摘要
目的 研究椎旁关节和骶髂关节注射臭氧水治疗强直性脊柱炎性疼痛的有效性和安全性.方法 2013年10月至2016年10月山西焦煤西山煤电集团职工总医院诊治的强直性脊柱炎患者40例,根据治疗方法将患者分为A组和B组,每组20例患者.A组采用椎旁关节和骶髂关节注射臭氧水,B组口服双氯芬酸钠缓释片,两组均同时给予免疫抑制剂进行治疗.评估治疗前和治疗后2个月内的镇痛效果、关节活动度Schober值、巴斯强直性脊柱炎病情活动指数（BASDAI）、CRP和ESR及不良反应.结果 A组治疗前、治疗后1周及1、2个月时VAS评分分别为（8.20±0.92）、（2.60±0.79）、（2.30±0.67）、（1.50±0.53）分,腰椎活动度检查Schober值分别为（2.55±1.62）、（3.10±1.59）、（3.35±1.99）、（4.10±1.37） cm,BASDAI值分别为6.30±0.64、2.68±0.46、2.08±0.40、1.56±0.48;B组治疗前、治疗后1周及1、2个月时VAS评分分别为（8.30±1.06）、（4.00±1.05）、（2.50±1.18） （1.80±1.03）分,Schober值分别为（2.50±1.80）、（2.85±1.49）、（3.95±1.19）、（4.05±0.89） cm,BASDAI值分别为5.64±0.47、2.98±0.29、2.20±0.37和1.70±0.45.两组患者治疗后1周及1、2个月时VAS评分和BASDAI值均明显低于治疗前（P均＜0.05）,A组治疗后1周及1、2个月和B组治疗后1、2个月的Schober值明显高于治疗前（P均＜0.05）.A组治疗后1周及1、2个月的优良率分别为80％、100％和100％,B组分另为40％、80％和90％.A组在1周和1个月时的优良率均高于B组（P均＜0.05）.A组治疗前、治疗后1周CRP值分别为（43.3±12.6）、（8.46±6.92） mg/L,ESR值分别为（38.3±9.4）、（14.2±5.5） mm/1h;B组治疗前、治疗后1周CRP值分别为（43.1±16.9）、（9.92±6.98） mg/L,ESR值分别为（32.0±10.1）、（12.8±6.5）mm/1h;两组患者治疗后CRP和ESR值与治疗前比较均降低,差异均有统计学意义（P均＜0.01）.另外,A组和B组分别有20％和55
Objective To investigate the efficacy and safety of ozonated water injection for inflammatory pain of ankylosing spondylitis.Methods Forty patients suffered from inflammatory pain of ankylosing spondylit were admitted at the Xishan Coal Electricity Group Co.,Ltd Workers＆#39; General hospital from October 2013 to October 2016,and were randomly divided into Group A and Group B,20 cases in each group.Patients in Group A were treated with ozonated water injection into facet joint and sacroiliac joint,while patients in Group B were treated with diclofenac sodium controlled release table as control.Immunosuppressant was taken by all patients in both groups as the basic therapy.The VAS,ratio of VAS less than 3,Schober,Bath ankylosing spondylitis disease activity index（BASDAI）,CRP,ESR and side effects were evaluated before treatment and 1 week,1 and 2 months after treatment.Results Before treatment,1st week,1st and 2nd month after treatment,the VAS in group A were （8.20 ± 0.92） points,（2.60 ± 0.79） points,（2.30 ± 0.67） points,（1.50 ± 0.53） points respectively,the Schober were （2.55± 1.62） cm,（3.10± 1.59） cm,（3.35±1.99） cm,（4.10t 1.37） cm,and the BASDAI were （6.30±0.64）,（2.68±0.46）,（2.08±0.40）,（1.56±0.48）.Before treatment,1st week,1st and 2nd month after treatment,the VAS in group B were （8.30± 1.06） points,（4.00± 1.05） points,（2.50± 1.18） points,（1.80± 1.03） points,the Schober were （2.50 ± 1.80） cm,（2.85± 1.49） cm,（3.95 ± 1.19）cm,（4.05±0.89） cm,and the BASDAI were （5.64±0.47）,（2.98±0.29）,（2.20±0.37）,（1.70±0.45）.The repeated measured repeated measures analysis of variance showed that among three indexes of VAS,Schober and BASDAI,the difference within group was statistically significant （P 〈 0.05）,but there were no significant difference between groups and interaction （P 〉 0.05）.The VAS and BASDAI of patients in both groups were significantly lower at 1st week,1st and 2nd month after trea
出处
《中国综合临床》
2017年第6期492-496,共5页
Clinical Medicine of China
基金
福建省卫生厅中青年骨干人才培养项目资助计划（2015-ZQN-JC-15）
