摘要
目的观察依托考昔片联合玻璃酸钠注射液治疗膝关节骨性关节炎的临床疗效及安全性。方法将158例膝关节骨性关节炎患者随机分为对照组和试验组,每组79例。对照组予以玻璃酸钠每次2 mL,每周1次,关节腔内注射;试验组在对照组治疗的基础上,予以依托考昔每次60 mg,qd,口服。2组患者均治疗4周。比较2组患者的临床疗效、西安大略和麦克马斯特大学(WOMAC)骨性关节炎指数评分、炎性因子和基质金属蛋白酶(MMP)水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为93. 67%(74例79例)和83. 54%(66例79例),差异有统计学意义(P <0. 05)。治疗后,试验组和对照组的WOMAC骨性关节炎指数总评分分别为(20. 46±2. 88)和(39. 57±4. 39)分,白细胞介素-1β分别为(81. 15±10. 44)和(108. 54±13. 28)ng·L^(-1),肿瘤坏死因子-α分别为(60. 36±7. 45)和(72. 14±9. 36) pg·mL^(-1),超敏C反应蛋白分别为(2. 19±0. 31)和(5. 05±0. 72) mg·L^(-1),MMP-1分别为(0. 39±0. 05)和(0. 78±0. 11)μg·L^(-1),MMP-3分别为(10. 37±1. 35)和(16. 75±2. 19)μg·L^(-1),MMP-9分别为(24. 18±3. 08)和(35. 22±4. 59)μg·L^(-1),差异均有统计学意义(均P <0. 05)。2组患者的药物不良反应主要有上腹部不适、恶心、注射部位疼痛和皮疹。试验组和对照组的总药物不良反应发生率分别为8. 87%和5. 07%,差异无统计学意义(P> 0. 05)。结论依托考昔片联合玻璃酸钠注射液治疗膝关节骨性关节炎的临床疗效确切,其能有效减轻炎症反应,降低血清MMP-1、MMP-3和MMP-9水平,减轻关节软骨破坏,且不增加药物不良反应发生率。
Objective To observe the clinical efficacy and safety of etoricoxib tablets combined with sodium hyaluronate injection in the treatment of knee osteoarthritis. Methods A total of 158 patients with osteoarthritis of the knee were randomly divided into control and treatment groups with 79 cases per group. Control group was treated with sodium hyaluronate injection 2 mL per time,once a week,intra-articular injection. Treatment group was treated with etoricoxib tablets 60 mg per time,qd,orally,on the basis of control group. Two groups were treated for 4 weeks. The clinical efficacy,Western Ontario and McMaster Universities Osteoarthritis Index( WOMAC) scores,the levels of inflammatory factors and matrix metalloproteinases( MMP),and adverse drug reactions werecompared between two groups. Results After treatment,the total effective rates of treatment and control groups were93. 67%( 74 cases/79 cases) and 83. 54%( 66 cases/79 cases),the difference was statistically significant( P < 0. 05). After treatment,the WOMAC osteoarthritis index pain scores in the treatment group and the control group were( 20. 46 ± 2. 88) and( 39. 57 ± 4. 39) scores,interleukin-1β were( 81. 15 ± 10. 44) and( 108. 54 ± 13. 28)ng·L-1,tumor necrosis factor-α were( 60. 36 ± 7. 45) and( 72. 14 ± 9. 36) pg·mL-1,high sensitive C reactive protein were( 2. 19 ± 0. 31) and( 5. 05 ± 0. 72) mg · L-1,matrix metalloproteinase-1 were( 0. 39 ± 0. 05) and( 0. 78 ± 0. 11) μg·L-1,matrix metalloproteinase-3 were( 10. 37 ± 1. 35) and( 16. 75 ± 2. 19) μg·L-1,matrix metalloproteinase-9 were( 24. 18 ± 3. 08) and( 35. 22 ± 4. 59) μg·L-1,the differences were statistically significant( all P < 0. 05). The adverse reactions of two groups were upper abdominal discomfort,nausea,injection site pain and skin rash. The total incidences of adverse drug reactions in the treatment and control groups were 8. 87% and 5. 07%without significant difference( P > 0. 05). Conclusion Etoricoxib tablets combined with sodium hyaluronate injection have a definitive clinical efficacy in the treatment of patients with knee osteoarthritis,which can effectively reduce the inflammatory response,decrease serum levels of MMP-1,MMP-3 and MMP-9,relieve articular cartilage damage,without increasing the incidence of adverse drug reactions.
作者
刘圣星
王隆辉
韩贵宾
LIU Sheng-xing;WANG Long-hui;HAN Gui-bin(First Department of Orthopedics Second Affiliated Hospital of Hainan Medical University,Haikou 571000,China;Department of Orthopedics Haikou People’s Hospital,Haikou 571000,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2019年第3期235-237,279,共4页
The Chinese Journal of Clinical Pharmacology
基金
海南省医药卫生科研课题资助项目(琼卫2013资助-036号)
