美洛昔康联合运动训练治疗老年性膝关节骨关节炎(1)
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【中图分类号】R684.3【文献标识码】A【文章编号】1005-2720(2009)04-0165-03
【摘要】目的：评价美洛昔康联合膝关节功能训练对膝骨关节炎关节功能改善的状况。方法：选择124例膝关节骨关节炎病人，随机分为两组，对照组接受口服美洛昔康治疗2w，每次7.5mg。联合治疗组持续进行膝关节功能训练8w，在最初2w同样口服美洛昔康，每日3次，每次7.5mg。在治疗至8w时评定两组患者膝关节功能改善之间的差异。结果：至第8周时对照组疗效评定优1例，良22例；可26例；差1例。而联合治疗组疗效评定优3例，良33例；可13例；差1例。两组之间的疗效评定差异有显著性意义，联合治疗组疗效明显优于对照组(P<0.0l)。结论：口服美洛昔康结合运动训练治疗膝骨关节炎能有效改善关节功能。与单纯口服美洛昔康比较，关节功能改善更明显。
【关键词】骨关节炎；功能训练；膝关节；美洛昔康
Meloxicam therapy combined with the functional training for osteoarthritis(OA) of the elder’s knee.Chen Zuyan.(Kaiping hospital of TCM，Guangdong 529300，China)
【Abstract】Objective：To evaluate the joint function improvement of Meloxicam Therapy combined with the functional training for osteoarthritis(OA) of the knee.Methods：100 patients with OA of the knee were equally randomized into two groups.The patients in the control group took Meloxicam 7.5mg per day for two weeks.The patients in the combined treatment group underwent an eight-week functional training program for OA of the knee and took Meloxicam 7.5mg per day in the first two weeks.The function improvement of the knee between the two groups was evaluated.Results：1 patient was A，22 patients were B，26 patients were C and 1 patient was D within the control group.While 3 patients were A，33patients were B，13patients were C and 1 patient was D in the combined treatment group.The combined treatment group obtained more improvement of joint function than the control group.It showed significant difference between the two groups(P<0.01).Conclusion：The combination management of Meloxicam therapy and functional training program on OA of the knee is more significantly effective for joint functional improvement than Meloxicam treatment alone for osteoarthritis of the knee.
【Key Words】Osteoarthritis；Functional training；Knee；Meloxicam
骨关节炎(osteoarthritis，OA)是以关节软骨病理性损害为主的老年性退行性疾病，以膝关节疼痛、肿胀及关节僵硬为特征，最终导致无法独立生活或生活质量下降。应用药物消除炎症、控制疼痛是一种主要的治疗手段。非甾体抗炎药(non-steroidal anti-inflammatory drugs，NSAIDs)是最常用的OA症状缓解药物。患者多需长期服用这类药物，其长期应用易产生胃肠道并发症。选择抗炎镇痛效果良好而不良反应极少的药物具有非常重要的临床意义。传统的NSAIDs因同时抑制COX-1与COX-2而常引起胃肠道不适等不良反应。美洛昔康(Meloxicam)是近年才应用于临床的新的NSAIDs，对COX-2具有选择性抑制作用。以往的研究认为，运动训练的作用在于治疗疼痛和减少残疾，但有国外研究表明，运动训练可能降低骨关节炎的发病率，并具有减缓骨关节炎的作用，因而受到越来越多的关注[1]。本文采用美洛昔康结合运动训练治疗膝关节骨关节炎，取得了良好的治疗效果。
1 资料与方法
1.1 一般资料：2006年4月~2008年7月我院收治老年性膝关节OA患者100例。均符合1995年美国风湿病学会(ACR)关于膝关节OA的分类诊断标准，年龄≥65岁。排除标准：①有炎症、创伤、肿瘤、糖尿病等疾病的患者；②诊为或疑似风湿、类风湿性关节炎等风湿免疫性疾病的患者；③治疗前2w内使用过糖皮质类固醇激素、非甾体类消炎止痛药者；④妊娠或哺乳期妇女；⑤有感染性关节炎、反应性关节炎等其他关节疾病的患者；⑥重度OA患者需行关节置换者 ......
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