奉贤地区农村中老年人膝骨关节炎药物干预比较研究

Comparable studies with drugs intervention of knee osteoarthritis in rural middle - aged and senior in Fengxian district of Shanghai

目的：对确诊的中老年人膝OA患者分组进行洛索洛芬、双醋瑞因、氨基葡萄糖、仙灵骨葆干预治疗，比较上述四种药物对膝OA的疗效和安全性，为探索OA的规范治疗方案提供依据。方法：以上海市奉贤地区农村中老人膝OA流行病学调查课题中确诊的156例膝OA患者为研究对象。采用随机、开放和自身对照的方法，分为洛索洛芬、双醋瑞因、氨基葡萄糖、仙灵骨葆四组进行干预治疗。参照Lequesne的OA严重性和活动性指数评估法。进行随访调查，填写调查表、药物不良反应调查表、药物发放和回收登记表。结果：洛索洛芬、双醋瑞因、氨基葡萄糖、仙灵骨葆对膝OA患者进行干预治疗，膝关节干预前后x线自身对照比较各组IMK分级无明显变化（P〉0．05）；在膝关节疼痛、15m行走时问（t／s）、日常活动能力及患者综合评估等方面，前后自身对照各组均有显著性差异（P〈0．05）；四组药物干预总有效率分别为92．30％，69．23％，87．18％，74．36％，经Ridit分析。R（-）1=0．4227．R（-）2=0．6057，R（-）3：0．4734，R（-）4=0．4982；x2=8．3537，P〈0．05，四种药物干预治疗比较洛索洛芬、氨基葡萄糖疗效较好。双醋瑞因、仙灵骨葆次之：四种药物的不良反应均较轻微。结论：洛索洛芬、双醋瑞因、氨基葡萄糖、仙灵骨葆胶囊四种药物对膝OA干预治疗均有一定疗效，不良反应轻微．可作为OA的规范化治疗药物使用，运用药物干预治疗能有效延缓膝OA发展。

Objective To treat and assess the grouping patients of knee osteoarthritis with loxoprofen, diacerhein, glucosamine, and Xianling Gubao capsules, in order to study the guidelines for the medical management of knee osteoarthritis. Methods 156 patients with knee OA were enrolled , they were grouped with randomized and open approach corresponding for loxoprefen, diacerhein, glucosamine, and Xianling Gubao capsules four drugs. In accordance with Lequesen＇s indices of severity and activity assessment methods, to carry out follow - up survey, fill out questionnaires, the side - effects of drugs survey, drugs delivery and recovery registration form. Results There were no significant differences in knee X -ray grade in each group self-control before and after drugs intervention with loxoprofen, diacerhein, glucosamine（ P 〉 O. 05 ）, and Xianling Gubao capsules ; there were significant differences in each group self - control before and after drugs intervention in pain in the knee, 15m walking time （t/s）, activities of daily living and comprehensive assessment aspects（ P 〈0.05 ）. The total effective rate of four groups of drugs intervention were 92.30%, 69.23%, 87.18% and 74.36%, respectively, the results by Ridit analysis were R1 =0.4227, R2 =0.6057, R3 =0.4734, R4 =0.4982, respectively（ P 〈 0.05 ）. Compared the results of drugs intervention, loxoprofen and glucosamine were better than diacerhein and Xianling Gubao capsules. Conclusion Four intervention drugs of loxeprofen, diacerhein, glucosamine, and Xianling Gubao capsules on the knee OA had some effects, and its side -effects was mild, these four drugs can be used for normalized treatment on knee OA. The drug intervention therapy can delay the progression of knee OA.