CAJ | 학술논문

目的：探讨不同药物治疗膝骨性关节炎综合症状的临床效果，寻找膝骨性关节炎较为有效的药物疗法。方法选取2010年1月~2013年1月浙江省余姚市人民医院骨科收治的膝骨性关节炎患者160例，根据治疗方法的不同将其分为三组，A组50例患者给予非选择性非甾体抗炎药联合质子泵抑制剂口服治疗；B组54例患者给予非选择性非甾体抗炎药联合质子泵抑制剂以及氨基葡萄糖口服治疗；C组56例患者在服用氨基葡萄糖的同时向关节腔内注入透明质酸钠。观察三组患者治疗前以及治疗2、12周后的膝关节综合评分、疗效及不良反应发生情况。结果治疗2周后，A、B、C三组的总有效率(64.0%、64.8%、62.5%)、膝关节功能Lysholm评分[(58.9±3.8)、(59.1±4.0)、(59.8±3.7)分]比较，差异无统计学意义(P>0.05)。治疗12周后，B组患者总有效率(90.7%)明显高于A组及C组(74.0%、61.7%)，差异均有统计学意义(P<0.05)；B组膝关节功能Lysholm评分[(80.6±3.9)分]明显高于A组[(69.1±3.7)分]和C组[(61.4±3.5)分]，差异均有高度统计学意义(P<0.01)；三组患者不良反应发生率比较，差异无统计学意义(P>0.05)。结论非选择性非甾体抗炎药联合质子泵抑制剂及氨基葡萄糖治疗膝骨性关节炎，近期和远期疗效较优，膝关节功能Lysholm评分较高，是一种有效的治疗方案，值得临床推广应用。
목적：탐토불동약물치료슬골성관절염종합증상적림상효과，심조슬골성관절염교위유효적약물요법。방법선취2010년1월~2013년1월절강성여요시인민의원골과수치적슬골성관절염환자160례，근거치료방법적불동장기분위삼조，A조50례환자급여비선택성비치체항염약연합질자빙억제제구복치료；B조54례환자급여비선택성비치체항염약연합질자빙억제제이급안기포도당구복치료；C조56례환자재복용안기포도당적동시향관절강내주입투명질산납。관찰삼조환자치료전이급치료2、12주후적슬관절종합평분、료효급불량반응발생정황。결과치료2주후，A、B、C삼조적총유효솔(64.0%、64.8%、62.5%)、슬관절공능Lysholm평분[(58.9±3.8)、(59.1±4.0)、(59.8±3.7)분]비교，차이무통계학의의(P>0.05)。치료12주후，B조환자총유효솔(90.7%)명현고우A조급C조(74.0%、61.7%)，차이균유통계학의의(P<0.05)；B조슬관절공능Lysholm평분[(80.6±3.9)분]명현고우A조[(69.1±3.7)분]화C조[(61.4±3.5)분]，차이균유고도통계학의의(P<0.01)；삼조환자불량반응발생솔비교，차이무통계학의의(P>0.05)。결론비선택성비치체항염약연합질자빙억제제급안기포도당치료슬골성관절염，근기화원기료효교우，슬관절공능Lysholm평분교고，시일충유효적치료방안，치득림상추엄응용。
Objective To explore the clinical effect of different drugs in the treatment of the symptoms complice of knee osteoarthritis and to look for more effective drug therapy for knee osteoarthritis. Methods Total of 160 patients with knee osteoarthritis who were diagnosed in the Department of Orthopedic, People's Hospital of Yuyao City from January 2010 to January 2013 were enrolled and they were divided into three groups according to different therapeutic methods, 50 patients of group A were given the therapy of NSAIDs and PPIs, 54 patients of group B were given the therapy of NSAIDs, PPIs and glucosamine, 56 patients of group C were given the therapy of glucosamine and sodium hyalurate. Knee joint comprehensive score, efficacy and adverse reactions of three groups at 2 and 12 weeks after treatment were observed. Results The effective rate of group A, B and group C (64.0%, 64.8%, 62.5%) and knee Lysholm score [(58.9±3.8), (59.1±4.0), (59.8±3.7) scores] 2 weeks after treatment of three groups had no statistically sig-nificant differences (P> 0.05); 12 weeks after treatment, the effective rate of group B (90.7%) was higher than that of the group A and C (74.0%, 61.7%), the differences were statistically significant (P< 0.05), the knee Lysholm score [(80.6±3.9) scores] was significant higher than that of the group A [(69.1±3.7) scores] and group C [(61.4±3.5) scores], the differences were statistically significant (P<0.01). There were no significant differences of the incidence of adverse reactions among the three groups (P>0.05). Conclusion NSAIDs combined with PPIs and glucosamine can obtain sat-isfactory recent and forward curative effect, which has higher knee Lysholm score, is an ideal pharmacotherapy, is wor-thy of clinical application.