盐酸氨基葡萄糖协同关节腔内注射玻璃酸钠治疗膝关节骨关节炎疗效观察

Efficacy of oral administration of glucosamine hydrochloride combined with intra-articular injection of sodium hyaluronate for knee joint osteoarthritis

目的观察比较口服盐酸氨基葡萄糖胶囊、关节腔内注射玻璃酸钠以及二者联合使用对膝关节骨关节炎的疗效。方法将150例膝关节骨关节炎患者随机分为3组(口服盐酸氨基葡萄糖胶囊、关节腔内注射玻璃酸钠以及联合用药组),每组各50例,分别给予单独口服盐酸氨基葡萄糖胶囊(0.75g,2次/d)、单独关节腔注射玻璃酸钠(2ml,1次/周)及二者联合使用。关节腔注射玻璃酸钠疗程为5周,口服盐酸氨基葡萄糖胶囊疗程为8周,疗效观察时间为12周。采用Lequesne指数作为疗效评分标准,观察治疗前后膝关节症状变化包括休息痛、运动痛、压痛、肿胀、晨僵和行为能力的改善程度。结果3组患者第4、8、12周时分别与同组第1周时疗效比较均有改善(P<0.05),第4周时注射组和联合组疗效均优于口服组(P<0.05),第8周时3组疗效无显著差异,第12周时联合组疗效优于口服组和注射组(P<0.05)。结论口服盐酸氨基葡萄糖协同关节腔内注射玻璃酸钠治疗膝关节骨关节炎效果更快,疗效更佳。

Objective To study and compare the efficacy of oral administration of glucosamine hydrochloride, and intra-articular injection of sodium hyaluronate, respectively, and the efficacy of the combined therapy of both for osteoarthritis. Methods 150 patients with knee joint osteoarthritis were randomly divided in to group A, B, C, with 50 patients in each. In group A, patients were treated with oral administration of glucosamine hydrochloride（0.75 g, 2/day, treatment for 8 weeks）. In group B, patients were treated with intra-artictdar injection of sodium hyaluronate （2ml, 1/ week, treatment for 8 weeks）. In group C, patients were treated with oral administration of glucosamine hydrochloride combined with intra-articular injection of sodium hyaluronate. Observation time of the curative effect was 12 weeks. The Lequesne index was used as the curative effect assessment criteria. The observation targets of post-treatment knee joint symptom improvement were rest pain, motion pain, tenderness, swelling, morning stiffness and behavioral ability improvement. Results All 3 groups showed better improvements 4, 8, 12 weeks in comparison with the improvments shown 1 week after treatment respectively （P〈0.05）. Group B and C showed better efficacy then group A 4 weeks after treatment （P〈0.05）. No significant difference of efficacy was found among these groups 8 weeks after treatment. Group C showed better efficacy than group A and B 12 weeks after treatment （P〈0.05）. Conclusions Oral administration of glucosamine hydrochloride combined with intra-articular injection of sodium hyaluronate has faster and better long-term efficacy for osteoalthritis.