唐令

[摘要] 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。

[关键词] 膝骨性关节炎；药物治疗； 膝关节功能Lysholm评分

[中图分类号] R684 [文献标识码] A [文章编号] 1673-7210（2015）05（c）-0132-04

[Abstract] 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 significant 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 satisfactory recent and forward curative effect， which has higher knee Lysholm score， is an ideal pharmacotherapy， is worthy of clinical application.

[Key words] Knee osteoarthritis； Drugs therapy； Knee Lysholm score

膝骨性关节炎（knee osteoarthritis）是一种关节软骨退变疾病，多发于老年人，也称为老年性骨关节炎[1]，目前对于其发病机制尚不明确，多为机械外伤因素或者炎症导致关节软骨损失，从而导致关节疼痛[2]。现代膝骨性关节炎的治疗主要为手术治疗以及药物治疗，其中药物治疗为主体，包括中药治疗以及西药治疗[3]，但尚无一种较为有效的药物疗法。本研……