目的:评价双醋瑞因联合玻璃酸钠治疗骨关节炎的临床疗效。方法:采用回顾性临床对照研究方案设计,65例膝骨关节炎患者应用关节腔内注射玻璃酸钠治疗为对照组,69例膝骨关节炎患者在玻璃酸钠基础治疗的同时合用双醋瑞因6个月作为联合治疗组,通过VAS评分、WOMAC评分、ESR和CRP在治疗前、治疗后1个月、3个月和后3个月3个时段四个时间断面的病情改变作为疗效判断指标。结果:与治疗前相比,两组的关节触痛、20米步行痛评分、WOMAC评分、ESR和CRP有明显改善(P lt;0.001);在治疗后的3个月,各个观察指标联合治疗组明显优于对照组(χ2=5.256,P lt;0.05);在治疗后的第2、3个月和治疗后的后3个月两个时段,应用NSAIDs的患者例数上,联合治疗组明显少于对照组(P=0.022;χ2=10.428,P=0.001),在治疗初的1个月内两组无差异(χ2=0.137,P=0.711),并且未发生严重不良事件。结论:双醋瑞因和玻璃酸钠二者对骨关节炎治疗都有临床疗效;在对OA采用玻璃酸钠治疗的基础上,同时合用和维持治疗,临床疗效更持久有效,值得临床推广。
Citation:
LI Jiangtao,ZHANG Jie,YANG Nanping,et al. The Observation of Clinical Effect of Therapeutic Alliance of Diacerein and Sodium Hyaluronate in Osteoarthritis Patients. West China Medical Journal, 2009, 24(8): 2050-2053. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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- 2. PEYRON J G, BALAZS E A. Preliminary clinical assessment of Nahyaluronate injection into human arthritic joints[J]. Pathol Biol (Paris),1974,22(8):731-736.
- 3. 施桂英.关节炎概要[M].北京:中国医药科技出版社,2000:678-679.
- 4. 赫双林,田宝斌,王铃,等.VAS测痛法的临床初步评估[J].中国医学科学院学报,1994,5:397-398.
- 5. MURRAY C J, LOPEZ A D, BLACK R, et al. Global burden of disease 2005: call for collaborators[J]. Lancet,2007,370(9582):109-110.
- 6. FIDELIX T S, SOARES B G, TREVISANI V F. Diacerein for osteoarthritis[J]. Cochrane Database Syst Rev,2006,(1):CD005117.
- 7. CARNEY S L. Effect of diacetyl rhein on the development of experimental osteoarthritis[J]. A Biochem Invest,1996,4(4):251-261.
- 8. PELLETIER J P, YARON M, HARAOUI B, et al. Efficacy and safety of diacerein in osteoarthritis of the knee: a doubleblind, placebocontrolled trial. The Diacerein Study Group[J]. Arthritis Rheum,2000,43(10):2339-2348.
- 9. DOUGADOS M, NGUYEN M, BERDAH L, et al. Evaluation of the structuremodifying effects of diacerein in hip osteoarthritis: ECHODIAH, a threeyear, placebocontrolled trial. Evaluation of the Chondromodulating Effect of Diacerein in OA of the Hip[J]. Arthritis Rheum,2001,44(11):2539-2547.
- 10. COLVILLENASH P R. Comparison of the pharmacologic effect of diacerein and a selective COX-2 inhibitor in the mouse inducedgranuloma model[J].[Article in French]. Presse Med,2002,31(39 Pt 2):4S16-4S17.