骨营养制剂治疗膝关节骨性关节炎的临床疗效观察

Clinical observation on the treatment of knee osteoarthritis with bone nutrition preparation

目的 观察骨营养制剂治疗膝关节骨性关节炎(Knee osteoarthritis,KOA)的临床疗效。方法 纳入符合标准的KOA患者40例,随机分成治疗1组和治疗2组,每组20例,并对患者设盲。治疗1组口服氨糖骨胶原软骨素片,3片/次,2次/天;治疗2组口服氨糖骨胶原钙维生素K酪蛋白磷酸肽片,2片/次,2次/天;共服用12周。记录治疗前、治疗12周后的视觉模拟评分(Visual analogue scale,VAS)、西安大略和麦克马斯特大学骨关节炎指数评分(Western Ontario and McMaster Universities Arthritis Index,WOMAC)、髌上囊积液深度、滑膜厚度、左髋和股骨颈骨密度值(Bone mineral density,BMD)和血清钙、无机磷、碱性磷酸酶、白细胞介素-1β(Interleukin-1β,IL-1β)、Ⅱ型胶原羧基末端交链(Collagen typeⅡC-telopeptide,CTX-Ⅱ)的浓度,并监测不良反应的发生情况。结果 经过12周的治疗后,两组患者的VAS评分、WOMAC评分、髌上囊积液深度、滑膜厚度均较治疗前出现显著下降(P <0.05),两组IL-1β、CTX-II较前无明显降低(P> 0.05);两组股骨颈BMD值及血清钙、无机磷、碱性磷酸酶较治疗前变化不明显(P> 0.05);观察期间不良反应发生率分别为15%、16.7%。两组患者组间比较差异均无统计学意义(P> 0.05)。结论 氨糖骨胶原软骨素片、氨糖骨胶原钙维生素K酪蛋白磷酸肽片治疗KOA安全有效,能明显缓解关节疼痛和肿胀的症状,改善膝关节活动功能。

Objective To investigate the clinical efficacy of bone nutrition preparation in the treatment of knee osteoarthritis. Methods A single-blind,randomized,small-sample observational design was used to include 40 patients with knee osteoarthritis, who were randomly divided into treatment group 1 and treatment group 2, with 20 cases in each group. Treatment group 1 was given glucosamine collagen chondroitin tablets 3 g twice daily for 12 weeks.Treatment group 2 was given glucosamine collagen calcium vitamin K casein phosphopeptide tablets 2 g twice daily for 12 weeks. The visual analogue scale, Western Ontario and McMaster Universities arthritis index, the depth of suprapatellar effusion, synovial thickness, BMD value of left femoral neck and the concentration of serum calcium, inorganic phosphorus, alkaline phosphatase, Interleukin-1β and collagen type II C-telopeptide were recorded before and 12 weeks after of treatment. Results After 12 weeks of treatment, the VAS score, WOMAC score, the depth of suprapatellar sac effusion and synovial thickness in both groups were significantly decreased compared with before treatment(P < 0.05),but there was no significant difference between the two groups(P> 0.05). The content of serum IL-1β, CTX-II, calcium,phosphorus,alkaline phosphatase and the BMD of femoral neck had no significant difference in within and between the two groups(P > 0.05). Conclusion Both the glucosamine collagen chondroitin tablets and the glucosamine collagen calcium vitamin K casein phosphopeptide tablets are safe and effective in the treatment of KOA,which can significantly relieve the symptoms of joint pain and swelling,and improve the activity of knee joint.