硫酸氨基葡萄糖联合透明质酸钠治疗膝关节炎的疗效观察

目的观察硫酸氨基葡萄糖联合透明质酸钠关节腔内注射治疗膝关节炎的疗效。方法 98例膝关节炎患者随即分为实验组(n=46)和对照组(n=52)。实验组采用口服硫酸氨基葡萄糖500mg/次,3次/d。24周为一疗程+膝关节腔注射透明质酸钠2mL,每周一次,共注射5周。对照组采用口服双氯芬酸钠,每天服用剂量75~200mg。运用Womac关节炎指数和平均OA严重程度指数评价临床症状,X线检查评价关节改变情况。结果两组治疗3、6个月后Womac关节炎指数评分和平均OA严重程度指数均低于治疗前(t=2.323,t=2.214,t=2.378,t=23411,P均<0.05);实验组治疗3、6个月后Womac关节炎指数和平均OA严重程度指数均低于对照组(t=2.213,t=2.355,t=2.412,t=2.347,P均<0.05);实验组半年后关节间隙变窄2例(4.3%)明显低于对照组7例(13.4%)(χ2=3.9141,P<0.05)。结论透明质酸钠联合硫酸氨基葡萄糖治疗膝关节炎具有良好的临床效果,且具有保护关节软骨,延缓病程进展的作用。值得临床推广应用。

The Treatment Effect of Glucosamine Sulfate and Sodium Hyaluronate in Patients with Knee Osteoarthritis

Objective To observe the treatment effect of glucosamine sulfate combined with the sodium hyaluronate via interarticular injection on the knee osteoarthritis.Methods 98 cases with knee osteoarthritis were divided into Experimental group（n=52）and Control group（n=46）.Experimental group to use glucosamine sulfate 500mg per time orally,and three times per day were,lasting five weeks of injection.24 weeks is one treatment.Then interarticular injection of the sodium hyaluronate 2mL once a week,lasting five weeks of injection.Control group to use diclofenac orally 75-200mg per day.The clinical indexes were evaluated by Womac arthritis index score and the average OA severity index.X-ray evaluates the changing situation of the knee joints.Results Womac arthritis index score and the average OA severity index in 3 months,6 months after treatment were lower than before treatment two groups（t= 2.323,t=2.214,t=2.378,t=23411,all P0.05）;Womac arthritis index score and the average OA severity index in experimental group of 3 months,6 months after treatment were lower than the control group（t=2.213,t=2.355,t=2.412,t=2.347, all P〉0.05）;The joint gap narrowing in 2 cases（4.3%）in experimental group six months after were significantly lower than the control group 7 cases（13.4%）（χ ^2 =3.9141,P〈0.05）.Conclusion Glucosamine sulfate combined with the sodium hyaluronate has satisfactory clinical effects in treating the knee osteoarthritis and good protection of the cartilage,slowing down the course of disease,which deserves the promotion and application in the clinical treatment.