骨關(guān)節(jié)炎內(nèi)科治療新進(jìn)展(4)
小結(jié)
骨關(guān)節(jié)炎患者治療方式的選擇必須按個(gè)體化原則和按照癥狀的程度而異。如果癥狀較輕,可以選用患者的指導(dǎo)、物理和職業(yè)療法以及其他非藥物治療;藥物治療有非鴉片類口服(對(duì)乙酰氨基酚)和局部用止痛劑。如果患者對(duì)這些方法不敏感,可采用NSAIDs加上非藥物治療;膝關(guān)節(jié)有積液時(shí),關(guān)節(jié)抽液和關(guān)節(jié)腔內(nèi)注射皮質(zhì)激素較為合適;關(guān)節(jié)內(nèi)透明質(zhì)酸鈉注射在短期內(nèi)可以緩解疼痛癥狀;關(guān)節(jié)沖洗和關(guān)節(jié)鏡下清掃不一定對(duì)每位患者有效,因此不應(yīng)作為常規(guī)方法采用;嚴(yán)重的骨關(guān)節(jié)炎患者則可能需要手術(shù)治療。
參考文獻(xiàn)
1.Dieppe P: In Russell R.G.G and Dieoe P.A.(Eds.): Osteoarthritis. 1991, IBC Technical Services Ltd., London, 4-23.
2.Badley EM, Thompson RP., Wood P.H.N. Int. J. Epidemiol., 1978;7:145-151.
3.Hardingham TE, Caterson B. Biochemistry of articular cartilage joint disease. In Russell RG and Dieoe PA (Eds.): Osteoarthritis. 1991, IBC Technical Services Ltd., London, 51-64.
4.Vane JR, Botting RM. Mechanism of action of aspirin-like drugs. Semin Arthritis Rheum, 1997; 26(1): 2-10.
5.Hawkey CJ. COX-2 inhibitors. Lancet, 1999; 353:307-314.
6.Simon LS. Preliminary study of the safety and efficacy of SC58635, a novel cyclo-oxygenase inhibitor. Arthritis and Rheumatism, 1998; 13:1591-1602.
7.Bradley JD, et al. Comparison of an anti-inflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of knee. New Engl J Med, 1991; 325: 87-91.
8.Chang RW, Falconer J, Stulberg SD, et al. A randomized, controlled trial of arthroscopic surgery versus closed-needle joint lavage for patients with Osteoarthritis of the knee. Arthritis Rheum, 1993; 36: 289-296., http://www.www.srpcoatings.com(王毅)
骨關(guān)節(jié)炎患者治療方式的選擇必須按個(gè)體化原則和按照癥狀的程度而異。如果癥狀較輕,可以選用患者的指導(dǎo)、物理和職業(yè)療法以及其他非藥物治療;藥物治療有非鴉片類口服(對(duì)乙酰氨基酚)和局部用止痛劑。如果患者對(duì)這些方法不敏感,可采用NSAIDs加上非藥物治療;膝關(guān)節(jié)有積液時(shí),關(guān)節(jié)抽液和關(guān)節(jié)腔內(nèi)注射皮質(zhì)激素較為合適;關(guān)節(jié)內(nèi)透明質(zhì)酸鈉注射在短期內(nèi)可以緩解疼痛癥狀;關(guān)節(jié)沖洗和關(guān)節(jié)鏡下清掃不一定對(duì)每位患者有效,因此不應(yīng)作為常規(guī)方法采用;嚴(yán)重的骨關(guān)節(jié)炎患者則可能需要手術(shù)治療。
參考文獻(xiàn)
1.Dieppe P: In Russell R.G.G and Dieoe P.A.(Eds.): Osteoarthritis. 1991, IBC Technical Services Ltd., London, 4-23.
2.Badley EM, Thompson RP., Wood P.H.N. Int. J. Epidemiol., 1978;7:145-151.
3.Hardingham TE, Caterson B. Biochemistry of articular cartilage joint disease. In Russell RG and Dieoe PA (Eds.): Osteoarthritis. 1991, IBC Technical Services Ltd., London, 51-64.
4.Vane JR, Botting RM. Mechanism of action of aspirin-like drugs. Semin Arthritis Rheum, 1997; 26(1): 2-10.
5.Hawkey CJ. COX-2 inhibitors. Lancet, 1999; 353:307-314.
6.Simon LS. Preliminary study of the safety and efficacy of SC58635, a novel cyclo-oxygenase inhibitor. Arthritis and Rheumatism, 1998; 13:1591-1602.
7.Bradley JD, et al. Comparison of an anti-inflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of knee. New Engl J Med, 1991; 325: 87-91.
8.Chang RW, Falconer J, Stulberg SD, et al. A randomized, controlled trial of arthroscopic surgery versus closed-needle joint lavage for patients with Osteoarthritis of the knee. Arthritis Rheum, 1993; 36: 289-296., http://www.www.srpcoatings.com(王毅)
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