目的 观察盐酸氨基葡萄糖治疗膝骨关节炎（KOA）的临床疗效。 方法 2010年5月－2012年7月将130例经膝关节镜清理术后的KOA患者随机分成A、B两组，每组65例。A组联合口服盐酸氨基葡萄糖胶囊750 mg，2次/d，6周为1个疗程，治疗3个疗程；B组联合口服尼美舒利胶囊0.1 g，2次/d，服用12周。采用Lequesne指数作为疗效评定指标，观察治疗前后膝关节体征及症状变化，休息痛、运动痛、压痛、肿胀、晨僵和行走能力的改善情况。 结果 B组患者在治疗早期症状改善优于同期A组，且在第3个月有统计学意义（P＜0.05），随着治疗时间的延长，A组患者总有效率在1、3、6个月分别为70.8%、76.9%和92.3%，均呈逐渐上升趋势，且第6个月疗效较前2个时间点差异有统计学意义（P＜0.05）。分别停药后继续随访至1年，两组患者总有效率均有所下降，但A组疗效仍优于B组，且有统计学意义（P＜0.05）。A组出现不良反应2例，B组4例，均较轻微，无严重不良事件发生。 结论 盐酸氨基葡萄糖在改善OA患者膝关节症状等方面效果肯定，且疗效较稳定，安全性良好；但远期疗效仍需随访观察。
ObjectiveTo evaluate the therapeutic effect of glucosamine hydrochloride combined with Tenghuangjiangu tablets on knee osteoarthritis. MethodsFrom August 2012 to February 2014, 180 patients with knee osteoarthritis were randomly divided into three groups with 60 in each. Patients in group A were treated with glucosamine hydrochloride; patients in group B were treated with Tenghuangjiangu tablets; and patients in group C were treated with the combination of glucosamine hydrochloride and Tenghuangjiangu tablets. After the 12-week treatment, clinical efficacy and safety of the treatment were observed and compared with those before the treatment. ResultsThe twenty-meter walking pain, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the joint tenderness in the three groups 12 weeks after the treatment and 4 weeks after withdrawal improved obviously compared with those before the treatment (P<0.05), and the difference between the results of 12 weeks after treatment and 4 weeks after withdrawal was not significant (P>0.05). The improvement in group C was better than both group A and B with significant differences (P<0.05), while the difference between group A and B was not significant (P>0.05). There was no obvious abnormal routine blood and urine test result or damage of liver and lung functions during the treatment in all the three groups. Twelve weeks after treatment, six patients with abdominal ache were found in group A with an incidence of 10.0%; 5 abdominal ache and 2 diarrhea were in group B with a rate of 12.5%; and 4 abdominal ache and 3 diarrhea were in group C with a rate of 12.5%. All the patients completed the treatment. No significant difference in the incidence of adverse reactions was found among the three groups (P>0.05). ConclusionThe therapeutic effect of combined glucosamine hydrochloride and Tenghuangjiangu tablets is obvious on knee osteoarthritis with low incidence of adverse reactions.
ObjectiveTo investigate the clinical effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride in the treatment of early knee osteoarthritis. MethodsWe retrospectively analyzed the clinical data of 172 patients with knee osteoarthritis treated between March 2007 and August 2013. The patients were divided into observation group (n=82) and control group (n=90) according to their treatment. Patients in the control group only underwent arthroscopic debridement and cartilage defect microfracture surgery, while those in the observation group underwent arthroscopic microfracture surgery combined with oral glucosamine hydrochloride. The Lysholm knee functional scores, the Lequesne index and X ray image were used to compare the clinical efficacy between the two groups. ResultsThe postoperative symptoms of both the two groups were significantly alleviated. The Lequesne index was not significantly different between the two groups before surgery, and 1 and 3 months after surgery (P>0.05), but it was significantly difference between the two groups 6, 12, 18 and 24 months after surgery (P<0.05). Before surgery, the Lysholm score was not significantly different between the two groups (P>0.05), and the score increased significantly after surgery in both the two groups (P<0.05). One and 3 months after surgery, the Lysholm score was not significantly different between the two groups (P>0.05), but it was significantly higher in the observation group 6, 12, 18 and 24 months after surgery. ConclusionArthroscopic microfracture surgery combined with oral glucosamine hydrochloride is effective in treating patients with early knee osteoarthritis, and the clinical efficacy becomes more significant with the time of treatment.
目的 探讨盐酸氨基葡萄糖联合降钙素对绝经后膝骨关节炎基质金属蛋白酶3（MMP-3）和骨桥蛋白（OPN）表达的影响。 方法 2012年1月－6月将120例绝经后膝骨关节炎妇女随机分为盐酸氨基葡萄糖组（A组）、盐酸氨基葡萄糖+依降钙素组（B组）、依降钙素组（C组），每组40例，采用酶联免疫吸附试验测定各组血清MMP-3、OPN、雌二醇、Ⅰ型胶原C端肽（CTX）和Ⅰ型胶原N端前肽（PINP）水平。 结果 A组和B组在治疗后2周和6周其膝关节评分和视觉模拟评分明显优于C组（P＜0.05），A组在治疗后2周MMP-3的表达改善明显（P＜0.05），优于其他两组。治疗后6周，B组OPN表达水平改善明显（P＜0.05），优于其他两组。C组和B组CTX和PINP水平明显改善（P＜0.05），优于A组。 结论 盐酸氨基葡萄糖联合降钙素能有效改善绝经后膝骨关节炎的症状，可能通过调节MMP-3和OPN的复合体表达，实现改善关节软骨功能的目的。
目的 评价盐酸氨基葡萄糖治疗膝骨关节炎的疗效。 方法 将2012年1月－5月收治的150例膝骨关节炎患者随机分为A、B、C组。A组给予盐酸氨基葡萄糖治疗，B组给予碳酸钙D3片治疗，C组给予盐酸氨基葡萄糖联合碳酸钙D3片治疗，疗程8周。3组患者膝关节疼痛发作时服用塞来昔布并记录用量。比较试验前后3组患者骨关节炎指数评分（WOMAC）以及第1、8周塞来昔布用量变化情况。 结果 3组患者WOMAC总分、疼痛程度评分、关节僵硬程度评分、日常活动困难程度评分改善值比较，差异均无统计学意义。经过8周治疗，塞来昔布每周用量减少值A、B、C组分别为（0.41 ± 0.17）、（0.16 ± 0.22）、（0.46 ± 0.19）g，A、C组高于B组（P＜0.01），A、C组每周用量减少值差异无统计学意义（P＞0.05）。 结论 短期使用盐酸氨基葡萄糖治疗膝骨关节炎，在关节疼痛、僵硬及功能改善方面并不优于碳酸钙D3片，但可通过减少非甾体抗炎药物用量，使患者获益。
ObjectiveTo investigate the clinical effect of combined air pressure wave and oral glucosamine in the treatment of knee osteoarthritis. MethodsWe chose 200 patients with knee osteoarthritis treated in the Department of Rehabilitation between April 2013 and March 2015 as our research subjects. The patients were randomly divided into observation group and control group with 100 in each. The control group accepted conventional physical therapy, while the observation group underwent normal physical therapy in combination with air pressure wave and oral glucosamine treatment. We compared the two groups in terms of curative effects. ResultsThe total effective rate was not significantly different between the two groups (P＞0.05) , but in terms of efficiency rate, the observation group (85.0%) was significantly superior to the control group (73.0%) (P ＜ 0.05) . ConclusionCombined air pressure wave and oral glucosamine treatment for knee osteoarthritis is high efficient, which is worthy of being popularized.
目的 研究盐酸氨基葡萄糖联合双醋瑞因在伴有骨髓水肿（BME）的膝骨关节炎（KOA）中的疗效评估。 方法 依据MRI检查结果，选取2011年1月－2012年6月入院60例伴BME的KOA患者随机分入A组（口服盐酸氨基葡萄糖）、B组（口服双醋瑞因）、C组（口服盐酸氨基葡萄糖和双醋瑞因），每组各20例；另纳入同期30例不伴BME的KOA患者30例为D组（口服盐酸氨基葡萄糖和双醋瑞因）。完成标准方案后24周，随访临床疗效和影像学评分及炎症因子变化。 结果 治疗24周后4组在20 m 步行后视觉模拟评分（VAS）、关节压痛VAS评分较治疗前有改善（P＜0.05）；在BME改善方面，C组容积积分和程度积分均优于A、B两组（P＜0.05）；在炎症因子方面，治疗24周后4组白细胞介素（IL）-1β、IL-6和肿瘤坏死因子α表达水平明显降低（P＜0.05）。 结论 盐酸氨基葡萄糖联合双醋瑞因能有效改善伴有BME的KOA患者临床症状、降低炎症因子表达水平以及促进BME在影像学方面的改善。
ObjectiveTo compare the clinical efficacy of glucosamine hydrochloride and diacerein for patients with knee osteoarthritis and the MRI variation. MethodsBetween January and June 2014, 90 patients with knee osteoarthritis were randomized into three groups: group A (treated by glucosamine hydrochloride), group B (treated by diacerein) and group C (treated by both glucosamine hydrochloride and diacerein). The score of Western Ontario and McMaster Universities (WOMAC) index of osteoarthritis, MRI cartilage injury Recht grading and the curative effects for bone marrow edema, joint cavity effusion and meniscus injury were compared before and after the treatment. ResultsThe scores of WOMAC after treatment in all the groups were improved, while the therapeutic effect of group C lasted longer when medical treatment suspended. The number of articular surface with different degrees of cartilage injury showed no statistically significant change in all three groups (P ＞ 0.05) . The state of bone marrow edema and joint cavity effusion were improved with a statistically significant difference in all groups (P ＜ 0.05) . Patients with lateral meniscus degeneration in group A and patients with medial meniscal tear in group B both increased with statistically significant differences (P ＜ 0.05) . However, in group C, patients with lateral meniscus degeneration or meniscal tear decreased with statistically significant differences (P ＜ 0.05) . ConclusionsThe treatment for osteoarthritis by glucosamine hydrochloride is effective, and the curative effect lasts longer when treated by both glucosamine hydrochloride and diacerein. Glucosamine hydrochloride ameliorates the bone marrow edema and joint cavity effusion. Treatment together with diacerein leads to a better therapeutic effect for patients with meniscus degeneration, yet further studies are needed to prove its effects in ameliorating cartilage injury.
ObjectiveTo evaluate the efficacy of the glucosamine hydrochloride combined with risedronate in the treatment of knee osteoarthritis (KOA) associated with cold pain of knee. MethodsThe clinical data of 50 KOA patients including 25 with cold pain and 25 without cold pain, treated in the Department of Rheumatology between January and December 2015 were collected. The clinical symptoms, Western Ontario and McMater Universities (WOMAC) index of osteoarthritis score, knee cold pain score, knee joint therml texture maps (TTM) score, serum osteoprotegerin (OPG), Dickkopf-1 (DKK-1) , and sclerostin levels (SO) were recorded for comparison between patients with and without cold pain in order to investigate the correlation between these indicators and cold pain degree. Patients in the cold pain group were treated with glucosamine hydrochloride combined with risedronate. Follow-up lasted for six months, and the improvement of above indexes and the treatment safety were analyzed. ResultsThere were significant differences between the two groups in the disease course, TTM score of knee front and popliteal fossa, ΔTTM, DKK-1 and SO (P ＜ 0.05) . After 6 months of treatment, patients in the cold pain group improved significantly in WOMAC score, knee cold pain score, TTM score of knee front and popliteal fossa, ΔTTM, OPG, DKK-1 and SO (P ＜ 0.05) . ConclusionsAs one of the main complaints of patients with advanced OA, knee cold pain is associated with the metabolic activity of osteoclasts. It can be alleviated by the treatment with risedronate combined with glucosamine.
ObjectiveTo observe the therapeutic effect of electro-acupuncture combined with oral glucosamine hydrochloride capsules in the treatment of knee osteoarthritis, and compare it with the curative effect of the two methods separately. MethodsA total of 168 patients with knee osteoarthritis treated from March 2006 to December 2012 were randomly divided into 3 groups. Electro-acupuncture combined with oral glucosamine hydrochloride capsules were given to the 58 patients in the treatment group, single acupuncture treatment was given to the 57 patients in control group A, and simple oral glucosamine hydrochloride capsules were given to the 53 patients in control group B. The treatment lasted for 6 weeks. Assessment of knee osteoarthritis by Lequesne international standard index number and the total efficiency was carried out before treatment and 3 weeks, 6 weeks and 6 months after treatment, respectively. ResultsThe total effective rate of the treatment group was 91.38%, of control group A was 68.42%, and of control group B was 79.25%. There was a significant difference between the treatment group and control group A, and between the treatment group and control group B (P<0.05). No blood, liver or kidney damage or gastrointestinal adverse reaction occurred among patients in all the three groups. ConclusionThe efficacy of electro-acupuncture plus oral glucosamine hydrochloride capsules is better than simple acupuncture and simple oral glucosamine hydrochloride capsules treatment.