氨基葡萄糖胶囊联合玻璃酸钠治疗膝骨性关节炎的疗效及对炎症因子水平的影响

Therapeutic effect of glucosamine capsule combined with sodium hyaluronate in the treatment of knee osteoarthritis and its effect on inflammatory cytokines

目的探讨氨基葡萄糖胶囊联合玻璃酸钠治疗膝骨性关节炎的疗效及对炎症因子水平的影响。方法 70例膝骨性关节炎患者随机分为观察组和对照组。两组均予以玻璃酸钠针25 mg关节腔内注射,1次/周。观察组在对照组基础上加用盐酸氨基葡萄糖胶囊,2粒/次,3次/d,口服。两组病程均6周。分别于治疗前后观察血清超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)指标的变化,并比较其临床效果及不良反应。结果治疗6周后,两组血清hs-CRP和TNF-α水平明显下降(P<0.05或P<0.01),且观察组治疗后上述指标明显低于对照组(P<0.05);观察组临床总有效率较对照组更佳(χ~2=4.20,P<0.05);对照组和观察组分别出现不良反应4例(11.43%)和6例(17.14%),症状均较轻,两组比较差异无统计学意义(χ~2=0.47,P>0.05)。结论氨基葡萄糖胶囊联合玻璃酸钠治疗膝骨性关节炎的疗效优于单纯的玻璃酸钠治疗,具有较好的安全性,其发病机制可能与其能下调血清hs-CRP和TNF-α指标、控制其炎症反应密切相关。

Objective To investigate the therapeutic effect of glucosamine capsule combined with sodium hyaluronate in the treatment of knee osteoarthritis and its effect on the level of inflammatory cytokines.Methods 70 knee osteoarthritis patients were randomly divided into observation group and control group.Both groups were given intra-articular injection of 25 mg sodium hyaluronate needle,once a week.The observation group was further orally given two capsules of glucosamine hydrochloride capsules once,three times a day.The duration of both groups was 6 weeks.The changes of serum hs-CRP and TNF-αwere observed before and after treatment,and their clinical effects and adverse reactions were compared.Results After 6 weeks of treatment,the serum levels of hs-CRP and TNF-αin both groups were significantly decreased(P<0.05 or P<0.01).The above indexes in the observation group were significantly lower than those in the control group(P<0.05);the total clinical effective rate in the observation group was better than that in the control group(χ2=4.20,P<0.05);there were 4 cases(11.43%)and 6 cases(17.14%)of adverse reactions in the control group and observation group,respectively.The symptoms were mild,and the difference was no statistically significant between the two groups(χ2=0.47,P>0.05).Conclusion The therapeutic effect of glucosamine capsules combined with sodium hyaluronate in the treatment of knee osteoarthritis is better than that of sodium hyaluronate alone.It has a good safety.Its pathogenesis may be closely related to its ability to down-regulate serum hs-CRP and TNF-α,and control their inflammatory response.