medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-073medsovet-7429Research ArticleРЕВМАТОЛОГИЯRHEUMATOLOGYОценка эффективности кеторолака для наружного применения в комплексном лечении остеоартрита коленных суставовEvaluation of the effectiveness of ketorolac or external use in the complex treatment of osteoarthritis of the knee jointshttps://orcid.org/0000-0002-9563-2208СветловаМ. С.SvetlovaM. S.

Светлова Марина Станиславовна - доктор медицинских наук, профессор кафедры госпитальной терапии.

185910, Республика Карелия, Петрозаводск, проспект Ленина, д. 33

Marina S. Svetlova - Dr. Sci. (Med.), Professor of the Department of Hospital Therapy.

33, Lenin Ave., Petrozavodsk, Republic of Karelia, 185910

marinasvetlovacom@yandex.ruПетрозаводский государственный университетРоссияPetrozavodsk State UniversityRussian Federation20231204202303156160Copyright © Светлова М.С., 20232023Светлова М.С.Svetlova M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7429Введение

Введение. Проблема лечения остеоартрита (ОА), при котором часто страдают коленные суставы, остается актуальной вследствие распространенности заболевания, небезопасности препаратов, применяющихся пациентами в лечении боли.  В комплексной терапии ОА широко применяются локальные средства. В составе препаратов для локального применения нестероидные противовоспалительные средства (НПВС), которые эффективны и при правильном назначении практически безопасны, лишены значимых побочных эффектов, не ухудшают течения сопутствующей патологии.

Цель

Цель. Изучить эффективность кеторолака для наружного применения (КНП) в комплексной терапии остеоартрита коленных суставов (ОАКС).

Материалы и методы

Материалы и методы. В исследование были включены 58 пациентов с ОАКС II–III рентгенологических стадий. Основная группа (n = 30) в комплексном лечении заболевания использовала КНП локально на коленные суставы в течение 2 недель. В группе контроля (n = 28), как и в основной, использовали физиолечение, НПВС, но КНП не назначался.

Результаты

Результаты. Через неделю лечения в основной группе боль уменьшилась в покое и при ходьбе (p < 0,01 для ВАШ при ходьбе, p < 0,05 для ВАШ покоя). Индекс WOMAC боли также стал достоверно ниже своих исходных значений (р < 0,01). Положительная динамика клинических показателей наблюдалась и в контрольной группе, однако достоверные различия  с исходными значениями через неделю терапии отсутствовали как для ВАШ покоя, так и индекса WOMAC функции. Достоверность различий с исходными в основной группе сохранялась и через 2 недели наблюдения, достоверно отличалось и значение индекса WOMAC функции (p < 0,01). В контроле через 2 недели лечения значения выраженности боли по ВАШ в покое, индекса WOMAC функции так и не достигли достоверных различий с исходными. Через неделю и 2 недели лечения в основной группе положительные результаты были достигнуты у 17 (56,3%) и 23 (76,6%) пациентов соответственно. В группе контроля в контрольные сроки наблюдения положительные результаты терапии отмечены у 13 (46,4%)  и 18 (64,2%) пациентов соответственно. Больные основной группы раньше смогли отказаться от приема небезопасных НПВС. Побочных эффектов терапии КНП отмечено не было.

Выводы

Выводы. КНП эффективен при ОАКС.

Introduction

Introduction. The problem of treatment of osteoarthritis (OA) remains relevant due to the high prevalence of the disease, the insecurity of drugs used by patients in the treatment of pain. The knee joints are most often affected. Chronic pain, impaired joint function significantly reduce the quality of life of patients, lead to the destabilization of concomitant diseases. In the complex therapy of OA, local remedies are widely used.

Objective

Objective. To study the effectiveness of ketorolac for external use (KEU)in the complex therapy of osteoarthritis of the knee joints (OAKJ).

Materials and methods

Materials and methods. 58 patients with OAKJ of II-III radiological stages were studied. The main group (n = 30) in the complex treatment of the disease used KEU locally for two weeks. In the control group (n = 28), as in the main one, physiotherapy, nonsteroidal antiinflammatory drugs (NSAIDs) were used, KEU was not prescribed.

Results

Results. The values of VAS at rest and when walking after a week of treatment significantly differed from the initial values in the main group of patients (p < 0.01 for VAS when walking, p < 0.05 for VAS at rest). The WOMAC pain index was also significantly lower than its initial values (p < 0.01). Positive dynamics of clinical indicators was also observed in the control group, however, there were no significant differences after a week of therapy for both your VAS at rest and the WOMAC function index. The reliability of the differences with the baseline in the main group was maintained after two weeks of observation, and the value of the WOMAC function index was significantly different (p < 0.01). In the control after two weeks of treatment, the values of the severity of pain according to VAS at rest, the index of WOMAC function did not reach significant differences with the baseline. After a week and two weeks of treatment in the main group, positive results were achieved in 17 (56.3%) and 23 (76.6%) patients, respectively. In the control group, positive therapy results were observed in 13 (46.4%) and 18 (64.2%) patients, respectively, at the control periods of observation.

Сonclusion

Сonclusion. The use of KEU is effective and appropriate in the complex therapy of OAKJ.

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The authors declare that there are no conflicts of interest present.