盐酸氨基葡萄糖片单独使用及与仙灵骨葆胶囊联合治疗膝骨性关节炎的疗效比较

Glucosamine hydrochloride tablets alone and combination with Xianlinggubao capsules for treatment patients with knee osteoarthritis

目的：探讨盐酸氨基葡萄糖片（GH）单独使用及联合仙灵骨葆胶囊（XLGB）治疗膝骨性关节炎（KOA）的临床疗效。方法选择 KOA 患者96例，按照随机数字表法分为两组，观察组和对照组各48例。对照组单纯使用 GH 治疗，观察组在对照组基础上联合 XLGB 治疗。治疗前后利用美国西部 Ontario 和McMaster 大学骨性关节炎指数（WOMAC）对患者症状进行评分，包括疼痛、僵硬、身体功能单项得分及总分，统计两组患者起效时间、治疗3个月和6个月的膝关节功能（HSS）评分，测量患者治疗前后的 CRP 和红细胞沉降率（ESR），并在治疗结束后对总疗效进行评价。结果治疗前，两组 WOMAC 各项及总分、CRP 和 ESR差异无统计学意义（P ＞0．05）；治疗后，观察组疼痛、僵硬、身体功能和总分分别为（10．2±177;1.4）分、（3．5±177;1．6）分、（40．5±177;5．0）分和（56．4±177;6．7）分，对照组为（14．8±177;2．6）分、（6．2±177;2．3）分、（52．2±177;6．8）分和（73．3±177;4．5）分，两组差异均有统计学意义（t ＝7．631、4．721、6．791、10．26，均 P ＜0．01）；观察组起效时间、治疗3个月和6个月的 HSS 评分分别为（6．0±177;2．2）d、（68．2±177;6．4）分和（84．3±177;6．2）分，对照组为（9．8±177;2.8）d、（58．5±177;3．9）分和（72．8±177;5．4）分，两组差异均有统计学意义（t ＝5．228、6．341、6．852，均 P ＜0.01）；观察组 ESR、CRP 水平较对照组改善更为明显（t ＝3．880、2．668，均 P ＜0．05）；治疗后，观察组总有效率为93.8％（45／48），对照组总有效率为77．1％（37／48），两组差异有统计学意义（χ2＝5．352，P ＜0．05）。结论GH 与 XLGB 联合使用能明显改善 KOA 患者的主要临床症状，膝关节功能恢复更迅速，是 KOA 安全有效的疗法。

Objective To explore the clinical value of Glucosamine hydrochloride tablets（GH）alone and combination with Xianlinggubao capsules（XLGB）for treatment patients with knee osteoarthritis（KOA）.Methods 96 patients with KOA were selected,and were divided into two groups according to the random number method, 48 cases in each group.The control group was treated with GH alone,while the observation group was treated with XL-GB on the basis of the control group.US Western Ontario and McMaster University Osteoarthritis Index （WOMAC） were used to evaluate the symptoms change,including pain,stiffness,physical function scores and total scores before and after treatment.The onset time,knee function （HSS）score at 3 months and 6 months after treatment were recor-ded.CRP and ESR were measured,and the total efficacy was evaluated at the end of treatment.Results The differ-ence of WOMAC score between the two groups was not statistically significant before treatment （P 〈0.05 ）.After treatment,pain,stiffness,physical function scores and total scores were （10.2 ±177;1.4）points,（3.5 ±177;1.6）points, （40.5 ±177;5.0）points and （56.4 ±177;6.7）points in the observation group,those were （14.8 ±177;2.6）points,（6.2 ±177;2.3）points, （52.2 ±177;6.8）points and （73.3 ±177;4.5）points in the control group,the differences were statistically significant （t =7.631,4.721,6.791,10.26,all P ＆lt;0.01）.The onset time,HSS score at 3 months and 6 months after treatment in the observation group were （6.0 ±177;2.2）d,（68.2 ±177;6.4）points and （84.3 ±177;6.2）points,while those were （9.8 ±177; 2.8）d,（58.5 ±177;3.9）points and （72.8 ±177;5.4）points in the control group,the differences were statistically significant （t =5.228,6.341,6.852,all P 〈0.01 ）.The improvements of CRP level and ESR in the observation group were more pronounced than those in the control group （t =3.880,2.668,all P ＆lt;0.05）.After treatment,the total effective rate of the observation group was 93.8%（45 /48）,while that was 77.1%（37 /48）in the control group,the difference was statistically significant （χ2 =5.352,P ＆lt;0.05）.Conclusion GH combines with XLGB can significantly improve symptoms in patients with KOA,with more rapid recovery of knee function,thus it is a safe and effective therapy.