鹽酸氨基葡萄糖結合塞來昔布治療膝骨關節炎的療效觀察_《華西醫學》

作者：

唐一侖 ,  王坤正 , 黨曉謙 , 宋金輝 , 時志斌

西安交通大學第二附屬醫院骨一科（西安，710061）;

關鍵詞：

骨關節炎，膝鹽酸氨基葡萄糖塞來昔布

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目的　觀察評價鹽酸氨基葡萄糖結合塞來昔布治療膝骨關節炎（KOA）的療效及安全性。方法　2001年3月－2012年3月采用隨機對照方法，將184例KOA患者隨機分為對照組與試驗組，各92例。對照組單獨給予塞來昔布，試驗組給予塞來昔布和鹽酸氨基葡萄糖，共治療8周，停藥后繼續觀察4周。采用Lequesne指數作為療效評分標準，觀察服藥前后的膝關節癥狀變化，包括休息痛、運動痛、壓痛、腫脹、晨僵和行走能力的改善程度，紀錄不良反應及實驗室生化指標等。結果　兩組Lequesne指數在治療前相比均明顯下降，兩組治療8周后Lequesne總指數比較差異均有統計學意義（P＜0.05）。治療8周后試驗組總有效率明顯優于對照組。安全性方面兩組比較無差異。結論　鹽酸氨基葡萄糖結合塞來昔布治療KOA，能明顯改善患者的臨床癥狀，療效優于單純的塞來昔布治療，且不會增加藥物不良反應，具有較好的臨床價值。

引用本文： 唐一侖,王坤正,黨曉謙,宋金輝,時志斌. 鹽酸氨基葡萄糖結合塞來昔布治療膝骨關節炎的療效觀察. 華西醫學, 2012, 27(12): 1780-1783. doi: 復制

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2.	Felson DT. Clinical practice--osteoarthritis of the knee[J]. N Engl J Med, 2006, 354(8): 841-848.
3.	Lanas A, Tornero J, Zamorano JL. Asessment of gastrointestinal and cardiaovascular risk in patients with osteoarthritis who require NSAIDs: the LOGICA study[J]. Ann Rheum Dis, 2010, 69(8): 1453-1458.
4.	Oegema TR Jr, Deloria LB, Sandy JD, et al. Effect of oral glucosamine on cartilage and meniscus in normal and chymopapain-injected knees of young rabbits[J]. Arthritis Rheum, 2002, 46(9): 2495-2503.
5.	Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro[J]. Osteoarthritis Cartilage, 1998, 6(6): 427-434.
6.	Fenton JI, Chlebek-Brown KA, Peters TL, et al. Glucosamine HCl reduces equine articular cartilage degradation in explant culture[J]. Osteoarthritis Cartilage, 2000, 8(4): 258-265.
7.	Brief AA, Maurer SG, Di Cesare PE. Use of glucosamine and chondroitin sulfate in the management of osteoarthritis[J]. J Am Acad Orthop Surg, 2001, 9(2): 71-78.
8.	Barr S, Bellamy N, Buchanan WW, et al. A comparative study of signal versus aggregate methods of outcome measurement based on the WOMAC Osteoarthritis Index. Western Ontario and McMaster Universities Osteoarthritis Index[J]. J Rheumatol, 1994, 21(11): 2106-2112.
9.	Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee[J]. Arthritis Rheum, 1986, 29(8): l049-1039.
10.	Lequesne MG, Samson M. Indices of severity in osteoarthritis for weight bearing joints[J]. J Rheumatol, 1991, 27: 16-18.
11.	Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention[J]. Arthritis Rheum, 1998, 41(8): 1343-1355.
12.	Wieland HA, Michaelis M, Kirschbaum BJ, et al. Osteoarthritis - an untreatable disease?[J]. Nat Rev Drug Discov, 2005, 4(4): 331-344.
13.	Bliddal H, Christensen RD, Kristensen PK, et al. Glucosamine effectiveness in the treatment of knee osteoarthritis. Presentation of a Cochrane analysis with the perspective on the GAIT trial[J]. Ugeskr Laeger, 2006, 168(50): 4405-4409.
14.	Toda Y, Tsukimura N. A six-month followup of a randomized trial comparing the efficacy of a lateral-wedge insole with subtalar strapping and an in-shoe lateral-wedge insole in patients with varus deformity osteoarthritis of the knee[J]. Arthritis Rheum, 2004, 50(10): 3129-3136.
15.	Mcalindon TE, Lavalley MP, Gulin JP, et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis[J]. JAMA, 2000, 283(11): 1469-1475.

1. 　Xu L, Nevitt MC, Zhang Y, et al. High prevalence of knee, but not hip or hand ostetarthritis in Beijing elders:comprision with data of Caucasian in United States[J]. Nat Med J China, 2003, 83(14): l206-l209.
2. 　Felson DT. Clinical practice--osteoarthritis of the knee[J]. N Engl J Med, 2006, 354(8): 841-848.
3. 　Lanas A, Tornero J, Zamorano JL. Asessment of gastrointestinal and cardiaovascular risk in patients with osteoarthritis who require NSAIDs: the LOGICA study[J]. Ann Rheum Dis, 2010, 69(8): 1453-1458.
4. 　Oegema TR Jr, Deloria LB, Sandy JD, et al. Effect of oral glucosamine on cartilage and meniscus in normal and chymopapain-injected knees of young rabbits[J]. Arthritis Rheum, 2002, 46(9): 2495-2503.
5. 　Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro[J]. Osteoarthritis Cartilage, 1998, 6(6): 427-434.
6. 　Fenton JI, Chlebek-Brown KA, Peters TL, et al. Glucosamine HCl reduces equine articular cartilage degradation in explant culture[J]. Osteoarthritis Cartilage, 2000, 8(4): 258-265.
7. 　Brief AA, Maurer SG, Di Cesare PE. Use of glucosamine and chondroitin sulfate in the management of osteoarthritis[J]. J Am Acad Orthop Surg, 2001, 9(2): 71-78.
8. 　Barr S, Bellamy N, Buchanan WW, et al. A comparative study of signal versus aggregate methods of outcome measurement based on the WOMAC Osteoarthritis Index. Western Ontario and McMaster Universities Osteoarthritis Index[J]. J Rheumatol, 1994, 21(11): 2106-2112.
9. 　Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee[J]. Arthritis Rheum, 1986, 29(8): l049-1039.
10. 　Lequesne MG, Samson M. Indices of severity in osteoarthritis for weight bearing joints[J]. J Rheumatol, 1991, 27: 16-18.
11. 　Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention[J]. Arthritis Rheum, 1998, 41(8): 1343-1355.
12. 　Wieland HA, Michaelis M, Kirschbaum BJ, et al. Osteoarthritis - an untreatable disease?[J]. Nat Rev Drug Discov, 2005, 4(4): 331-344.
13. 　Bliddal H, Christensen RD, Kristensen PK, et al. Glucosamine effectiveness in the treatment of knee osteoarthritis. Presentation of a Cochrane analysis with the perspective on the GAIT trial[J]. Ugeskr Laeger, 2006, 168(50): 4405-4409.
14. 　Toda Y, Tsukimura N. A six-month followup of a randomized trial comparing the efficacy of a lateral-wedge insole with subtalar strapping and an in-shoe lateral-wedge insole in patients with varus deformity osteoarthritis of the knee[J]. Arthritis Rheum, 2004, 50(10): 3129-3136.
15. 　Mcalindon TE, Lavalley MP, Gulin JP, et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis[J]. JAMA, 2000, 283(11): 1469-1475.

《華西醫學》

鹽酸氨基葡萄糖結合塞來昔布治療膝骨關節炎的療效觀察

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《華西醫學》

鹽酸氨基葡萄糖結合塞來昔布治療膝骨關節炎的療效觀察

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