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目的 通过锝[99TC]亚甲基二磷酸盐(云克)与硫酸软骨素联合用药观察药物疗效,为临床治疗成人大骨节病提供科学数据.方法 按照《大骨节病诊断标准》(GB 16003-1995),在呼伦贝尔市大骨节病病区选择79例大骨节病患者,分为治疗组与对照组.治疗组44人,给予静脉注射云克和口服硫酸软骨素;对照组35人,仅静脉注射云克.3个月后观察效果[以治疗前后疼痛、功能改善情况、骨关节炎指数(WOMAC)变化情况进行判定].结果 治疗组和对照组经过3个月治疗后,疼痛症状及关节功能恢复显效率分别为81.82％(36/44)和60.00％(21/35);有效分别为15.91％(7/44)和34.29％(12/35)；无效分别为2.72％ (1/44)和5.71％(2/35)；总有效率分别为97.73％(43/44)和94.29％(33/35).治疗组和对照组患者治疗前后握力、15 m步行时间、血钙、WOMAC指数比较,差异均有统计学意义(治疗组t=3.37、7.99、8.73、16.19,P均＜0.05；对照组t=6.21、9.46、5.49、8.73,P均＜0.05).两组之间疗效比较差异无统计学意义(x2=1.06,P＞ 0.05).结论 云克与硫酸软骨素联合或单独用药,都是目前治疗大骨节病理想、疗效可靠的药物治疗方法,值得临床推广应用.“,”Objective To observe the clinical therapeutic efficiency of technetium (yunke) combined with chondroitin sulfate,and to provide a scientific data for clinical treatment of adults patients with Kashin-Beck disease(KBD).Methods In accordance with “Kashin-Beck Disease Diagnostic Criteria”(GB 16003-1995),79 cases of KBD patients in Hulunbuir city were selected and divided into treatment group and control group.Treatment group(n =44) were given intravenous yunke and oral chondroitin sulfate,and control group(n =35)were given intravenous yunke only.The effect was observed after 3 months by womac index(judged by pain,function improvement and WOMAC index chanse before and after the treatment).Results The pain and joint function had improved after the treatment in two groups.The significant effective rate was 81.82％ (36/44) and 60.00％(21/35),respectively; effective rate was 15.91％(7/44) and 34.29％(12/35),respectively; invalid rate was 2.72％ (1/44) and 5.71％(2/35),respectively; total effective rate was 97.73％(43/44) and 94.29％(33/35),respectively.Grip strength,15 m walking time,blood calcium,WOMAC index change were statistically significant,treatment group(t =3.37,7.99,8.73,16.19,all P ＜ 0.05) and the control group(t =6.21,9.46,5.49,8.73,all P ＜ 0.05).Curative effect of two groups was not statistical significance(x2 =1.06,P＞ 0.05).Conclusions At present,use yunke combined with chondroitin sulfate or use yunke only,is all effective,safe and economical treatment method of KDB.It is worthy of clinical application.