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盐酸氨基葡萄糖治疗膝退行性骨性关节炎的临床观察

中国修复重建外科杂志2008年1月第22卷第1期·29·盐酸氨基葡萄糖治疗膝退行性骨性关节炎的临床观察

冮相保1 高李侠2

【摘 要】  目的 评价盐酸氨基葡萄糖治疗膝退行性骨性关节炎(degenerative osteoarthritis,DOA)的临床疗效。 方法 2006年2月-2007年1月,采用盐酸氨基葡萄糖治疗60例膝DOA患者。男15例,女45例;年龄41~67岁,平均57.5岁。病程6个月~3年。每日2次,每次750 mg,6周为1个疗程,4个月后重复1个疗程。所有患者经过2个疗程治疗后,采用国际DOA的评分标准——Lequesne指数评定膝关节休息痛、运动痛、压痛、关节活动度、晨僵及行走能力。 结果 治疗期间3例患者产生不良反应,发生率为5%,未作特殊处理后恢复。60例患者均获随访8~11个月,平均9.6个月。经治疗后,31例DOA各种临床症状完全消失,治愈率为51.7%;27例临床症状有不同程度减轻,好转率为

45.0% ;总有效率为96.7%。膝关节休息痛、运动痛、压痛、关节活动度、晨僵及行走能力治疗后评分分别为(0.5±0.2)、(0.7±

0.4)、(0.8±0.3)、(0.9±0.4)、(0.6±0.3)及(0.9±0.4)分,治疗前各项评分为(1.6±0.5)、(2.1±0.4)、(2.2±0.5)、(1.8±0.6)、(1.7±

0.4)及(2.0±0.4)分,治疗前后比较差异有统计学意义(P < 0.01)。 结论 盐酸氨基葡萄糖对治疗膝DOA具有缓解临

床症状,改善关节功能的作用。

【关键词】  膝骨性关节炎  盐酸氨基葡萄糖  临床疗效

中图分类号: R684.3 R453  文献标志码:A 

THERAPEUTIC RESULTS OF GLUCOSAMINE HYDROCHLORIDE FOR KNEE DEGENERATIVE OSTEOAR-THRITIS /GANG Xiangbao1, GAO Lixia2. 1Department of Orthopeadics, Integrated Chinese and Western Medicine Hospital of Wuhan City, Wuhan Hubei,430000, P. R. China; 2Hubei College of Traditional Chinese Medicine.Corresponding author: GANG Xiangbao, E-mail: gangxb2008@http://www.wendangku.net/doc/7e5a454569eae009581bec5c.html

【Abstract】 Objective To evaluate the results of glucosamine hydrochloride in the treatment of knee degenerative osteoarthritis (DOA) . Methods From February 2006 to January 2007, 60 patients with knee DOA were treated with glucos-amine hydrochloride,including 15 males and 45 females. The ages of patients ranged from 41 to 67 years with an average age of 57.5 years. The disease course ranged from 6 months to 3 years. Oral glucosamine hydrochloride was given twice a day, each 750 mg, for a 6-week course of treatment; another course of treatment was repeated after 4 months. After two courses of treat-ment, the international standard DOA score of Lequesne index was used to evaluate the rest of knee pain, sports pain, tenderness, joints activity, morning stiffness and walking ability. Results All 60 patients finished treatment, various clinical symptoms for DOA disappeared completely in 31 cases and subsided in 27 cases; the cure rate was 51.7% and the total response rate was

96.7%. The scores of rest pain, sport pain, tenderness, joints activity, morning stiffness and the ability to walk for knee after treat-

ment were 0.5±0.2,0.7±0.4,0.8±0.3,0.9±0.4,0.6±0.3 and 0.9±0.4, showing statistically significant differences (P < 0.01) when compared with preoperation (1.6±0.5,2.1±0.4,2.2±0.5,1.8±0.6,1.7±0.4 and 2.0±0.4). Adverse effect occurred in 3 cases (5%) and the patients recovered without special treatment. Conclusion Glucosamine hydrochloride can cure knee DOA with symptom-relieving and joint function-improving action.

【Key words】  Knee osteoarthritis Glucosamine hydrochloride Clinical efficacy

退行性骨性关节炎(degenerative osteoarthritis,

DOA)是老年常见病,并随着年龄的增长发病率逐渐增高,主要表现为关节肿痛和不同程度的功能障碍,严重时可能导致关节功能的丧失。膝关节是人体的主要负重关节,发生DOA的几率较其他关节高。2006年2月-2007年1月,我们采用盐酸氨基葡萄糖治疗60例膝DOA患者,对其疗效进行分析。报告如下。

作者单位:1 武汉市中西医结合医院骨科(武汉,430000);2 湖北中医学院

通讯作者:冮相保,主任医师,硕士导师,研究方向:中西医结合治疗脊柱和老年性疾病,E-mail:gangxb2008@http://www.wendangku.net/doc/7e5a454569eae009581bec5c.html 1 临床资料

1.1 一般资料  

本组男15例,女45例。年龄41~67岁,平均57.5岁。病程6个月~3年。患者均采用1995年美国风湿病学会诊断标准,根据患者的临床表现、体征和影像学等辅助检查诊断为膝DOA[1]。临床及放射学标准:①近1个月大多数时间有膝痛;②X线片示骨赘形成;③关节液检查符合骨性关节炎;④年龄≥40岁;

⑤膝关节晨僵≤30 min;⑥有骨摩擦音。满足①、②或①、③、⑤、⑥或①、④、⑤、⑥者可诊断膝为DOA。根