骨关节炎内科治疗新进展(4)
小结
骨关节炎患者治疗方式的选择必须按个体化原则和按照症状的程度而异。如果症状较轻，可以选用患者的指导、物理和职业疗法以及其他非药物治疗；药物治疗有非鸦片类口服(对乙酰氨基酚)和局部用止痛剂。如果患者对这些方法不敏感，可采用NSAIDs加上非药物治疗；膝关节有积液时，关节抽液和关节腔内注射皮质激素较为合适；关节内透明质酸钠注射在短期内可以缓解疼痛症状；关节冲洗和关节镜下清扫不一定对每位患者有效，因此不应作为常规方法采用；严重的骨关节炎患者则可能需要手术治疗。
参考文献
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.100md.com(王毅)
骨关节炎患者治疗方式的选择必须按个体化原则和按照症状的程度而异。如果症状较轻，可以选用患者的指导、物理和职业疗法以及其他非药物治疗；药物治疗有非鸦片类口服(对乙酰氨基酚)和局部用止痛剂。如果患者对这些方法不敏感，可采用NSAIDs加上非药物治疗；膝关节有积液时，关节抽液和关节腔内注射皮质激素较为合适；关节内透明质酸钠注射在短期内可以缓解疼痛症状；关节冲洗和关节镜下清扫不一定对每位患者有效，因此不应作为常规方法采用；严重的骨关节炎患者则可能需要手术治疗。
参考文献
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.100md.com(王毅)