盐酸氨基葡萄糖胶囊治疗肘关节创伤性关节炎的疗效及不良反应观察

Observation on efficacy and adverse reactions of glucosamine hydrochloride capsule in the treatment of traumatic arthritis of the elbow

目的 探讨盐酸氨基葡萄糖胶囊治疗肘关节创伤性关节炎的疗效及不良反应。方法 92例肘关节创伤性关节炎患者,随机分为对照组及观察组,每组46例。对照组口服醋氯芬酸片治疗,观察组口服盐酸氨基葡萄糖胶囊治疗。对比两组的临床疗效、不良反应发生情况及治疗前后视觉模拟评分法(VAS)评分、改良HSS肘关节评分、炎性因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、骨代谢指标[骨保护素(OPG)、硬骨素、Dickkopf相关蛋白1(DKK-1)]水平。结果 观察组治疗总有效率为93.48%,明显高于对照组的71.74%,差异有统计学意义(P<0.05)。治疗后,观察组VAS评分(2.02±0.51)分明显低于对照组的(4.73±0.89)分,改良HSS肘关节评分(86.75±5.24)分明显高于对照组的(72.18±6.39)分,差异有统计学意义(P<0.05)。治疗后,观察组血清IL-1β、TNF-α、hs-CRP、OPG、硬骨素水平分别为(5.11±1.39)ng/L、(309.59±37.26)pg/ml、(5.04±1.16)mg/L、(0.46±0.13)μg/L、(67.28±9.70)pg/ml,明显低于对照组的(10.05±2.13)ng/L、(491.36±40.52)pg/ml、(8.97±1.90)mg/L、(1.08±0.19)μg/L、(91.64±15.31)pg/ml, DKK-1水平(5426.97±343.62)pg/ml明显高于对照组的(4631.84±340.51)pg/ml,差异有统计学意义(P<0.05)。观察组不良反应发生率2.17%明显低于对照组的21.74%,差异有统计学意义(P<0.05)。结论 盐酸氨基葡萄糖胶囊治疗肘关节创伤性关节炎的疗效显著,能有效缓解疼痛,对改善肘关节功能,降低炎症反应,调节骨代谢,具有积极的临床意义。

Objective To discuss the efficacy and adverse reactions of glucosamine hydrochloride capsule in the treatment of traumatic arthritis of the elbow. Methods A total of 92 patients with traumatic arthritis of the elbow were randomly divided into a control group and an observation group, with 46 cases in each group. The control group was treated with aceclofenac tablets orally, and the observation group was treated with glucosamine hydrochloride capsules orally. Both groups were compared in terms of clinical efficacy, occurrence of adverse reactions, visual analogue scale(VAS) score, modified HSS score, and inflammatory factors [interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), high-sensitivity C-reactive protein(hs-CRP)], bone metabolic indexes [osteoprotegerin(OPG), sclerostin, Dickkopf-related protein 1(DKK-1)] levels before and after treatment.Results The total effective rate of treatment in the observation group was 93.48%, which was significantly higher than 71.74% in the control group, and the difference was statistically significant(P<0.05). After treatment, the VAS score(2.02±0.51) points of the observation group was significantly lower than(4.73±0.89) points of the control group, and the modified HSS score(86.75±5.24) points was significantly higher than(72.18±6.39) points of the control group. The differences were statistically significant(P<0.05). After treatment, the serum IL-1β,TNF-α, hs-CRP, OPG, and sclerostin levels in the observation group were(5.11±1.39) ng/L,(309.59±37.26) pg/ml,(5.04±1.16) mg/L,(0.46±0.13) μg/L, and(67.28±9.70) pg/ml, respectively, which were significantly lower than(10.05±2.13) ng/L,(491.36±40.52) pg/ml,(8.97±1.90) mg/L,(1.08±0.19) μg/L, and(91.64±15.31) pg/ml in the control group;the DKK-1 level(5426.97±343.62) pg/ml in the observation group was significantly higher than(4631.84±340.51) pg/ml in the control group;the differences were statistically significant(P<0.05). The incidence of adverse reactions 2.17% in the observation group was significantly lower than 21.74% in the control group, and the difference was statistically significant(P<0.05). Conclusion Glucosamine hydrochloride capsule has a significant effect in the treatment of traumatic arthritis of the elbow, and can effectively alleviate pain, improve elbow function, reduce inflammation response, regulate bone metabolism,which has a positive clinical significance.