ObjectiveTo evaluate the efficacy and safety of glucosamine hydrochloride in the treatment of osteoarthritis. MethodsA total of 150 patients with osteoarthritis treated between April 2014 and April 2015 were randomly divided into control group and trial group with 75 in each. Patients in the trial group accepted oral glucosamine hydrochloride, while those in the control group were given diclofenac sodium. Lequesne index, total effective rate and the incidence of adverse reactions of both groups were calculated before and 2, 4, 6 and 8 weeks after treatment, and 2 weeks after drug withdrawal. ResultsIn both groups, Lequesne index started to decrease after 2 weeks of treatment (P<0.05), and reached the minimum value at treatment week eight (P<0.05). The Lequesne index 2 weeks after drug withdrawal was still obviously lower than that before treatment (P<0.05). There was no significant differences in the total effective rate at treatment week eight (83.1% for the control group and 80.9% for the trial group) or the total effective rate 2 weeks after drug withdrawal (80.0% for the control group and 79.4% for the trial group) between the control group and the trial group (P>0.05). The incidence of adverse reactions of the trial group (6.7%) was significantly lower than that of the control group (21.3%) (P<0.05). ConclusionGlucosamine hydrochloride is effective and safe in the treatment of osteoarthritis, which is suitable for long-term treatment.
目的:研究双醋瑞因联合盐酸氨基葡萄糖和双氯芬酸钠治疗骨性关节炎的可行性及安全性。方法:选取100例骨性关节炎患者,随机分入双醋瑞因组联合双氯芬酸钠组(A组)、盐酸氨基葡萄糖联合双氯芬酸钠组(B组)、单用双氯芬酸钠组(C组)和双醋瑞因组联合双氯芬酸钠和盐酸氨基葡萄糖组(D组)四组中,用药12周后观察治疗前后临床疗效和综合疗效评分。结果:1.四组治疗方案在VAS评分、关节疼痛度评分方面均有良好改善率;2D组治疗方案优于A、B、C三组。结论:双醋瑞因联合盐酸氨基葡萄糖和双氯芬酸钠治疗骨性关节炎是可行、安全、优效的方案。
ObjectiveTo discuss the efficacy and safety of the joint application of oral glucosamine hydrochloride tablets and knee joint cavity ozone injection in the treatment of knee osteoarthritis. MethodsFrom January 2014 to January 2015, 72 patients who matched the criteria of moderate knee osteoarthritis were randomly divided into two groups according to the table of random number: oral glucosamine hydrochloride tablet and knee joint cavity ozone injection group (group G+O) and ozone group (group O). Patients of group G+O orally took glucosamine hydrochloride tablets (0.48 g, 3 times/day) for twelve weeks, and ozone was injected into the patients’ knee joint once a week for the first four weeks. The treatment for group O patients was the same with Group G+O, except that the glucosamine hydrochloride tablets were replaced by glucosamine hydrochloride placebo (2 tablets, 3 times/day, taking orally). We recorded the Visual Analogue Scale (VAS) score, Western Ontario & McMaster University (WOMAC) osteoarthritis index score and the adverse reactions before treatment and in the first, third and sixth month after treatment. ResultsPatients’ VAS scores and WOMAC scores of both the two groups in the first, third and sixth month after treatment were significantly different from those before the treatment (P ＜ 0.05) . In the first month after treatment, there were no significant difference in patients’ VAS scores and WOMAC scores between the two groups (P ＞ 0.05) . In the third and sixth month after treatment, there were significant differences in patients’ VAS scores and WOMAC scores between the two groups (P ＜ 0.05) . There was no obvious adverse reactions during the treatment. ConclusionsThe combined application of oral glucosamine hydrochloride tablets and knee joint cavity ozone injection and the ozone treatment for moderate knee osteoarthritis are both effective, without any adverse reaction. The combined treatment of oral glucosamine hydrochloride tablets and knee joint cavity ozone injection on moderate knee osteoarthritis has better long-term efficacy, and it is worth spreading.
ObjectiveTo compare the clinical efficacy of glucosamine hydrochloride and diacerein for patients with knee osteoarthritis and the MRI variation. MethodsBetween January and June 2014, 90 patients with knee osteoarthritis were randomized into three groups: group A (treated by glucosamine hydrochloride), group B (treated by diacerein) and group C (treated by both glucosamine hydrochloride and diacerein). The score of Western Ontario and McMaster Universities (WOMAC) index of osteoarthritis, MRI cartilage injury Recht grading and the curative effects for bone marrow edema, joint cavity effusion and meniscus injury were compared before and after the treatment. ResultsThe scores of WOMAC after treatment in all the groups were improved, while the therapeutic effect of group C lasted longer when medical treatment suspended. The number of articular surface with different degrees of cartilage injury showed no statistically significant change in all three groups (P ＞ 0.05) . The state of bone marrow edema and joint cavity effusion were improved with a statistically significant difference in all groups (P ＜ 0.05) . Patients with lateral meniscus degeneration in group A and patients with medial meniscal tear in group B both increased with statistically significant differences (P ＜ 0.05) . However, in group C, patients with lateral meniscus degeneration or meniscal tear decreased with statistically significant differences (P ＜ 0.05) . ConclusionsThe treatment for osteoarthritis by glucosamine hydrochloride is effective, and the curative effect lasts longer when treated by both glucosamine hydrochloride and diacerein. Glucosamine hydrochloride ameliorates the bone marrow edema and joint cavity effusion. Treatment together with diacerein leads to a better therapeutic effect for patients with meniscus degeneration, yet further studies are needed to prove its effects in ameliorating cartilage injury.
ObjectiveTo assess the therapeutic effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride on osteochondritis dissecans of the knee. MethodsBetween January 2014 and June 2015, 24 patients with osteochondritis dissecans of the knee ready to undergo arthroscopic microfracture surgery were divided into experimental group (odd surgery sequence numbers) treated with arthroscopic microfracture surgery combined with oral glucosamine hydrochloride (480 mg/time, 3 times per day, from the first day to 3 months after the surgery) and control group (even surgery sequence numbers) treated with arthroscopic microfracture surgery. All the patients were discharged from the hospital after one week of rehabilitation exercises with rehabilitation equipment of lower extremity. Follow-up lasted for at least 6 months. The therapeutic effects of the two methods were assessed according to Tegner scores for motor function of knee joint and United States New York specialty surgical hospital (HSS) scores. ResultsThe symptoms of knee joint was alleviated significantly after the operation. The function of knee joint was improved significantly after 6 weeks. Tegner and HSS scores before surgery were not significantly different between the two groups (P>0.05). The Tegner scores were not significantly different between the two groups 6 weeks after surgery (P>0.05). The difference of Tegner scores were statistically significant between the two groups 12 and 24 weeks after surgery (P<0.05), and HSS scores of the experimental group improved better than the control group 6, 12 and 24 weeks after surgery, and the differences were statistically significant (P<0.05). ConclusionThe short-term effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride is better than that of arthroscopic microfracture surgery in the treatment of osteochondritis dissecans of the knee.
ObjectiveTo observe the therapeutic effect of electro-acupuncture combined with oral glucosamine hydrochloride capsules in the treatment of knee osteoarthritis, and compare it with the curative effect of the two methods separately. MethodsA total of 168 patients with knee osteoarthritis treated from March 2006 to December 2012 were randomly divided into 3 groups. Electro-acupuncture combined with oral glucosamine hydrochloride capsules were given to the 58 patients in the treatment group, single acupuncture treatment was given to the 57 patients in control group A, and simple oral glucosamine hydrochloride capsules were given to the 53 patients in control group B. The treatment lasted for 6 weeks. Assessment of knee osteoarthritis by Lequesne international standard index number and the total efficiency was carried out before treatment and 3 weeks, 6 weeks and 6 months after treatment, respectively. ResultsThe total effective rate of the treatment group was 91.38%, of control group A was 68.42%, and of control group B was 79.25%. There was a significant difference between the treatment group and control group A, and between the treatment group and control group B (P<0.05). No blood, liver or kidney damage or gastrointestinal adverse reaction occurred among patients in all the three groups. ConclusionThe efficacy of electro-acupuncture plus oral glucosamine hydrochloride capsules is better than simple acupuncture and simple oral glucosamine hydrochloride capsules treatment.
ObjectiveTo discuss the effect of glucosamine-hydrochloride (Glu/Ch) in protecting and repairing the cartilage in blood-induced joint damage (BJD) in vivo. MethodsThirty-two adult New Zealand rabbits were randomly divided into 4 groups (n=8):high-dose Glu/Ch treated group (group A), low-dose Glu/Ch treated group (group B), positive control group (group C), and negative control group (group D). A joint bleeding model was established by blood injection into articular cavity in groups A, B, and C. Glu/Ch was given by gavage in groups A (250 mg/kg) and B (21.5 mg/kg) once a day for 8 weeks, and the same dosage of saline was given in groups C and D. The serum cartilage oligomeric matrix protein (COMP), serum chondroitin sulfate 846(CS846), and urinary C-terminal telopepide of type II collagen (CTX-II) were measured at 3 days, 7 days, 2 weeks, and 8 weeks after modeling. The expressions of cytokines such as interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in synovial fluid were analyzed by ELISA at 8 weeks after modeling. The expression of matrix metalloproteinase 13(MMP-13) was detected by immunohistochemistry. Alcian blue staining and Safranin-O staining were performed to calculate the percentage of the positive staining areas. The proteoglycan content was detected by semi-quantitative analysis in the articular cartilage. ResultsThe COMP concentration was significantly higher in groups A, B, and C than group D, and in groups B and C than group A at 3 days after modeling (P<0.05); no significant difference was found among groups A, B, and D at 7 days (P>0.05), and it was significantly lower in groups A, B, and D than group C (P<0.05); there was no significant difference among 4 groups after 2 and 8 weeks (P>0.05). Difference in CS846 concentration had no significance among 4 groups at each time point (P>0.05). The CTX-II concentration of groups A, B, and C was significantly higher than that of group D at each time point (P<0.05); it was significantly lower in group A than groups B and C at 7 days, 2 weeks, and 8 weeks (P<0.05). The TNF-α concentration of groups A and B was significantly higher than group D, and was significantly lower than group C at 8 weeks (P<0.05), but no significant difference was observed between groups A and B (P>0.05). The IL-1β concentration was significantly higher in group C than the other groups (P<0.05), and in group B than groups A and D (P<0.05), but there was no significant difference between groups A and D (P>0.05). The MMP-13 expression was significantly higher in group C than groups A, B, and D (P<0.05), in groups A and B than group D (P<0.05). A significant decrease in the area stained with Alcian blue and Safranin-O was observed in group C. There were significant differences in the percentage of the positive stained areas of Alcian blue and Safranin-O among 4 groups (P<0.05). The relative quantities of proteoglycan from small to large in order was groups C, B, A, and D, respectively, showing significant differences (P<0.05). ConclusionThe metabolism disorder of cartilage matrix and synovium inflammatory reaction can be observed in rat joint bleeding model. Glu/Ch has certain protective effect on the cartilage after BJD by down-regulating IL-1β, TNF-α, and MMP-13, as well as increasing proteoglycan content in the cartilage.
ObjectiveTo explore the efficacy of calcitonin combined with glucosamine hydrochloride on knee osteoarthritis. MethodsAccording to Kellgren-Lawrence radiographic scoring system, 156 patients with knee osteoarthritis diagnosed from November 2014 to April 2015 were classified as mild, moderate and severe cases. All of the patients were divided into control group (treated by glucosamine hydrochloride only) and trial group (treated by calcitonin combined with glucosamine hydrochloride) via table of random sampling numbers (with 78 patients in each group). The West Ontario and Manchester University (WOMAC) score was recorded at the 6th week and the 3rd month after the medication treatment. ResultsIn the patients with mild osteoarthritis, there were significant differences in WOMAC score of both groups at the 6th week and the 3rd month after treatment compared with those before the treatment (P<0.05); there were no significant differences between the two groups at the same time points after the treatment (P>0.05). In the patients with moderate osteoarthritis, WOMAC scores in the control group at the 3rd month differed much from that before the treatment (P<0.05); there were no significant differences between the two groups at the same time points after the treatment (P>0.05). In the patients with serious osteoarthritis, there was no significant difference in WOMAC scores in the control group after the treatment compared with that before the treatment (P>0.05); while in the trial group, the scores at the 3rd month after the treatment differed much from that before the treatment (P<0.05), and also from that in the control group (P<0.05). ConclusionFor mild knee osteoarthritis, the combined treatment is not superior to the single use of glucosamine hydrochloride. For moderate knee osteoarthritis, the combined treatment has faster effect than the single use of glucosamine hydrochloride. For severe osteoarthritis, the use of single glucosamine hydrochloride is not effective, while the combination of calcitonin and glucosamine hydrochloride is effective at the 3rd month after the treatment.
ObjectiveTo study the effectiveness and safety of glucosamine for osteoarthritis (OA) in Asian population. MethodDatabases of PubMed, Embase, CNKI, VIP and Wanfang were searched from the time of establishment till May 2014 and controlled trials of glucosamine compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs) were included. Quality evaluation and Meta-analysis by using RevMan 5.1 were performed. ResultsA total of 17 studies including 2 251 cases were included. The efficiency rate in the glucosamine group was higher than that in the NSAIDs group[OR=3.03, 95% CI (1.78, 5.18), P<0.000 1]. The efficiency rate in the glucosamine combined NSAIDs group was higher than that in the NSAIDs group[OR=4.30,95%CI (1.84,10.06),P=0.000 8]. The safety analysis showed that the adverse event rate in the glucosamine group was lower than that in the NSAIDs group[OR=0.23,95%CI (0.14,0.37),P<0.000 01], while the difference between the glucosamine combined NSAIDs group and the NSAIDs group was not statistically significant[OR=0.84, 95%CI (0.50, 1.41), P=0.50]. ConclusionsCompared with NSAIDs, glucosamine is better and safer for OA treatment in Asian population.
目的 观察盐酸氨基葡萄糖治疗膝骨关节炎（KOA）的临床疗效。 方法 2010年5月－2012年7月将130例经膝关节镜清理术后的KOA患者随机分成A、B两组，每组65例。A组联合口服盐酸氨基葡萄糖胶囊750 mg，2次/d，6周为1个疗程，治疗3个疗程；B组联合口服尼美舒利胶囊0.1 g，2次/d，服用12周。采用Lequesne指数作为疗效评定指标，观察治疗前后膝关节体征及症状变化，休息痛、运动痛、压痛、肿胀、晨僵和行走能力的改善情况。 结果 B组患者在治疗早期症状改善优于同期A组，且在第3个月有统计学意义（P＜0.05），随着治疗时间的延长，A组患者总有效率在1、3、6个月分别为70.8%、76.9%和92.3%，均呈逐渐上升趋势，且第6个月疗效较前2个时间点差异有统计学意义（P＜0.05）。分别停药后继续随访至1年，两组患者总有效率均有所下降，但A组疗效仍优于B组，且有统计学意义（P＜0.05）。A组出现不良反应2例，B组4例，均较轻微，无严重不良事件发生。 结论 盐酸氨基葡萄糖在改善OA患者膝关节症状等方面效果肯定，且疗效较稳定，安全性良好；但远期疗效仍需随访观察。