CAJ | 학술논문

背景:骨性膝关节炎保守治疗一直以尽量减少膝关节负重及保持肌肉锻炼为主,急性发作时辅以非类固醇抗炎镇痛药.目的:探讨玻璃酸钠膝关节腔内注射结合倍他米松痛点注射对骨性膝关节炎疼痛症状的缓解效应. 设计:开放性实验.单位:首都医科大学附属北京天坛医院.对象:纳入首都医科大学附属北京天坛医院疼痛门诊2004-01/10就诊的骨性膝关节炎患者45例,年龄40～85岁.方法:采用玻璃酸钠注射液行患膝关节腔内注射,2.5 mL/次,1次/周,5周为1个疗程.详细体格检查,寻找膝关节周围痛点.使用消炎镇痛液行痛点注射,每一痛点用药2.0～3.0 mL.每周治疗前重复体格检查,若有痛点则继续行痛点注射,若经过治疗已经没有痛点则仅行玻璃酸钠关节腔内注射治疗.主要观察指标:①安静时、运动时疼痛评分.②疼痛消失时间和应用倍他米松治疗的次数.结果:纳入的45例患者均进入结果分析.①联合治疗1周后安静时疼痛和运动时疼痛较治疗前明显降低(P＜0.01),安静时疼痛较运动时疼痛缓解为著(P＜0.01).②疼痛平均于治疗后(17.07±6.00)d消失,应用倍他米松治疗的次数平均为(2.42±0.78)次.③病例中无一例出现注射后局部关节疼痛等不良反应.结论:玻璃酸钠关节腔内注射联合倍他米松痛点注射可有效缓解骨性膝关节炎的疼痛症状,且无明显不良反应发生.
배경:골성슬관절염보수치료일직이진량감소슬관절부중급보지기육단련위주,급성발작시보이비류고순항염진통약.목적:탐토파리산납슬관절강내주사결합배타미송통점주사대골성슬관절염동통증상적완해효응. 설계:개방성실험.단위:수도의과대학부속북경천단의원.대상:납입수도의과대학부속북경천단의원동통문진2004-01/10취진적골성슬관절염환자45례,년령40～85세.방법:채용파리산납주사액행환슬관절강내주사,2.5 mL/차,1차/주,5주위1개료정.상세체격검사,심조슬관절주위통점.사용소염진통액행통점주사,매일통점용약2.0～3.0 mL.매주치료전중복체격검사,약유통점칙계속행통점주사,약경과치료이경몰유통점칙부행파리산납관절강내주사치료.주요관찰지표:①안정시、운동시동통평분.②동통소실시간화응용배타미송치료적차수.결과:납입적45례환자균진입결과분석.①연합치료1주후안정시동통화운동시동통교치료전명현강저(P＜0.01),안정시동통교운동시동통완해위저(P＜0.01).②동통평균우치료후(17.07±6.00)d소실,응용배타미송치료적차수평균위(2.42±0.78)차.③병례중무일례출현주사후국부관절동통등불량반응.결론:파리산납관절강내주사연합배타미송통점주사가유효완해골성슬관절염적동통증상,차무명현불량반응발생.
BACKGROUND: Conservative treatment of osseous gonarthritis (OG) is mainly to reduce the loading of knee joint and maintain muscle exercise,and non-steroidal anti-inflammatory drugs serve as supplements in case of acute occurrence.OBJECTIVE: To investigate the effect of combination of intraarticular in jection of hyaluronate and pain-point injection of betamethasone in improving the pain symptom in patients with OG.DESIGN: Open experiment.SETTING: Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: We selected 45 OG patients, who were aged 40 to 85years and received treatment in the clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between January 2004 and October 2004.METHODS: OG parenteral solution was intraarticularly injected into the knee joint, 2.5 mL once a week, 5 weeks set as a disease course. Pain points around knee joint were searched for following thorough physical examination. Anti-inflammatory analgesic solution of 2.0-3.0 mL was injected at each pain point. Physical examination was repeated before treatment in each week. Injection at pain points was maintained if they were still present. Intraarticular injection of hyaluronate was performed only when the pain points disappeared after treatment.MAIN OUTCOME MEASURES: ① Pain score at rest and at exercise.② Time when pain disappeared and times of betamethasone administration.RESULTS: Totally 45 patients entered the result analysis. ① Pain at rest and at exercise 1 week after combination treatment of intraarticular injection of hyaluronate and pain-point injection of betamethasone was ignificantly lessened compared to that before treatment (P ＜ 0.01). Pain relief was more significant at rest than at exercise (P ＜ 0.01). ② Pain disappeared at (17.07±6.00)days after treatment on average. The average times of betamethasone administration was (2.42±0.78) times. ③ No local joint pain and other adverse reactions occurred after administration in any case.CONCLUSION: Combination of intraarticular injection of hyaluronate and pain-point injection of betamethasone can effectively relieve the pain symptom of osseous gonarthritis, with no obvious adverse reactions.