脉冲射频联合关节腔注射倍他米松治疗膝骨性关节炎临床研究
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摘要
目的探讨脉冲射频联合关节腔注射倍他米松治疗膝骨性关节炎的临床疗效及对视觉模拟评分(VAS)与西安大略和麦马斯特大学骨关节炎指数可视化量表(WOMAC)评分的影响。方法选取医院2016年4月至2017年8月收治的膝骨性关节炎患者92例,按随机数字表法分为对照组与观察组,各46例。对照组患者采取复方倍他米松关节腔内注射2 m L治疗,1次/周,观察组患者在对照组基础上联合脉冲射频治疗,两组均治疗2个月。结果治疗后1,2个月,观察组患者VAS和WOMAC评分均显著低于同时点的对照组患者(P <0. 05);观察组临床总有效率为95. 65%,高于对照组的78. 26%(χ~2=6. 133,P=0. 013 <0. 05);不良反应发生率观察组与对照组相当(6. 52%比4. 35%,χ~2=0. 211,P=0. 646)。结论脉冲射频联合关节腔注射倍他米松治疗膝骨性关节炎,临床效果更佳,可有效减轻患者的疼痛,改善膝关节功能,安全性好。
Objective To investigate the clinical effect of pulsed radiofrequency combined with intra-articular injection of betamethasone in the treatment of knee osteoarthritis and its effect on Visual Analogue Scale( VAS) score and Western Ontario and McMaster University( WOMAC) Osteoarthritis Index score. Methods Totally 92 patients with knee osteoarthritis admitted to our hospital from April 2016 to August 2017 were divided into the control group and the observation group according to the random number table method,46 cases in each group. The patients in the control group were treated with intra-articular injection of 2 m L Compound Betamethasone,once a week,on this basis,the patients in the observation group were treated with pulsed radiofrequency. The patients in the two groups were treated for 2 months. Results After 1 and 2 months of treatment,the scores of VAS and WOMAC in the observation group were significantly lower than those in the control group at the same time points( P < 0. 05). The total clinical effective rate of the observation group was 95. 65%,which was higher than 78. 26% of the control group( χ~2 = 6. 133,P = 0. 013 < 0. 05). The incidence rate of adverse reactions in the observation group was not significantly different from that in the control group( 6. 52% vs. 4. 35%,χ~2 = 0. 211,P = 0. 646). Conclusion Pulsed radiofrequency combined with intra-articular injection of betamethasone has better clinical effect and safety in the treatment of knee osteoarthritis,which can effectively relieve the pain of patients and improve knee function.
Objective To investigate the clinical effect of pulsed radiofrequency combined with intra-articular injection of betamethasone in the treatment of knee osteoarthritis and its effect on Visual Analogue Scale( VAS) score and Western Ontario and McMaster University( WOMAC) Osteoarthritis Index score. Methods Totally 92 patients with knee osteoarthritis admitted to our hospital from April 2016 to August 2017 were divided into the control group and the observation group according to the random number table method,46 cases in each group. The patients in the control group were treated with intra-articular injection of 2 m L Compound Betamethasone,once a week,on this basis,the patients in the observation group were treated with pulsed radiofrequency. The patients in the two groups were treated for 2 months. Results After 1 and 2 months of treatment,the scores of VAS and WOMAC in the observation group were significantly lower than those in the control group at the same time points( P < 0. 05). The total clinical effective rate of the observation group was 95. 65%,which was higher than 78. 26% of the control group( χ~2 = 6. 133,P = 0. 013 < 0. 05). The incidence rate of adverse reactions in the observation group was not significantly different from that in the control group( 6. 52% vs. 4. 35%,χ~2 = 0. 211,P = 0. 646). Conclusion Pulsed radiofrequency combined with intra-articular injection of betamethasone has better clinical effect and safety in the treatment of knee osteoarthritis,which can effectively relieve the pain of patients and improve knee function.
引文
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[6]王一帆,李小峰,罗道明,等.关节腔内注射自体富血小板血浆治疗膝关节骨性关节炎的临床疗效[J].广西医学,2017,39(9):1304-1308.
[7] SARI S,AYDIN ON,TURAN Y,et al. Which one is more effective for the clinical treatment of chronic pain in knee osteoarthritis:radiofrequency neurotomy of the genicular nerves or intra-articular injection?[J]. International Journal of Rheumatic Diseases,2018,21(10):1772-1778.
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[9]胡鸢,唐金树,侯树勋,等.脉冲射频术治疗膝关节骨关节炎的临床疗效观察[J].中国疼痛医学杂志,2016,22(7):514-518.
[2]薄存菊,陈金生,宫庆娟,等.背根神经节脉冲射频联合复方倍他米松注射治疗老年退行性腰椎管狭窄症的疗效观察[J].中华生物医学工程杂志,2017,23(1):61-63.
[3]李国铨,刘楠,郑颜萍,等.玻璃酸钠联合复方倍他米松注射液治疗膝关节骨性关节炎疗效观察[J].海南医学,2016,27(24):90-93.
[4]黄丽强,季蓉.雷火灸对膝关节骨性关节炎患者VAS、WOMAC评分影响的临床研究[J].江苏中医药,2017,49(8):57-58.
[5]袁泉,蒋健,李浩,等.膝关节封闭试验结合WOMAC评分在腰-膝综合征中的应用[J].徐州医学院学报,2016,36(11):743-746.
[6]王一帆,李小峰,罗道明,等.关节腔内注射自体富血小板血浆治疗膝关节骨性关节炎的临床疗效[J].广西医学,2017,39(9):1304-1308.
[7] SARI S,AYDIN ON,TURAN Y,et al. Which one is more effective for the clinical treatment of chronic pain in knee osteoarthritis:radiofrequency neurotomy of the genicular nerves or intra-articular injection?[J]. International Journal of Rheumatic Diseases,2018,21(10):1772-1778.
[8] HABIB G,KHATIB M,SAKAS F,et al. Pre-injection of hyaluronic acid does not affect the systemic effects of intra-articular depot betamethasone injection at the knee joint[J]. Clinical Rheumatology,2017,36(1):1-5.
[9]胡鸢,唐金树,侯树勋,等.脉冲射频术治疗膝关节骨关节炎的临床疗效观察[J].中国疼痛医学杂志,2016,22(7):514-518.