增生疗法联合神经周围注射治疗膝关节骨性关节炎临床效果

打开文本图片集

[关键词] 骨关节炎，膝;葡萄糖溶液，高渗;注射，关节内;增生疗法;周围神经;关节痛 [中图分类号] R684.3 [文献标志码] A [文章编号] 2096-532（2025）02-0195-04 doi：10.1712/jms.2096-532.2025.61.059

[Abstract] Objective Toinvestigatetheeficacyofultrasound-guidedhypertonicglucoseprolotherapycombinedwithperineuralinjectioninpatientswithkne osteoarthritis （KOA）. Methods Thisstudywasasingle-centerrandomizedcontroled trial.Atotalof40patientswithKOApatientswereenroled，amongwhom3werelosttofolow-up，andfinalytherewere19patientsintheexperimentalgroupand18inthecontrolgroup.Thepatientsinbothgroupsreceivedultrasound-guidedinjectionof 200g/L glucoseintothesuprapatelarcapsuleandlocalizationoffourdepnervebranches（thesaphenousnerve，thefrapatelar branchofthesaphenousnerve，thesuperomedialgenicularnerve，andthesuperolateralgenicularnerve）aroundtheknejoint;the patientsintheexperimentalgroupreceivedinjectionof 50g/L glucoseintoeachnerve，andthoseinthecontrolgroupdidnotreceivesuchinjection.Thepatientsinbothgroupsreceivedthreinjections.ThetwogroupswereobservedintermsofVisualAnalogueScale（VAS）painscore，WesternOntarioand McMasterUniversitiesOsteoarthritis（WOMAC）index，andpresurepain threshold（P T）beforetreatmentandat2，4，and8weksaftertreatment. Results Aftertreatment，bothgroupshadsignificantimprovementsinVASscoreandWOMACindexatdiferenttimepoints （F=98.62-182.37，P<0.05） ），andcomparedwith thecontrolgroupateachtimepointaftertreatment，theexperimentalgrouphadsignificantlygreaterimprovementsinVASscore andWOMACindex .Aftertreatment，theexperimentalgrouphadasignificantimprovementin PT aroundtheknejointandasignificantlygreaterimprovementthanthecontrolgroupateachtimepoint ′F=15.12-132.30，P< 0.05）. Conclusion Hypertonicglucoseprolotherapycombinedwithperineuralinjectionof 50g/L glucosecanefectivelyaleviate thepainofKOAandimproveknejointfunction，withabetereficacythanprolotherapyalone，andtherefore，itcanbeusedas asafeandefectivemethodfortheclinicaltreatmentofKOA.

[Keywords] osteoarthritis，kne;glucosesolution，hypertonic;injections，intra-articular;prolotherapy;peripheralnerves; arthralgia

膝关节骨性关节炎（KOA）是好发于中老年人群的退行性病变，目前尚无治愈方法，主要治疗原则是减轻疼痛、延缓疾病进展、提高生活质量。（剩余7528字）