ObjectiveTo observe and study the clinical effect of glucosamine in the treatment of patients with knee articular cartilage injury caused by rheumatoid arthritis. MethodsForty-six patients with knee articular cartilage injury caused by rheumatoid arthritis treated from January 2013 to June 2015 were selected as the research subjects, and they were randomly divided into control group (conventional treatment group, n=23) and observation group (conventional and glucosamine treatment group, n=23) . Then the Noyes classification and serum articular cartilage injury related indexes [cartilage oligomeric matrix protein (COMP), matrix metalloproteinase (MMP)-1, MMP-3 and mouse tissue inhibitors of metalloproteinase (TIMP)-1], inflammatory indexes [tumor necrosis factor (TNF)-α, interleukin (IL)- 17 and IL-33] of the two groups before and after treatment were compared. ResultsIn the observation group, after treatment for 4, 8 and 12 weeks, Noyes grade was better than that in the control group, but with no statistical significance (P ＞ 0.05) . In the observation group, after treatment for 4, 8 and 12 weeks, serum inflammatory markers serum COMP, MMP-1, MMP-3 and TIMP-1 and other related indicators of cartilage damage and serum TNF-α, IL-17 and IL-33 were all significantly lower than those in the control group (P ＜ 0.05) . ConclusionIn the treatment of patients with knee articular cartilage injury caused by rheumatoid arthritis, glucosamine has active role for the improvement of articular cartilage injury and inflammatory stress state of patients.
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.
目的 观察比较盐酸氨基葡萄糖单独使用及与硫酸软骨素联合使用治疗腰椎小关节骨关节炎（LFOA） 的临床疗效。 方法 2009年1月－2011年1月，将80例LFOA患者随机分成两组，A组口服盐酸氨基葡萄糖，B组口服盐酸氨基葡萄糖和硫酸软骨素两种药物，6周为1个疗程，间断治疗4个疗程。分别比较用药前与用药后3、6周及5、8、11个月时的日本骨科协会（JOA）评分、晨僵和压痛程度变化。 结果 治疗后，两组的JOA评分在各观察时点均增加，与治疗前比较差异有统计学意义（P＜0.05）。组间行JOA评分治疗改善率的比较，在各观察时点差异均有统计学意义（P＜0.05），B组JOA评分改善率优于A组。治疗3周后，两组晨僵和压痛评分均降低，与本组治疗前比较差异有统计学意义（P＜0.05）；组间比较，差异亦有统计学意义（P＜0.05），B组晨僵和压痛程度均低于A组。第6周，第5、8、11个月，两组组间比较晨僵和压痛程度差异均无统计学意义（P＞0.05），但各疗程结束后两组晨僵和压痛程度均呈持续降低趋势。 结论 单独应用盐酸氨基葡萄糖及盐酸氨基葡萄糖与硫酸软骨素的联合应用治疗LFOA疗效确切，联合用药优于单独应用盐酸氨基葡萄糖。
目的 研究盐酸氨基葡萄糖联合抗骨增生片治疗膝骨关节炎（KOA）的可行性及安全性。 方法 2011年1月－2012年8月选取90例KOA患者，按关节面改变部位归入A组（髌股关节面改变）、B组（胫股关节面改变）、C组（全关节软骨改变），每组30例。均予以盐酸氨基葡萄糖、抗骨增生片治疗，12周后观察治疗前后临床疗效、综合疗效及安全性等指标及评分。 结果 ① 3组比较，A组疗效高于B、C组（P＜0.05）；② A组与B、C两组在平地行走20 m疼痛评分、关节压痛度评分和骨关节炎指数（WOMAC）评分方面差异有统计学意义（P＜0.05）；③ A组和B、C两组在患者自我疗效评价、医生疗效评价方面差异有统计学意义（P＜0.05）；④ A组在治疗12周后血液血沉、C反应蛋白（CRP）、白细胞介素（IL）-1、IL-6、肿瘤坏死因子-α（TNF-α）较治疗前差异有统计表学意义（P＜0.05）；B组则在CRP、IL-6、TNF-α较治疗前有差异（P＜0.05）；C组仅在CRP、TNF-α较前有差异（P＜0.05）；⑤3组不良反应发生率则无明显差异（P＞0.05）。 结论 盐酸氨基葡萄糖联合抗骨增生片治疗髌股关节面改变的KOA疗效优于胫股关节改变，且治疗方案可行、安全、优效。
ObjectiveTo observe the clinical effect of combined glucosamine hydrochloride and antiosteoporosis drugs in the treatment of senile knee osteoarthritis. MethodsA total of 120 patients with osteoarthritis of the knee treated from January 2014 to December 2015 were randomly divided into observation group and control group with 60 cases in each. The observation group received not only oral glucosamine hydrochloride, but calcium D3, alfacalcidol, and sodium phosphate for anti-osteoporosis treatment, while the control group was only given oral glucosamine hydrochloride. Lequesne score, curative effect and adverse drug reactions were compared between the two groups 2, 4, and 6 weeks after the beginning of treatment. ResultsWithin two weeks of treatment, there was no significant difference between the two groups in the effective rate (P ＞ 0.05) . But four and six weeks after treatment, the efficiency in the observation group was significantly higher than that in the control group (χ2=6.806, P ＜ 0.01; χ2=24.762, P ＜ 0.01) . Four and six weeks after treatment, Lequesne score of the observation group was significantly lower than that of the control group (t=2.199, P ＜ 0.05; t=4.748, P ＜ 0.001) . There was no significant difference in terms of adverse reactions between the two groups before and after treatment (χ2=0.617, P ＞ 0.05) . ConclusionCompared with single hydrochloric amino glucose treatment, glucosamine hydrochloride combined with anti-osteoporosis treatment for senile knee osteoarthritis has better treatment effect without increase in adverse drug reactions, and it is worth of clinical application.
目的 观察盐酸氨基葡萄糖对Pilon骨折的辅助治疗作用。 方法 2007年6月－2010年9月，将43例接受手术治疗的Pilon骨折患者随机分成两组，A组术后口服盐酸氨基葡萄糖，B组作为对照组（仅服用安慰剂）。A组21例患者，平均年龄（35.7± 8.0）岁，B组22例患者，平均年龄（36.7 ± 7.1）岁。两组患者年龄、性别、骨折分型及手术时机相比较，无统计学差异（P＞0.05）。定期随诊（术后6、12、18个月），根据美国足与踝关节协会踝与后足功能评分（AOFAS）评分系统对患者进行功能评分，进行前瞻、对照、双盲研究。 结果 术后6、12、18个月，A组患者的AOFAS评分均明显高于B组，差异有统计学意义（t=2.530，2.856，2.881；P=0.015，0.007，0.006）；术后18个月，A组临床疗效优良率为95.2%，B组优良率为72.3%，差异有统计学意义（χ2=3.995，P=0.046）。A组2例患者分别发生轻度头晕及恶心，无严重不良反应发生。 结论 盐酸氨基葡萄糖辅助治疗Pilon骨折可改善踝关节功能，减少创伤性骨关节炎的发生。
ObjectiveTo investigate the effect of arthroscopic debridement combined with oral glucosamine hydrochloride tablets in the treatment of knee osteoarthritis. MethodsSixty-two patients with knee osteoarthritis treated between January 2013 and April 2015 were chosen to be our research subjects. They were randomly divided into trial group (n=31) and control group (n=31). The control group was treated with arthroscopic debridement, and the trial group was given glucosamine hydrochloride tablets for treatment, apart from arthroscopic debridement. We evaluated the clinical effects by visual analogue scale (VAS) score and Lysholm knee joint function score before, and 1 week, 4 weeks, 3 months and 6 months after surgery. ResultsOne week after surgery, the VAS score and Lysholm knee joint function score were not significantly different between the two groups (P>0.05). Four weeks, 3 months and 6 months after surgery, the VAS score of the trial group was respectively 3.08±0.91, 2.46±0.87, and 1.45±0.66, and was 5.47±1.02, 3.55±1.20, and 2.37±0.53 in the control group; the Lysholm score of the trial group was 80.55±2.24, 85.35±1.79, and 89.74±4.58, respectively, and of the control group was 72.55±4.47, 74.68±2.94, and 76.69±5.63. The VAS score and the Lysholm score of the trial group were both better than those of the control group (P<0.05). ConclusionArthroscopic debridement can alleviate the symptoms of knee osteoarthritis, and oral administration of glucosamine hydrochloride tablets after surgery has obvious effects.
ObjectiveTo evaluate the therapeutic effect of glucosamine hydrochloride combined with Tenghuangjiangu tablets on knee osteoarthritis. MethodsFrom August 2012 to February 2014, 180 patients with knee osteoarthritis were randomly divided into three groups with 60 in each. Patients in group A were treated with glucosamine hydrochloride; patients in group B were treated with Tenghuangjiangu tablets; and patients in group C were treated with the combination of glucosamine hydrochloride and Tenghuangjiangu tablets. After the 12-week treatment, clinical efficacy and safety of the treatment were observed and compared with those before the treatment. ResultsThe twenty-meter walking pain, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the joint tenderness in the three groups 12 weeks after the treatment and 4 weeks after withdrawal improved obviously compared with those before the treatment (P<0.05), and the difference between the results of 12 weeks after treatment and 4 weeks after withdrawal was not significant (P>0.05). The improvement in group C was better than both group A and B with significant differences (P<0.05), while the difference between group A and B was not significant (P>0.05). There was no obvious abnormal routine blood and urine test result or damage of liver and lung functions during the treatment in all the three groups. Twelve weeks after treatment, six patients with abdominal ache were found in group A with an incidence of 10.0%; 5 abdominal ache and 2 diarrhea were in group B with a rate of 12.5%; and 4 abdominal ache and 3 diarrhea were in group C with a rate of 12.5%. All the patients completed the treatment. No significant difference in the incidence of adverse reactions was found among the three groups (P>0.05). ConclusionThe therapeutic effect of combined glucosamine hydrochloride and Tenghuangjiangu tablets is obvious on knee osteoarthritis with low incidence of adverse reactions.
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 探讨关节镜清理术配合盐酸氨基葡萄糖对膝骨关节炎的治疗作用。 方法 2009年6月－2011年6月纳入轻度膝骨关节炎（AhlbackⅠ级）患者135例，随机分成3组。A组（n=45）接受关节镜清理术治疗；B组（n=45）口服盐酸氨基葡萄糖胶囊治疗；C组（（n=45）先行关节镜清理术治疗，术后口服盐酸氨基葡萄糖胶囊。观察3组Lequesne评分和WOMAC指数，用以评价治疗效果。 结果 成功随访患者123例，随访时间8个月。治疗后各组Lequesne评分和WOMAC指数较治疗前均显著好转（P＜0.01），其中治疗后C组好转较A组和B组具有显著性（P＜0.01），但B组和C组之间差异无统计学意义（P＞0.05）。 结论 关节镜清理术配合盐酸氨基葡萄糖，较之单用关节镜清理术或盐酸氨基葡萄糖，对膝骨关节炎的治疗有更好的效果。