降钙素联合盐酸氨基葡萄糖治疗膝骨关节炎的随机对照研究

Calcitonin Combined with Glucosamine Hydrochloride for the Treatment of Knee Osteoarthritis:A Randomized Controlled Study

目的探讨降钙素联合盐酸氨基葡萄糖治疗膝骨关节炎的治疗效果。方法 2014年11月-2015年4月收治156例膝骨关节炎患者,采用Kellgren-Lawrence分级标准将其分为轻、中、重度,按随机数字表法分为单用盐酸氨基葡萄糖组(对照组)和盐酸氨基葡萄糖联合降钙素组(试验组),每组各78例。于治疗6周、3个月后采用西安大略和麦克马斯特骨关节指数(WOMAC)问卷调查进行疗效评价。结果轻度膝骨关节炎患者中,两组治疗6周、3个月后与治疗前WOMAC评分比较差异均有统计学意义(P<0.05);两组治疗后同时间比较差异无统计学意义(P>0.05)。中度膝骨关节炎患者中,对照组治疗3个月、试验组治疗6周及3个月后与治疗前WOMAC评分比较差异均有统计学意义(P<0.05);两组治疗后同时间比较差异无统计学意义(P>0.05)。重度膝骨关节炎患者中,对照组治疗前后WOMAC评分比较差异无统计学意义(P>0.05);试验组治疗3个月后与治疗前比较差异有统计学意义(P<0.05);试验组治疗3个月后与对照组同时间点比较差异有统计学意义(P<0.05)。结论对轻度膝骨关节炎盐酸氨基葡萄糖联合降钙素与单用盐酸氨基葡萄糖比较无明显治疗优势;对中度膝骨关节炎联合治疗方案比单用盐酸氨基葡萄糖起效更快;对重度膝骨关节炎单用盐酸氨基葡萄糖无效,盐酸氨基葡萄糖联合降钙素治疗3个月后有效。

Objective To explore the efficacy of calcitonin combined with glucosamine hydrochloride on knee osteoarthritis.Methods According to Kellgren-Lawrence radiographic scoring system,156 patients with knee osteoarthritis diagnosed from November 2014 to April 2015 were classified as mild,moderate and severe cases.All of the patients were divided into control group（treated by glucosamine hydrochloride only） and trial group（treated by calcitonin combined with glucosamine hydrochloride） via table of random sampling numbers（with 78 patients in each group）.The West Ontario and Manchester University（WOMAC） score was recorded at the 6th week and the 3rd month after the medication treatment.Results In the patients with mild osteoarthritis,there were significant differences in WOMAC score of both groups at the 6th week and the 3rd month after treatment compared with those before the treatment（P〈 0.05）;there were no significant differences between the two groups at the same time points after the treatment（P〈 0.05）.In the patients with moderate osteoarthritis,WOMAC scores in the control group at the 3rd month differed much from that before the treatment（P〈 0.05）;there were no significant differences between the two groups at the same time points after the treatment（P〉 0.05）.In the patients with serious osteoarthritis,there was no significant difference in WOMAC scores in the control group after the treatment compared with that before the treatment（P〉 0.05）;while in the trial group,the scores at the 3rd month after the treatment differed much from that before the treatment（P〈 0.05）,and also from that in the control group（P〈 0.05）.Conclusions For mild knee osteoarthritis,the combined treatment is not superior to the single use of glucosamine hydrochloride.For moderate knee osteoarthritis,the combined treatment has faster effect than the single use of glucosamine hydrochloride.For severe osteoarthritis,the use of single glucosamine hydrochloride is not effective,while the combination of calcitonin and glucosamine hydrochloride is effective at the 3rd month after the treatment.