盐酸氨基葡萄糖联合塞来昔布治疗膝

盐酸氨基葡萄糖联合塞来昔布治疗膝 中国组织工程研究 第17卷 第43期 2013–10–22出版 Chinese Journal of Tissue Engineering Research October 22, 2013 Vol.17, No.43 www.CRTER .org doi:10.3969/j.issn.2095-4344.2013.43.024 [http://www.crter.org] 李明辉，刘洋，王彩民，游浩，黄亮，孙凯. 盐酸氨基葡萄糖联合塞来昔布治疗膝骨性关节炎的随机对照[J]. 中国组织工程研究，2013，17(43):7654-7660. 盐酸氨基葡萄糖联合塞来昔布治疗膝骨性关节炎的随机对照★ 李明辉，刘 洋，王彩民，游 浩，黄 亮，孙 凯(武汉市第五医院(江汉大学第二附属医院)骨科，湖北省武汉市 430050) 文章亮点： 1 课题组首次提出采用Lequesne膝骨性关节炎严重性指数(ISOA)进行骨性关节炎的严重程度分级，分级后分别观察单用氨基葡萄糖及联合应用非类固醇类抗炎药治疗前后的临床疗效。 2 从实验结论中可以看出，对于轻度骨性关节炎患者，单用盐酸氨基葡萄糖胶囊后4周患者膝部评分明显改善。与轻度组相比，中度骨性关节炎治疗组中联合用药组改善骨性关节炎更显著。对重度骨性关节炎，单用及联合应用氨基葡萄糖治疗均无明显改善，说明氨基葡萄糖不适用于重度骨性关节炎。 3 课题的不足在于量尚小，由于干扰因素较多，未能将患者性别、年龄等作为统计学因素分析。 关键词： 骨关节植入物；骨与关节临床实践；骨性关节炎；盐酸氨基葡萄糖；塞来昔布；非类固醇类抗炎药；联合用药；Lequesne评分；不良反应 主题词： 关节成形术，置换，髋；骨性关节炎；葡萄糖；消炎药，非甾类 李明辉★，男，1976年生，湖南省邵阳市人，汉族，2008年华中科技大学同济医学院毕业，硕士，主治医师，主要从事四肢创伤、运动医学研究。 lmh061127@163.com 通讯作者：刘洋，武汉市第五医院(江汉大学第二附属医院)骨科，湖北省武汉市 430050 liuyang19642000@ 163.com 中图分类号:R318 文献标识码:B 文章编号:2095-4344 (2013)43-07654-07 摘要 背景：盐酸氨基葡萄糖被认为具有治疗膝关节骨性关节炎的作用，但其是否对不同程度的骨性关节炎都有效，联合应用非类固醇类抗炎药与单用盐酸氨基葡萄糖是否存在疗效差别，尚需进一步临床研究。 目的：采用前瞻性研究的方法对比单用盐酸氨基葡萄糖以及联合应用塞来昔布治疗不同程度膝关节骨性关节炎的临床疗效。 方法：采用Lequesne评分将152例膝关节骨关节炎患者分为轻、中、重度，然后随机配比法均分为单用盐酸氨基葡萄糖组和盐酸氨基葡萄糖联合塞来昔布用药组，于用药后2，4，6周以及停药8，12周统计患者Lequesne评分，用药前后及组间进行对比并统计盐酸氨基葡萄糖的不良反应。 结果与结论：在轻度骨性关节炎治疗组中，盐酸氨基葡萄糖组治疗4周、停药12周后Lequesne评分与治疗前比较，差异有显著性意义；而联合用药组治疗2周后评分即有改善，两组比较，评分在治疗2，4周差异有显著性意义，说明联合用药组效果改善更显著；中度骨性关节炎患者在治疗2，4，6周和停药8周时，联合用药患者Lequesne评分均低于单纯使用盐酸氨基葡萄糖患者，差异均有显著性意义(P < 0.05)，说明在中度骨性关节炎，盐酸氨基葡萄糖联合塞来昔布治疗效果好于单独用药；重度骨性关节炎中，两组治疗后Lequesne评分与治疗前比较，均无明显改善。结果说明对于轻度膝骨性关节炎，单用盐酸氨基葡萄糖口服即可明显改善患者临床症状，对于中度膝骨关节炎，建议联合非类固醇类抗炎药类用药，可以较好改善临床症状，而对于重度膝骨关节炎，两种方法均无效。 收稿日期：2013-03-11 修回日期：2013-04-25 (201303111/D・C) Glucosamine hydrochloride combined with celecoxib for the treatment of knee osteoarthritis: Randomized controlled trials Li Ming-hui, Liu Yang, Wang Cai-min, You Hao, Huang Liang, Sun Kai (Department of Orthopedics, Fifth Hospital of Wuhan (the Second Affiliated Hospital of Jianghan University), Wuhan 430050, Hubei Province, China) Li Ming-hui★, Master, Attending physician, Department of Orthopedics, Fifth Hospital of Wuhan (the Second Affiliated Hospital of Jianghan University), Wuhan 430050, Hubei Province, China lmh061127@163.com Corresponding author: Liu Yang, Department of Orthopedics, Fifth Hospital of Wuhan (the Second Affiliated Hospital of Jianghan University), Wuhan 430050, Hubei Province, China liuyang19642000@163.com Received: 2013-03-11 Accepted: 2013-04-25 Abstract BACKGROUND: Glucosamine hydrochloride is considered to have the role in the treatment of knee osteoarthritis. Whether it is effective for varying degrees of osteoarthritis and whether there are efficacy differences between the combinations nonsteroidal anti-inflammatory drugs and simple glucosamine hydrochloride need further clinical research. OBJECTIVE: To compare the clinical effects between glucosamine hydrochloride capsules and combined with celecoxib for the treatment of knee osteoarthritis through prospective study. METHODS: According to Lequesne score, 152 patients with knee osteoarthritis were divided into mild, moderate and severe groups, then each group was divided into groups treated just by glucosamine hydrochloride and groups treated by glucosamine hydrochloride combined with celecoxib randomly. The Lequesne score was recorded at 2, 4 and 6 weeks after drug administration and 8 and 12 weeks after drug withdrawal, and then the adverse reactions of glucosamine hydrochloride were compared between groups 7654 P.O. Box 1200, Shenyang 110004 www.CRTER.org