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关节腔内注射帕瑞昔布治疗早期膝关节骨关节炎的临床疗效

[Clinical efficacy of intra-articular parecoxib injection for the treatment of early knee osteoarthritis].

作者信息

Lu Lu, Huang Xiao-Wen, Xie Yu, Wang Yue

机构信息

Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu, China;

出版信息

Zhongguo Gu Shang. 2019 May 25;32(5):418-422. doi: 10.3969/j.issn.1003-0034.2019.05.006.

Abstract

OBJECTIVE

To observe and evaluate the clinical effect of intra-articular injection of parecoxib in patients with early knee osteoarthritis.

METHODS

From September 2016 to August 2017, 107 patients with early knee osteoarthritis were treated, including 50 males and 57 females, aged 45 to 64 (51.9±4.2) years. They were divided into basic therapy+oral glucosamine group(group A) 36 cases, oral celecoxib+basic therapy+oral glucosamine group(group B) 36 cases, intra-articular injection of parecoxib+basic therapy+oral glucosamine group(group C) 35 cases. There was no significant difference in gender, age, BMI and clinical stage(Kellgren-Lawrence classification) between the three groups before treatment. VAS score, HSS score and patient satisfaction were compared before and after treatment in the three groups. The levels of inflammatory cytokines in synovial fluid were measured before and after treatment in the three groups.

RESULTS

All cases were followed up for(15.2±2.6) months on average. The VAS score and HSS score of each group were improved after treatment(<0.001). There were significant differences in VAS and HSS scores among the three groups after treatment(<0.001). The clinical efficacy of group C was better than that of group A and B(<0.001), group B was better than that of group A(<0.001), and group C had the highest satisfaction(<0.001). After treatment, the concentration of proinflammatory factor TNF-α and IL-6 in the synovial fluid of each group decreased(<0.001) and the concentration of anti-inflammatory factor IL-10 increased(<0.001). After treatment, the concentrations of TNF-α, IL-6 and IL-10 in the synovial fluid of the three groups were significantly different(<0.001).

CONCLUSIONS

For patients with early knee osteoarthritis, intra-articular injection of parecoxib can significantly improve clinical symptoms and avoid adverse reactions of long-term oral NSAIDs, which is an effective treatment.

摘要

目的

观察并评价帕瑞昔布关节腔内注射治疗早期膝关节骨关节炎患者的临床效果。

方法

选取2016年9月至2017年8月收治的107例早期膝关节骨关节炎患者,其中男性50例,女性57例,年龄45至64岁(51.9±4.2岁)。将其分为基础治疗+口服氨基葡萄糖组(A组)36例、口服塞来昔布+基础治疗+口服氨基葡萄糖组(B组)36例、关节腔内注射帕瑞昔布+基础治疗+口服氨基葡萄糖组(C组)35例。三组治疗前在性别、年龄、BMI及临床分期(Kellgren-Lawrence分级)方面差异无统计学意义。比较三组治疗前后的视觉模拟评分(VAS)、美国特种外科医院膝关节评分(HSS)及患者满意度。检测三组治疗前后滑液中炎症细胞因子水平。

结果

所有病例平均随访(15.2±2.6)个月。三组治疗后VAS评分及HSS评分均改善(<0.001)。三组治疗后VAS及HSS评分差异有统计学意义(<0.001)。C组临床疗效优于A组和B组(<0.001),B组优于A组(<0.001),C组满意度最高(<0.001)。治疗后,三组滑液中促炎因子肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)浓度降低(<0.001)且抗炎因子白细胞介素-10(IL-10)浓度升高(<0.001)。治疗后,三组滑液中TNF-α、IL-6及IL-10浓度差异有统计学意义(<0.001)。

结论

对于早期膝关节骨关节炎患者,关节腔内注射帕瑞昔布可显著改善临床症状,避免长期口服非甾体抗炎药的不良反应,是一种有效的治疗方法。

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