盐酸氨基葡萄糖辅助治疗Pilon骨折的临床研究

Clinical study of Glucosamine Hydrochloride as An Adjuvant therapy for Pilon Fractures

目的观察盐酸氨基葡萄糖对Pilon骨折的辅助治疗作用。方法 2007年6月-2010年9月,将43例接受手术治疗的Pilon骨折患者随机分成两组,A组术后口服盐酸氨基葡萄糖,B组作为对照组(仅服用安慰剂)。A组21例患者,平均年龄(35.7±8.0)岁,B组22例患者,平均年龄(36.7±7.1)岁。两组患者年龄、性别、骨折分型及手术时机相比较,无统计学差异(P>0.05)。定期随诊(术后6、12、18个月),根据美国足与踝关节协会踝与后足功能评分(AOFAS)评分系统对患者进行功能评分,进行前瞻、对照、双盲研究。结果术后6、12、18个月,A组患者的AOFAS评分均明显高于B组,差异有统计学意义(t=2.530,2.856,2.881;P=0.015,0.007,0.006);术后18个月,A组临床疗效优良率为95.2%,B组优良率为72.3%,差异有统计学意义(χ2=3.995,P=0.046)。A组2例患者分别发生轻度头晕及恶心,无严重不良反应发生。结论盐酸氨基葡萄糖辅助治疗Pilon骨折可改善踝关节功能,减少创伤性骨关节炎的发生。

Objective To study the effect of glucosamine hydrochloride as an adjuvant therapy for Pilon fractures.Methods From June 2007 to September 2010,43 patients with pilon fractures who had accepted surgical treatment were randomized prospectively into group A and group B.Patients of group A were given oral glucosamine hydrochloride after operation.Patients of group B（control group） took placebo after operation.The functional rating scale of American Orthopedic Foot and Ankle Society（AOFAS） was used to evaluate the patients at the time of 6,12,and 18 months after surgery.Results Group A had 21 patients with a mean age of（35.7 ± 8.0） years old and group B had 22 patients with a mean age of（36.7 ± 7.1） years old.There was no significant difference in age,sex,classification of fracture and operation time between group A and group B（P 0.05）.The AOFAS scores of group A were obviously higher than those of group B at the time of 6,12,and 18 months after surgery（t=2.530,2.856,2.881;P=0.015,0.007,0.006）.The clinical therapeutic effect of group A was superior to that of group B at the time of 18 months after surgery with the excellent rate being 95.2% and 72.3%（χ2=3.995,P=0.046）.No serious adverse reactions occurred except that two patients had mild dizziness and nausea respectively.Conclusion Glucosamine hydrochloride is an effective adjuvant therapy for Pilon fractures,which can reduce the occurrence of ankle traumatic arthritis.