外用NSAIDs联合玻璃酸钠和氨基葡萄糖治疗膝关节炎的临床Ⅳ期研究

Clinical phase iv study of topical NSAIDs combined with sodium hyaluronat e and glucosamine in the treatment of knee arthritis

目的:评价外用非甾体类消炎药(NSAIDs)联合玻璃酸钠、氨基葡萄糖治疗膝关节炎的有效性与安全性。方法:选取2019年1月至12月武平县第二人民医院收治的432例膝关节炎患者作为研究对象。将其随机分为A组、B组、C组、D组和E组。为五组患者均采用注射玻璃酸钠和口服氨基葡萄糖疗法进行治疗。在此基础上,为A组患者外用洛索洛芬钠凝胶膏进行治疗,为B组患者外用氟比洛芬酯凝胶膏进行治疗,为C组患者外用吲哚美辛凝胶膏进行治疗,为D组患者外用洛索洛芬钠贴剂进行治疗,为E组患者外用吡罗昔康贴片进行治疗。治疗4周后,比较各组患者的疗效和不良反应的发生情况。结果:1)A组患者、B组患者、C组患者、D组患者和E组患者治疗的总有效率分别为92.3%、88.2%、87.2%、85.1%、86.7%。五组患者治疗的总有效率相比,P>0.05。2)治疗后,五组患者的VAS评分、各项WOMAC评分均较治疗前显著下降,其Lysholm评分均较治疗前显著提高,P<0.05。治疗后,A组患者的VAS评分显著低于B组患者、C组患者、D组患者和E组患者,其Lysholm评分显著高于B组患者、C组患者、D组患者和E组患者,P<0.05。3)治疗后,A组患者、B组患者、C组患者、D组患者和E组患者不良反应的发生率分别为3.3%、2.4%、3.5%、3.4%、2.4%;五组患者不良反应的发生率相比,P>0.05。结论:外用NSAIDs联合玻璃酸钠、氨基葡萄糖治疗膝关节炎的有效性与安全性均较为理想。与采用氟比洛芬酯凝胶膏、吲哚美辛凝胶膏、洛索洛芬钠贴剂、吡罗昔康贴片相比,用洛索洛芬钠凝胶膏联合玻璃酸钠和氨基葡萄糖治疗膝关节炎的效果较好,可显著改善患者的膝关节功能,减轻其疼痛症状。

Objective:To evaluate the efficacy and safety of topical non-steroidal anti-inflammatory drugs(NSAIDs)combined with sodium hyaluronate and glucosamine in the treatment of knee arthritis.Methods:A total of 432 patients with knee arthritis admitted to the Second People’s Hospital of Wuping County from January to December 2019 were selected as the research objects.They were randomly divided into group A,group B,group C,group D and group E.Five groups of patients were treated with sodium hyaluronate injection and oral glucosamine therapy.On this basis,for the patients of group A topical los SuoLuoFen sodium gel cream treatment,for group B patients topical flurbiprofen ester gel cream treatment for the patients of group C topical indomethacin gel cream treatment,for patients with group D los SuoLuoFen sodium patch treatment for external use only,for the group E patients treated with topical piroxicam patch.After 4 weeks of treatment,the curative effect and the occurrence of adverse reactions in each group were compared.Results:1)The total effective rates of group A,B,C,D and E were 92.3%,88.2%,87.2%,85.1%and 86.7%,respectively.The total effective rate of 5 groups was compared,P>0.05.2)After treatment,VAS score and WOMAC score of 5 groups were significantly decreased compared with before treatment,and Lysholm score was significantly increased compared with before treatment,P<0.05.After treatment,VAS score of group A was significantly lower than that of group B,GROUP C,group D and group E,and Lysholm score was significantly higher than that of group B,GROUP C,group D and group E,P<0.05.3)After treatment,the incidence of adverse reactions was 3.3%in group A,2.4%in group B,3.5%in group C,3.4%in group D and 2.4%in group E;The incidence of adverse reactions in 5 groups was compared,P>0.05.Conclusion:The efficacy and safety of NSAIDs combined with sodium hyaluronate and glucosamine in the treatment of knee arthritis are ideal.Compared with flurbiprofen ester gel paste,indomethacin gel paste,losolprofen sodium patch,piroxicam patch,losolprofen sodium gel paste combined with sodium hyaluronate and glucosamine in the treatment of knee arthritis effect is better,can significantly improve the knee function of patients,alleviate the pain symptoms.