盐酸氨基葡萄糖治疗膝骨关节炎的随机对照研究

A Randomized Controlled Trial of Glucosamine Hydrochloride in the Treatment of Knee Osteoarthritis

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。

Objective To investigate the efficacy of glucosamine hydrochloride in the treatment of knee osteoarthritis.Methods A total of 150 out-patients with knee osteoarthritis treated in our hospital between January and May 2012 were randomly divided into group A,B and C.Patients in group A were treated with glucosamine hydrochloride for 8 weeks;Patients in group B were given calcium carbonate and vitamin D3 Tablets（Caltrate D） treatment for 8 weeks;and patients in group C were given glucosamine hydrochloride and Caltrate D treatment for 8 weeks.Patients in each group took celecoxib for pain killing,and the amount of celecoxib was recorded.We compared changes of WOMAC Osteoarthritis Index scores and weekly consumption of celecoxib among three groups after eight weeks of treatment.Results Improvement in WOMAC total score,pain intensity scores,joint stiffness scores,and scores of difficulty in daily activities among the three groups were not significantly different.After eight weeks of treatment,weekly consumption of celecoxib in group A decreased significantly more than that in group B（0.41 ± 0.17 and 0.16 ± 0.22,P0.01）;weekly consumption of celecoxib in group C also decreased significantly more than that in group B（0.46 ± 0.19 and 0.16 ± 0.22,P0.01）： there was no significant difference of weekly celecoxib consumption changes between group A and B（0.41 ± 0.17 and 0.46 ± 0.19,P0.05）.Conclusions Short-term use of glucosamine hydrochloride is no better than the control drug（Caltrate D） in pain reduction,stiffness reduction and functional improvement.However,by reducing the dosage of non-steroidal anti-inflammatory drugs,glucosamine hydrochloride can benefit some patients with knee osteoarthritis.