+基础治疗+口服氨基葡萄糖（B组）36例，关节腔注射帕瑞昔布+基础治疗+口服氨基葡萄糖组（C组）35例。3组患者治疗前性别、年龄、BMI、临床分期（Kellgren-Lawrence分级）比较差异无统计学意义。比较3组患者治疗前后VAS评分、HSS评分和患者满意度，并对3组患者治疗前后关节液中炎性细胞因子水平进行测定。
结果：所有病例获得随访，时间（15.2±2.6）个月。每组患者治疗后VAS评分、HSS评分均较治疗前改善（P<0.001）。3组患者治疗后的VAS评分、HSS评分，组间比较差异有统计学意义（P<0.001），C组临床疗效优于A、B两组（P<0.001），B组优于A组（P<0.001）；C组患者满意度最高（P<0.001）。每组患者治疗后关节液中促炎因子TNF-α、IL-6浓度均较治疗前下降（P<0.001），抑炎因子IL-10浓度较治疗前上升（P<0.001）。3组患者治疗后关节液中TNF-α、IL-6、IL-10浓度，组间比较差异有统计学意义（P<0.001）。
结论：对于早期膝骨关节炎患者，通过关节腔注射帕瑞昔布可以显著改善临床症状，避免长期口服NSAIDs药物的不良反应，是一种有效治疗手段。 |
| 【关键词】骨关节炎,膝 关节腔注射 帕瑞昔布 |
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| Clinical efficacy of intra-articular parecoxib injection for the treatment of early knee osteoarthritis |
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ABSTRACT
Objective:To observe and evaluate the clinical effect of intra-articular injection of parecoxib in patients with early knee osteoarthritis.
Methods:From September 2016 to August 2017,107 patients with early knee osteoarthritis were treated,including 50 males and 57 females,aged 45 to 64 (51.9±4.2) years. They were divided into basic therapy+oral glucosamine group(group A) 36 cases,oral celecoxib+basic therapy+oral glucosamine group(group B) 36 cases,intra-articular injection of parecoxib+basic therapy+oral glucosamine group(group C) 35 cases. There was no significant difference in gender,age,BMI and clinical stage(Kellgren-Lawrence classification) between the three groups before treatment. VAS score,HSS score and patient satisfaction were compared before and after treatment in the three groups. The levels of inflammatory cytokines in synovial fluid were measured before and after treatment in the three groups.
Results:All cases were followed up for(15.2±2.6) months on average. The VAS score and HSS score of each group were improved after treatment(P<0.001). There were significant differences in VAS and HSS scores among the three groups after treatment(P<0.001). The clinical efficacy of group C was better than that of group A and B(P<0.001),group B was better than that of group A(P<0.001),and group C had the highest satisfaction(P<0.001). After treatment,the concentration of proinflammatory factor TNF-α and IL-6 in the synovial fluid of each group decreased(P<0.001) and the concentration of anti-inflammatory factor IL-10 increased(P<0.001). After treatment,the concentrations of TNF-α,IL-6 and IL-10 in the synovial fluid of the three groups were significantly different(P<0.001).
Conclusion:For patients with early knee osteoarthritis,intra-articular injection of parecoxib can significantly improve clinical symptoms and avoid adverse reactions of long-term oral NSAIDs,which is an effective treatment. |
| KEY WORDS Osteoarthritis,knee Intra-articular injection Parecoxib |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 鲁璐,黄晓文,谢榆,汪悦.关节腔注射帕瑞昔布治疗早期膝骨关节炎的临床疗效分析[J].中国骨伤,2019,32(5):418~422 |
| 英文格式: | LU Lu,HUANG Xiao-wen,XIE Yu,WANG Yue.Clinical efficacy of intra-articular parecoxib injection for the treatment of early knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(5):418~422 |
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