依托考昔联合盐酸氨基葡萄糖治疗膝关节骨性关节炎的疗效分析

Clinical Efficacy of Etoricoxib Combined with Glucosamine Hydrochloride in Treatment of Osteoarthritis of Knees

目的探讨依托考昔联合盐酸氨基葡萄糖治疗膝关节骨性关节炎的疗效。方法选取2016年2月至2017年8月在我院治疗的膝关节骨性关节炎患者112例,采用随机数字表法将患者分为依托考昔治疗组(n=37)、盐酸氨基葡萄糖治疗组(n=40)和联合治疗组(n=35),观察各组治疗疗效、WOMAC评分、关节滑液肿瘤坏死因子α(TNF-α)、基质金属蛋白酶-3(MMP-3)、MMP-9、MMP-13和不良反应。结果联合治疗组临床疗效优于依托考昔治疗组和盐酸氨基葡萄糖治疗组(P<0.05),其总有效率为94.29%;联合治疗组治疗后疼痛评分、僵硬评分、功能障碍评分及WOMAC总分分别为(11.57±2.82)分、(3.48±1.77)分、(30.05±8.96)分和(45.18±9.27)分,明显低于依托考昔治疗组和盐酸氨基葡萄糖治疗组(P<0.05);联合治疗组治疗后TNF-α、MMP-3、MMP-9和MMP-13分别为(30.12±9.22)pg/ml、(101.02±20.33)ng/ml、(32.28±10.05)ng/ml和(156.38±18.38)ng/ml,明显低于依托考昔治疗组和盐酸氨基葡萄糖治疗组(P<0.05);依托考昔治疗组和盐酸氨基葡萄糖治疗组治疗后疼痛评分、僵硬评分、功能障碍评分、WOMAC总分、TNF-α、MMP-3、MMP-9和MMP-13比较差异无统计学意义(P>0.05);三组不良反应发生率比较差异无统计学意义(P>0.05)。结论依托考昔联合盐酸氨基葡萄糖治疗膝关节骨性关节炎的疗效较好,同时可抑制TNF-α的释放和基质金属蛋白酶表达。

Objective To investigate the clinical efficacy of etoricoxib combined with glucosamine hydrochloride in the treatment of osteoarthritis of knees. Methods Between February 2016 and August 2017,112 patients with osteoarthritis of knees were treated in our hospital,who were randomly divided into the etoricoxib treatment group（ n = 37）,the glucosamine hydrochloride treatment group（ n = 40） and the combined treatment group（ n = 35）. The curative effect,WOMAC score,synovial tumor necrosis factorα（ TNF-α）,matrix metalloproteinase-3（ MMP-3）,MMP-9,MMP-13 and the adverse reactions of each group were observed. Results The clinical effect of the combined treatment group was better than that of the etoricoxib group and the glucosamine hydrochloric group（ P〈 0. 05）,and the total effective rate was 94. 29%. The pain score,stiff score,dysfunction score and the total score of WOMAC were（ 11.57±2.82）,（ 3.48± 1. 77）,（ 30. 05 ± 8. 96） and（ 45. 18 ± 9. 27） in the combined treatment group after treatment,which were significantly lower than those of the etoricoxib treatment group and glucosamine hydrochloride treatment group（ P〈0.05）. TNF-α,MMP-3,MMP-9 and MMP-13 in the combined treatment group were（ 30.12±9.22） pg/ml,（ 101.02±20.33） ng/ml,（ 32.28± 10.05） ng/ml and（ 156.38± 18.38） ng/ml after treatment,significantly lower than those of the etoricoxib treatment group and glucosamine hydrochloride treatment group（ P〈0.05）. There was no statistically significant difference（ P〉0.05） between the etoricoxib treatment group and glucosamine hydrochloride treatment group in the pain score,stiff score,dysfunction score,WOMAC score,TNF-α,MMP-3,MMP-9 and MMP-13 after treatment. The incidence of adverse reactions of the three groups was of no statistical significance（ P 〉0.05）. Conclusion Etoricoxib combined with glucosamine hydrochloride is effective for the treatment of knee osteoarthritis,which can inhibit TNF-α release and the expression of matrix metalloproteinase.