医用几丁糖联合双醋瑞因治疗膝骨关节炎的疗效研究

Research on curative effects of medical chitosan combined with diacerein in treatment of knee osteoarthritis

目的评价膝关节腔注射医用几丁糖加口服双醋瑞因胶囊与膝关节腔注射曲安奈德加口服盐酸氨基葡萄糖胶囊治疗膝骨关节炎(OA)患者的疗效和安全性。方法选取2015年6月~2017年4月80例符合美国风湿病学院(ACR)膝OA标准的患者。随机纳入A组40例予以膝关节腔注射医用几丁糖加口服双醋瑞因胶囊、B组40例予以膝关节腔注射曲安奈德加口服盐酸氨基葡萄糖胶囊治疗4周后停药且再随访1个月观察持续疗效,观察记录疗效和不良事件。结果试验组37例对照组35例完成试验,经过治疗试验组和对照组在主要疗效参数(关节疼痛)和次要疗效参数(压痛及髌骨研磨、关节活动、肿胀)均较治疗前明显改善。在第4周末,对照组与实验组主要疗效参数缓解,差异无统计学意义(P>0.05),第8周末,试验组药物能持续发挥药效,相对于对照组主要疗效参数-疼痛减轻明显,差异有统计学意义(P<0.05)。在试验组和对照组中出现可能与试验药物相关的不良事件的比例分别为13.51%和14.29%。结论应用膝关节腔注射医用几丁糖加口服双醋瑞因胶囊比膝关节腔注射曲安奈德加口服盐酸氨基葡萄糖胶囊治疗膝OA有较好且持续性的疗效以及较高的安全性。

Objective To evaluate the curative effect and safety of medical chitosan for knee joint cavity injection combined with oral diacerein capsule or triamcinolone acetonide for knee joint cavity injection combined with oral glucosamine hydrochloride capsule in treatment of patients with knee osteoarthritis(OA).Methods 80 OA patients who met the knee OA criteria of American College of Rheumatology(ACR)from June 2015 to April 2017 were selected.40 patients were randomly included in group A and they were given medical chitosan for knee joint cavity injection combined with oral diacerein capsule.40 patients in group B were given triamcinolone acetonide for knee joint cavity injection combined with oral glucosamine hydrochloride capsule.After 4 weeks of treatment,the drug was discontinued and the patients were followed up for 1 month to observe the lasting curative effect.Curative rate and adverse events were observed and recorded.Results 37 patients in the experimental group and 35 patients s in the control group completed the experiment.After treatment,the main therapeutic parameters(joint pain)and the secondary therapeutic parameters(tenderness and patellar grinding,joint movement,swelling)of the experimental group and the control group were significantly improved compared with those before treatment.At the end of the fourth week,there was no difference in the main therapeutic parameters between the control group and the experimental group(P>0.05).At the end of the eighth week,the drug in the experimental group could continue to exert its efficacy,and the pain relief was more obvious than that in the control group(P<0.05).The proportion of adverse events that may be related to the experimental drugs in the experimental group and the control group was 13.51%and 14.29%,respectively.Conclusion Compared with triamcinolone acetonide for knee joint cavity injection combined with oral glucosamine hydrochloride capsule,medical chitosan for knee joint cavity injection combined with oral diacerein capsule has better and continuous curative effects and higher safety.