壮骨颗粒配合硫酸氨基葡萄糖片治疗膝骨性关节炎

Observation on Therapeutic Effects of Combination Therapy of Zhuanggu Granules and Glucosamine for the Treatment of Knee Osteoarthritis

目的:探讨壮骨颗粒联合硫酸氨基葡萄糖片治疗早中期膝骨性关节炎的临床疗效。方法:本实验为临床对照试验,试验时间为12周。将106名早中期(KL标准I-II级)膝骨性关节炎患者,男23例,女83例,按就诊时间随机分成A、B、C、D4组。A组男7例,女21例,平均年龄59.4±5.7岁,平均病程19.4±8.3个月,接受单纯功能锻炼;B组男4例,女22例,平均年龄58.5±5.1岁,平均病程18.2±8.0个月,口服硫酸氨基葡萄糖片治疗;C组男6例,女20例,平均年龄59.9±5.5岁,平均病程21.3±8.9个月,口服壮骨颗粒治疗;D组男6例,女19例,平均年龄59.6±6.0岁,平均病程19.8±8.7个月,同时口服壮骨颗粒和硫酸氨基葡萄糖片。B、C、D3组同时进行功能锻炼。采用Lysholm膝关节评分量表分别在治疗前、治疗第2周,第4周,第6周末及治疗后2周(第8周)、6周(第12周)6个时间点评定膝关节功能。并在治疗前和治疗第6周留取患者尿液,冻存,以便以后测定uCTX-Ⅱ含量。结果:各药物组同对照组(A组)有统计学意义(F=17.377,P<0.001),各组变化趋势呈现明显不同。uCTX-Ⅱ治疗前后含量A组和B组无统计学意义(P>0.05),C组和D组有统计学意义(P<0.01)。结论:硫酸氨基葡萄糖片和壮骨颗粒对于改善轻中度膝骨性关节炎功能均有治疗效果,壮骨颗粒和硫酸氨基葡萄糖片联合可有效地快速增强临床疗效。而且在减少Ⅱ胶原降解方面,只有壮骨颗粒有作用。

Objective： To investigate therapeutic effects of combination therapy Zhuanggu granules and Glucosamine for the treatment of osteoarthritis of knee joint. Methods：This study was a 12-week, clinical controlled and randomized trailo 106 patients with painful knee OA at early and medium stage （KL-score of Ⅰ-Ⅱ） including 83 women and 23 men were allocated to four groups, from GroupA to GroupD in order of precedence. GroupA （7 male and 21 female, with an average age with 59.4 ± 5.7 years and mean course of disease 19.4 ± 8.3 months）take physical exercise alone as control. GroupB （4 male and 22 female, with an average age with 58.5 ± 5.1 years and mean course of disease 18.2 ± 8.0 months）, GroupC （6 male and 20 female, with an average age with 59.9 ± 5.5 years and mean course of disease 21.3 ± 8.9 months） and GroupD（6 male and 19 female,with an average age with 59.6 ± 6.0 years and mean course of disease 19.8 ± 8.7 months） received 3 treatments： Glucosamine （GroupB）, Zhuanggu granules （GroupC）, Combination of Zhuanggu granules and Glucosamine （GroupD） .At the same time they perform the same Physical exercise as GroupA. They were evaluated by Lysholm knee score scale（LKSS） at 6 pionts, including at begainning of the study and the weeks 2, 4, 6, 8 and 12. Urine samples were obtained at initial time and the end of the sixth week. ELISA was used to measure the concentration of urine C-terminal telopeptide of collagen type Ⅱ （CTX-Ⅱ）.At the end of study, SPSS17.0 for windows was used to take histological analysis.Results： Compared with GroupA, LISS of GroupB, GroupC and GroupD at weeks 2,4,6,8 and 12 after treatment were obviously different（F= 17.377, P〈0.001）, their tendency were also different. Compared with GroupA, the concentration of uCTX-Ⅱ at the end of the sixth week, GroupC and GroupD were obviously different（P〈0.05）. Conclusion：For the treatment of mild OA,both Zhuanggu granules and Glucosarnine were effectiveo The Combination of Zhuanggu granules and Glucosamine improve the clinical symptomts and knee joint＇ function of patients with knee osteoarthritis fast and effectively. Zhuanggu granules also reduce destructive turnover of the collagen Ⅱ in articular cartilage.