中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2015年
7期
31-33,37
,共4页
王丹辉%张燕%刘丽娟%田雪秋%梁一男%魏凤娟
王丹輝%張燕%劉麗娟%田雪鞦%樑一男%魏鳳娟
왕단휘%장연%류려연%전설추%량일남%위봉연
骨关节炎,膝%受体,肿瘤坏死因子,Ⅱ型%透明质酸%薰洗%治疗,临床研究性
骨關節炎,膝%受體,腫瘤壞死因子,Ⅱ型%透明質痠%薰洗%治療,臨床研究性
골관절염,슬%수체,종류배사인자,Ⅱ형%투명질산%훈세%치료,림상연구성
osteoarthritis,knee%receptors,tumor necrosis factor,typeⅡ%hyaluronic acid%steaming washing therapy%therapies,investigational
目的：观察注射用重组人Ⅱ型肿瘤坏死因子受体－抗体融合蛋白（recombinant human tumor necrosis factor receptor －Fc fu-sion protein，rhTNFR：Fc）关节腔注射联合中药薰洗治疗膝骨关节炎的临床疗效。方法：将60例膝骨关节炎患者随机分为2组，每组30例。分别采用关节腔注射 rhTNFR：Fc 联合中药薰洗和关节腔注射玻璃酸钠联合中药薰洗治疗。比较治疗前后2组膝关节疼痛视觉模拟评分（visual analogue score，VAS）及西安大略和麦克马斯特大学（Western Ontario and McMaster Universities，WOMAC）骨关节炎评分，并于治疗结束后3个月比较2组患者的综合疗效。结果：治疗前2组患者的膝关节 VAS 评分及 WOMAC 评分比较，组间差异均无统计学意义[（7．15±1．09）分，（6．90±1．52）分，t ＝1．045，P ＝0．309；（54．75±3．23）分，（55．45±3．11）分，t ＝0．700，P ＝0．493]。治疗结束后3个月，2组患者的膝关节 VAS 评分[（3．05±0．76）分，（4．10±0．97）分]及 WOMAC 评分[（16．55±2．65）分，（27．20±3．17）分]均较治疗前下降（t ＝14．173，P ＝0．000；t ＝10．101，P ＝0．000；t ＝34．451，P ＝0．000；t ＝39．161，P ＝0．000）；rhTNFR：Fc 组的膝关节 VAS 评分及 WOMAC 评分下降幅度均大于玻璃酸钠组[（4．10±1．29）分，（2．80±1．31）分，t ＝3．771，P ＝0．001；（38．20±4．96）分，（28．25±3．23）分，t ＝8．132，P ＝0．000]。治疗结束后3个月，rhTNFR：Fc 组治愈10例、显效12例、有效7例、无效1例，玻璃酸钠组治愈6例、显效8例、有效13例、无效3例，rhTNFR：Fc 组疗效优于玻璃酸钠组（Z ＝1．987，P ＝0．047）。结论：采用关节腔注射 rhTNFR：Fc 联合中药薰洗治疗膝骨关节炎，可以有效缓解膝关节疼痛，促进膝关节运功功能恢复，疗效优于关节腔注射玻璃酸钠联合中药薰洗治疗，值得临床推广应用。
目的：觀察註射用重組人Ⅱ型腫瘤壞死因子受體－抗體融閤蛋白（recombinant human tumor necrosis factor receptor －Fc fu-sion protein，rhTNFR：Fc）關節腔註射聯閤中藥薰洗治療膝骨關節炎的臨床療效。方法：將60例膝骨關節炎患者隨機分為2組，每組30例。分彆採用關節腔註射 rhTNFR：Fc 聯閤中藥薰洗和關節腔註射玻璃痠鈉聯閤中藥薰洗治療。比較治療前後2組膝關節疼痛視覺模擬評分（visual analogue score，VAS）及西安大略和麥剋馬斯特大學（Western Ontario and McMaster Universities，WOMAC）骨關節炎評分，併于治療結束後3箇月比較2組患者的綜閤療效。結果：治療前2組患者的膝關節 VAS 評分及 WOMAC 評分比較，組間差異均無統計學意義[（7．15±1．09）分，（6．90±1．52）分，t ＝1．045，P ＝0．309；（54．75±3．23）分，（55．45±3．11）分，t ＝0．700，P ＝0．493]。治療結束後3箇月，2組患者的膝關節 VAS 評分[（3．05±0．76）分，（4．10±0．97）分]及 WOMAC 評分[（16．55±2．65）分，（27．20±3．17）分]均較治療前下降（t ＝14．173，P ＝0．000；t ＝10．101，P ＝0．000；t ＝34．451，P ＝0．000；t ＝39．161，P ＝0．000）；rhTNFR：Fc 組的膝關節 VAS 評分及 WOMAC 評分下降幅度均大于玻璃痠鈉組[（4．10±1．29）分，（2．80±1．31）分，t ＝3．771，P ＝0．001；（38．20±4．96）分，（28．25±3．23）分，t ＝8．132，P ＝0．000]。治療結束後3箇月，rhTNFR：Fc 組治愈10例、顯效12例、有效7例、無效1例，玻璃痠鈉組治愈6例、顯效8例、有效13例、無效3例，rhTNFR：Fc 組療效優于玻璃痠鈉組（Z ＝1．987，P ＝0．047）。結論：採用關節腔註射 rhTNFR：Fc 聯閤中藥薰洗治療膝骨關節炎，可以有效緩解膝關節疼痛，促進膝關節運功功能恢複，療效優于關節腔註射玻璃痠鈉聯閤中藥薰洗治療，值得臨床推廣應用。
목적：관찰주사용중조인Ⅱ형종류배사인자수체－항체융합단백（recombinant human tumor necrosis factor receptor －Fc fu-sion protein，rhTNFR：Fc）관절강주사연합중약훈세치료슬골관절염적림상료효。방법：장60례슬골관절염환자수궤분위2조，매조30례。분별채용관절강주사 rhTNFR：Fc 연합중약훈세화관절강주사파리산납연합중약훈세치료。비교치료전후2조슬관절동통시각모의평분（visual analogue score，VAS）급서안대략화맥극마사특대학（Western Ontario and McMaster Universities，WOMAC）골관절염평분，병우치료결속후3개월비교2조환자적종합료효。결과：치료전2조환자적슬관절 VAS 평분급 WOMAC 평분비교，조간차이균무통계학의의[（7．15±1．09）분，（6．90±1．52）분，t ＝1．045，P ＝0．309；（54．75±3．23）분，（55．45±3．11）분，t ＝0．700，P ＝0．493]。치료결속후3개월，2조환자적슬관절 VAS 평분[（3．05±0．76）분，（4．10±0．97）분]급 WOMAC 평분[（16．55±2．65）분，（27．20±3．17）분]균교치료전하강（t ＝14．173，P ＝0．000；t ＝10．101，P ＝0．000；t ＝34．451，P ＝0．000；t ＝39．161，P ＝0．000）；rhTNFR：Fc 조적슬관절 VAS 평분급 WOMAC 평분하강폭도균대우파리산납조[（4．10±1．29）분，（2．80±1．31）분，t ＝3．771，P ＝0．001；（38．20±4．96）분，（28．25±3．23）분，t ＝8．132，P ＝0．000]。치료결속후3개월，rhTNFR：Fc 조치유10례、현효12례、유효7례、무효1례，파리산납조치유6례、현효8례、유효13례、무효3례，rhTNFR：Fc 조료효우우파리산납조（Z ＝1．987，P ＝0．047）。결론：채용관절강주사 rhTNFR：Fc 연합중약훈세치료슬골관절염，가이유효완해슬관절동통，촉진슬관절운공공능회복，료효우우관절강주사파리산납연합중약훈세치료，치득림상추엄응용。
Objective:To observe the clinical curative effects of intra-articular injection of TypeⅡrecombinant human tumor necrosis factor receptor -Fc fusion protein(rhTNFR:Fc)combined with Chinese herbal steaming and washing therapy for treatment of knee osteoar-thritis(KOA).Methods:Sixty patients with KOA were randomly divided into 2 groups,30 cases in each group.The patients were treated with combination therapy of intra-articular injection of rhTNFR:Fc with Chinese herbal steaming and washing(rhTNFR:Fc group)and com-bination therapy of intra-articular injection of sodium hyaluronate(SH)with Chinese herbal steaming and washing(SH group)respectively. The knee visual analogue score(VAS)and Western Ontario and McMaster Universities(WOMAC)osteoarthritis score were compared be-tween the 2 groups before and after the treatment,and the total clinical curative effects were also compared between the 2 groups at 3 months after the end of the treatment.Results:There was no statistical difference in the knee VAS scores and WOMAC scores between the 2 groups before the treatment(7.15 +/-1.09 vs 6.90 +/-1.52 points,t =1.045,P =0.309;54.75 +/-3.23 vs 55.45 +/-3.11 points,t =0.700, P =0.493).The knee VAS scores(3.05 +/-0.76,4.10 +/-0.97 points)and WOMAC scores(16.55 +/-2.65,27.20 +/-3.17 points)of all patients decreased at 3 months after the end of the treatment(t =14.173,P =0.000;t =10.101,P =0.000;t =34.451,P =0.000;t =39.161,P =0.000).The decreased degree of knee VAS scores and WOMAC scores of rhTNFR:Fc group were greater than those of SH group(4.10 +/-1.29 vs 2.80 +/-1.31 points,t =3.771,P =0.001;38.20 +/-4.96 vs 28.25 +/-3.23 points,t =8.132,P =0.000). At 3 months after the end of the treatment,10 patients were cured,12 got a good result,7 fair and 1 poor in the rhTNFR:Fc group;while 6 patients were cured,8 got a good result,13 fair and 3 poor in the SH group.The rhTNFR:Fc group surpassed the SH group in the curativeeffect(Z =-1.987,P =0.047).Conclusion:The therapy of intra-articular injection of rhTNFR:Fc combined with Chinese herbal steaming and washing can effectively relieve the knee pain and promote the knee function recovery in the treatment of KOA,and its curative effect is better than that of intra-articular injection of SH combined with Chinese herbal steaming and washing,so it is worthy of popularizing in clinic.
