双醋瑞因、硫酸氨基葡萄糖联合透明质酸钠治疗膝骨关节炎疗效观察

目的研究双醋瑞因、硫酸氨基葡萄糖联合透明质酸钠治疗膝骨关节炎的临床疗效。方法将160例骨关节炎患者随机分为2组，治疗组80例给予双醋瑞因50mg，口服，1次／天，硫酸氨基葡萄糖胶囊500mg，口服，3次／天，共服药12周；透明质酸钠注射剂2．5ml膝关节腔内注射，每周1次，连续5周为1个疗程。对照组80例仅予双醋瑞因和硫酸氨基葡萄糖口服（剂量、疗程同前）观察治疗前、治疗后12周、24周临床疗效指标、炎性指标和影像学表现改善情况。结果12周时2组患者在临床疗效指标、炎性指标方面较治疗前比较均显著改善（P均〈0．05）；治疗组改善程度优于对照组（P〈0．05）。24周时，治疗组的临床疗效指标、炎性指标等均较治疗前改善（P〈0．05），但改善程度较12周时下降（P〈0．05），但仍优于对照组（P〈0．05），此时影像学表现方面有改善（P〈0．05）；对照组的临床疗效指标、炎性指标和影像学表现等与治疗前比较无明显改善（P〉0．05）。治疗过程中，两组患者均未发生严重不良反应。结论双醋瑞因和硫酸氨基葡萄糖联合透明质酸钠治疗膝骨关节炎是可行、安全、优效、便捷、疗效持久的方案，值得临床推广。

Efficacy and safety of diacerein combined with hyaluronate and glucosamine sulfate in the treatment of knee osteoarthritis

Objective To evaluate the efficacy and safety of intra-articular injection of sodium hyaluronate and oral glucosamine and diacerein with only oral glucosamine and diacerein for knee osteoarthritis（OA）. Methods A randomized parallel-controlled clinical trial of twice methords was performed. 80 patients suffering from knee OA were randomized into 2 groups. All patients received glucosamine 3 times daily with total 1500 mg per day and diacerein one time daily with 50 mg per day for 12 weeks. Observation group（40 cases）received sodium hyaluronate intra-articular injection 1 time weekly with 2.5 ml per week for 5 weeks at same time. The Lequesne index of the knee joint, ESR, CRP and X-ray improvement were evaluated in the two groups respectively. Results At the twelfth week,the Lequesne index,inflammation index in observation group more improved than that in control group（P 〈 0. 05 ）. At the twentyforth week, the Lequesne index and inflammation index in the observation group were lower than that in control group. X-ray improvement in observation group more improve than that in control group （ P 〈 0.05）. The rate of excellent effect were 80% and 52% in the observation and control groups respectively. Conclusion Diacerein combined with hyaluronate and glucosamine sulfafe provides a feasible, safety, excellent efficiency,convenient and curative effect lasting solutions for treatment of osteoarthritis and is worth clinical promotion.