研究关节内注射促红细胞生成素和葡萄糖的增殖疗法以及关节内脉冲射频对原发性膝关节骨关节炎疼痛程度降低和活动范围改善的疗效。
Investigation the efficacy of intra-articular prolotherapy with erythropoietin and dextrose and intra-articular pulsed radiofrequency on pain level reduction and range of motion improvement in primary osteoarthritis of knee.
作者信息
Rahimzadeh Poupak, Imani Farnad, Faiz Seyed Hamid Reza, Entezary Saeed Reza, Nasiri Ali Akbar, Ziaeefard Mohsen
机构信息
Department of Anesthesiology and Pain Medicine, Hazrat Rasul Medical Complex, Iran University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology and Pain Medicine, Shahid Rajaee Heart Center, Iran University of Medical Sciences, Tehran, Iran.
出版信息
J Res Med Sci. 2014 Aug;19(8):696-702.
BACKGROUND
Osteoarthritis is one of the most common diseases and the knee is the most commonly affected joint. Intra-articular prolotherapy is being utilized in acute and chronic pain management setting. This study was designed to compare the efficacy of three methods of intra-articular knee joint therapies with erythropoietin, dextrose, and pulsed radiofrequency.
MATERIALS AND METHODS
After approval by the Ethics Committee and explaining the therapeutic method to volunteers, 70 patients who were suffering from primary knee osteoarthrosis went through one of the treatment methods (erythropoietin, dextrose, and pulsed radiofrequency). The study was double-blind randomized clinical trial performed from December 2012 to July 2013. Patients' pain level was assessed through the visual analog pain scale (VAS), and range of motion (ROM) was measured by goniometric method. Furthermore, patients' satisfaction was assessed before and after different treatment methods in weeks 2, 4, and 12. For analysis, Chi-square, one-way ANOVA, and repeated measured ANOVA were utilized.
RESULTS
The demographic results among the three groups did not indicate any statistical difference. The mean VAS in erythropoietin group in the 2(nd), 4(th), and 12(th) weeks was 3.15 ± 1.08, 3.15 ± 1.08, and 3.5 ± 1.23, respectively (P ≤ 0.005). Knee joint ROM in the erythropoietin group in the 2(nd), 4(th), and 12(th) weeks was 124 ± 1.50, 124 ± 1.4, and 123 ± 1.53 respectively (P ≤ 0.005). Satisfaction score in the 12(th) week in erythropoietin group was extremely satisfied 15%, satisfied 55%, and moderately satisfied 30%, (P = 0.005). No specific side-effects were observed.
CONCLUSION
Intra-articular prolotherapy with erythropoietin was more effective in terms of pain level reduction and ROM improvement compared with dextrose and pulsed radiofrequency.
背景
骨关节炎是最常见的疾病之一，膝关节是最常受累的关节。关节内注射增殖疗法正用于急慢性疼痛管理。本研究旨在比较三种膝关节内治疗方法（促红细胞生成素、葡萄糖和脉冲射频）的疗效。
材料与方法
经伦理委员会批准并向志愿者解释治疗方法后，70例原发性膝关节骨关节炎患者接受了其中一种治疗方法（促红细胞生成素、葡萄糖和脉冲射频）。该研究为2012年12月至2013年7月进行的双盲随机临床试验。通过视觉模拟疼痛量表（VAS）评估患者的疼痛程度，采用测角法测量活动范围（ROM）。此外，在第2、4和12周不同治疗方法前后评估患者的满意度。分析时采用卡方检验、单因素方差分析和重复测量方差分析。
结果
三组间的人口统计学结果无统计学差异。促红细胞生成素组在第2、4和12周的平均VAS分别为3.15±1.08、3.15±1.08和3.5±1.23（P≤0.005）。促红细胞生成素组在第2、4和12周的膝关节ROM分别为124±1.50、124±1.4和123±1.53（P≤0.005）。促红细胞生成素组第12周的满意度评分中，非常满意为15%，满意为55%，中度满意为30%（P = 0.005）。未观察到特定的副作用。
结论
与葡萄糖和脉冲射频相比，关节内注射促红细胞生成素增殖疗法在降低疼痛程度和改善ROM方面更有效。
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