目的 觀察比較鹽酸氨基葡萄糖單獨使用及與硫酸軟骨素聯合使用治療腰椎小關節骨關節炎（LFOA） 的臨床療效。 方法 2009年1月－2011年1月，將80例LFOA患者隨機分成兩組，A組口服鹽酸氨基葡萄糖，B組口服鹽酸氨基葡萄糖和硫酸軟骨素兩種藥物，6周為1個療程，間斷治療4個療程。分別比較用藥前與用藥后3、6周及5、8、11個月時的日本骨科協會（JOA）評分、晨僵和壓痛程度變化。 結果 治療后，兩組的JOA評分在各觀察時點均增加，與治療前比較差異有統計學意義（P＜0.05）。組間行JOA評分治療改善率的比較，在各觀察時點差異均有統計學意義（P＜0.05），B組JOA評分改善率優于A組。治療3周后，兩組晨僵和壓痛評分均降低，與本組治療前比較差異有統計學意義（P＜0.05）；組間比較，差異亦有統計學意義（P＜0.05），B組晨僵和壓痛程度均低于A組。第6周，第5、8、11個月，兩組組間比較晨僵和壓痛程度差異均無統計學意義（P＞0.05），但各療程結束后兩組晨僵和壓痛程度均呈持續降低趨勢。 結論 單獨應用鹽酸氨基葡萄糖及鹽酸氨基葡萄糖與硫酸軟骨素的聯合應用治療LFOA療效確切，聯合用藥優于單獨應用鹽酸氨基葡萄糖。
目的 探討鹽酸氨基葡萄糖膠囊聯合透明質酸鈉注射液治療髖骨關節炎的臨床療效。 方法 納入疼痛門診2010年7月－2011年7月收治的髖骨關節炎患者60例，隨機分為透明質酸鈉關節腔內注射聯合口服鹽酸氨基葡萄糖膠囊組（A組）和單獨透明質酸鈉關節腔內注射組（B組），每組30例。透明質酸鈉關節腔內注射均為2.5 mL/次，每周1次，連續5周為1療程。鹽酸氨基葡萄糖膠囊口服，0.75 g/次，2次/d，6周為1個療程。評估兩組患者治療后6周后髖關節疼痛視覺模擬評分（VAS評分）及Lequesne指數評定髖關節休息痛、運動痛、局部壓痛、關節活動度、晨僵及行走能力，并觀察兩組不良反應發生情況。 結果 治療6周后A組Lequesne功能指數及VAS評分較B組顯著降低（P＜0.05），兩組不良反應比較差異無統計學意義（P＞0.05）。 結論 治療髖骨關節炎患者時，聯合應用透明質酸鈉及鹽酸氨基葡萄糖膠囊療效優于單獨應用透明質酸鈉者，且并未增加不良反應的發生。
ObjectiveTo study the effectiveness and safety of glucosamine for osteoarthritis (OA) in Asian population. MethodDatabases of PubMed, Embase, CNKI, VIP and Wanfang were searched from the time of establishment till May 2014 and controlled trials of glucosamine compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs) were included. Quality evaluation and Meta-analysis by using RevMan 5.1 were performed. ResultsA total of 17 studies including 2 251 cases were included. The efficiency rate in the glucosamine group was higher than that in the NSAIDs group[OR=3.03, 95% CI (1.78, 5.18), P<0.000 1]. The efficiency rate in the glucosamine combined NSAIDs group was higher than that in the NSAIDs group[OR=4.30,95%CI (1.84,10.06),P=0.000 8]. The safety analysis showed that the adverse event rate in the glucosamine group was lower than that in the NSAIDs group[OR=0.23,95%CI (0.14,0.37),P<0.000 01], while the difference between the glucosamine combined NSAIDs group and the NSAIDs group was not statistically significant[OR=0.84, 95%CI (0.50, 1.41), P=0.50]. ConclusionsCompared with NSAIDs, glucosamine is better and safer for OA treatment in Asian population.
目的 觀察鹽酸氨基葡萄糖治療膝骨關節炎（KOA）的臨床療效。 方法 2010年5月－2012年7月將130例經膝關節鏡清理術后的KOA患者隨機分成A、B兩組，每組65例。A組聯合口服鹽酸氨基葡萄糖膠囊750 mg，2次/d，6周為1個療程，治療3個療程；B組聯合口服尼美舒利膠囊0.1 g，2次/d，服用12周。采用Lequesne指數作為療效評定指標，觀察治療前后膝關節體征及癥狀變化，休息痛、運動痛、壓痛、腫脹、晨僵和行走能力的改善情況。 結果 B組患者在治療早期癥狀改善優于同期A組，且在第3個月有統計學意義（P＜0.05），隨著治療時間的延長，A組患者總有效率在1、3、6個月分別為70.8%、76.9%和92.3%，均呈逐漸上升趨勢，且第6個月療效較前2個時間點差異有統計學意義（P＜0.05）。分別停藥后繼續隨訪至1年，兩組患者總有效率均有所下降，但A組療效仍優于B組，且有統計學意義（P＜0.05）。A組出現不良反應2例，B組4例，均較輕微，無嚴重不良事件發生。 結論 鹽酸氨基葡萄糖在改善OA患者膝關節癥狀等方面效果肯定，且療效較穩定，安全性良好；但遠期療效仍需隨訪觀察。
ObjectiveTo observe the clinical effect of combined glucosamine hydrochloride and antiosteoporosis drugs in the treatment of senile knee osteoarthritis. MethodsA total of 120 patients with osteoarthritis of the knee treated from January 2014 to December 2015 were randomly divided into observation group and control group with 60 cases in each. The observation group received not only oral glucosamine hydrochloride, but calcium D3, alfacalcidol, and sodium phosphate for anti-osteoporosis treatment, while the control group was only given oral glucosamine hydrochloride. Lequesne score, curative effect and adverse drug reactions were compared between the two groups 2, 4, and 6 weeks after the beginning of treatment. ResultsWithin two weeks of treatment, there was no significant difference between the two groups in the effective rate (P ＞ 0.05) . But four and six weeks after treatment, the efficiency in the observation group was significantly higher than that in the control group (χ2=6.806, P ＜ 0.01; χ2=24.762, P ＜ 0.01) . Four and six weeks after treatment, Lequesne score of the observation group was significantly lower than that of the control group (t=2.199, P ＜ 0.05; t=4.748, P ＜ 0.001) . There was no significant difference in terms of adverse reactions between the two groups before and after treatment (χ2=0.617, P ＞ 0.05) . ConclusionCompared with single hydrochloric amino glucose treatment, glucosamine hydrochloride combined with anti-osteoporosis treatment for senile knee osteoarthritis has better treatment effect without increase in adverse drug reactions, and it is worth of clinical application.
目的 評價鹽酸氨基葡萄糖治療膝骨關節炎的療效。 方法 將2012年1月－5月收治的150例膝骨關節炎患者隨機分為A、B、C組。A組給予鹽酸氨基葡萄糖治療，B組給予碳酸鈣D3片治療，C組給予鹽酸氨基葡萄糖聯合碳酸鈣D3片治療，療程8周。3組患者膝關節疼痛發作時服用塞來昔布并記錄用量。比較試驗前后3組患者骨關節炎指數評分（WOMAC）以及第1、8周塞來昔布用量變化情況。 結果 3組患者WOMAC總分、疼痛程度評分、關節僵硬程度評分、日常活動困難程度評分改善值比較，差異均無統計學意義。經過8周治療，塞來昔布每周用量減少值A、B、C組分別為（0.41 ± 0.17）、（0.16 ± 0.22）、（0.46 ± 0.19）g，A、C組高于B組（P＜0.01），A、C組每周用量減少值差異無統計學意義（P＞0.05）。 結論 短期使用鹽酸氨基葡萄糖治療膝骨關節炎，在關節疼痛、僵硬及功能改善方面并不優于碳酸鈣D3片，但可通過減少非甾體抗炎藥物用量，使患者獲益。
ObjectiveTo study the clinical effect of the combination of glucosamine hydrochloride with exercise therapy and traditional Chinese medicine hot compress in the treatment of early patellofemoral osteoarthritis. MethodsA total of 126 patients with early patellofemoral osteoarthritis treated between June 2013 and April 2015 were divided into group A (n=43), B (n=42) and C (n=41) with the method of random number table. Oral administration of glucosamine hydrochloride tablets, exercise therapy of knee joints and traditional Chinese medicine hot compress were applied for the 43 patients in group A. Oral administration of glucosamine hydrochloride tablets and exercise therapy of knee joints were applied for the 42 patients in group B. Exercise therapy of knee joints and traditional Chinese medicine hot compress were applied for the 41 patients in group C. Chen's Scoring was applied before the treatment and 2, 4, 12 and 24 weeks after the treatment. ResultsThe differences of Chen's scores at the time points after treatment and those before treatment of the same group had statistical significance (P<0.05). The differences of Chen's scores at the time points after treatment in group A and those in group B and C had statistical significance (P<0.05). There were no obvious adverse effects due to administration of glucosamine hydrochloride tablets in group A and B. Five patients in group A and 4 patients in group C suffered from the symptoms of local erythema, light cutaneous pruritus and other contact dermatitis after traditional Chinese medicine hot compress. Those symptoms disappeared automatically several hours later without any special treatment. ConclusionThe treatment of early patellofemoral osteoarthritis by the combination of glucosamine hydrochloride tablets with exercise therapy and traditional Chinese medicine hot compress can rapidly relieve joint pain, and maintain efficacy for a long time.
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。