Observation On The Curative Effect Of Needle-knife-scope Joint Debridement Combined With Ozone Injection In The Treatment Of Rheumatoid Arthritis

Objective:To observe the curative effect of combination of needle knife mirror joint cleaning and ozone injection on rheumatoid arthritis.Methods:Ninety hospitalized patients with rheumatoid arthritis（RA）were selected for definite diagnosis,Mainly knee swelling and pain.The patients were divided into three groups using random numerical tables.Three groups of patients were in gender,age,course,and degree of disease activity.No statistical significance（P>0.05）.Patients in group A were treated with a simple oral dose of methotrexate（MTX）of 10 mg each time,once a week.Group B received ozone（O₃）injection into knee joint cavity on the basis of oral MTX,weekly joint cavity injection,concentration 40μg/mL O₃ injection 20mL treatment,4 consecutive injections,4 weeks is 1 course of treatment,and 1 course of treatment is treated.Group C was treated with MTX combined with needle knife mirror debridement and intra-articular injection of O₃,and needle knife mirror surgery once,intra-articular synovial morphology was observed,joint cavity was lavaged,Planing proliferative synovium.Each week,the knee joint O₃ is injected once,concentration40μg/mL O₃ injection 20mL treatment,4 consecutive injections,4 weeks is 1 course of treatment,and 1 course of treatment is treated.Observation after 3 months of treatment:（1）activity index before and after treatment:DAS28 score,VAS（visual simulation score）score;（2）Levels and changes of serum inflammatory cytokines TNF-α（tumor necrosis factory-α）and RF（rheumatoid factor）,sTNFR II（soluble tumor necrosis factor receptor II）before and after treatment;（3）Record the adverse reactions that occurred during the treatment,such as intra articular infection,cruciate ligament injury,internal and external meniscus injury,hemorrhage,articular effusion,and systemic symptoms.Results:（1）The difference between DAS28 score,VAS score and TNF-αlevel was statistically significant after treatment and before treatment in 3 groups（P<0.05）;（2）Compared with the treatment of Group A and Group A,the differences in the levels of VAS score and TNF-αwere statistically significant（P<0.05）;（3）The difference between VAS score and TNF-αwas statistically significant in group C and group A treatment（P<0.01）,and the difference between DAS28 score and sTNFR II level was statistically significant（P<0.05）;（4）The difference between VAS score and TNF-αwas statistically significant after treatment in Group C and Group B（P<0.05）.Conclusion:needle knife mirror joint cleaning and joint ozone injection+MTX for RA is better than joint ozone injection+MTX and simple MTX therapy.This treatment can quickly relieve joint pain,improve joint activity score,and have high safety.