【Abstract】 Objective To evaluate the results of glucosamine hydrochloride in the treatment of knee degenerativeosteoarthritis (DOA) . Methods From February 2006 to January 2007, 60 patients with knee DOA were treated with glucosaminehydrochloride,including 15 males and 45 females. The ages of patients ranged from 41 to 67 years with an average ageof 57.5 years. The disease course ranged from 6 months to 3 years. Oral glucosamine hydrochloride was given twice a day, each750 mg, for a 6-week course of treatment; another course of treatment was repeated after 4 months. After two courses of treatment,the international standard DOA score of Lequesne index was used to evaluate the rest of knee pain, sports pain, tenderness,joints activity, morning stiffness and walking abil ity. Results All 60 patients finished treatment, various cl inical symptomsfor DOA disappeared completely in 31 cases and subsided in 27 cases; the cure rate was 51.7% and the total response rate was96.7%. The scores of rest pain, sport pain, tenderness, joints activity, morning stiffness and the abil ity to walk for knee after treatmentwere 0.5±0.2,0.7±0.4,0.8±0.3,0.9±0.4,0.6±0.3 and 0.9±0.4, showing statistically significant differences (P lt; 0.01) whencompared with preoperation (1.6±0.5,2.1±0.4,2.2±0.5,1.8±0.6,1.7±0.4 and 2.0±0.4). Adverse effect occurred in 3 cases (5%)and the patients recovered without special treatment. Conclusion Glucosamine hydrochloride can cure knee DOA withsymptom-rel ieving and joint function-improving action.
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 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.
Objective To access the protective effects of glucosamine hydrochloride capsules (OTL) on articular cartilage in osteoarthritis of rabbit. Methods Thirty-six New Zealand white rabbits were divided randomly into three groups (n=12): sham group (group A), anterior cruciate l igament transection (ACLT)/normal sal ine group (group B), and ACLT/ OTL group (group C). Rabbits in groups B, C received ACLT on the right knee. Rabbits in group A were not given ACLT ascontrol. Group C received a daily administration of OTL at a dose of 150 mg/kg of body weight for 12 weeks; in contrast, group B received normal sal ine at the same dose. All rabbits were sacrificed after 12 weeks. The right femoral condyle were removed and observed at pathologic changes with HE staining and graded by Mankin’s scale, the expression level of transforming growth factor β1 (TGF-β1) and interleukin 1β (IL-1β) were detected by immunohistochemical staining. Results All rabbits survived at the end of experiment and incision healed well. The gross observation showed that joint synovia increased and articular surface was smooth and integrity in group A; that ulcer was observed on the articular surface of group B; and that articular surface was smooth and integrity in group C. There were sigificant differences in articular cartilage scores between 3 groups (P lt; 0.05). The histological observation showed that the articular cartilage had normal structure and the cells arranged regularly in group A; that the articular cartilage became thin and the cells arranged irregularly in group B; and that the cells arranged with a clear layer and had regular shape in group C. The Mankin scores were 1.04 ± 0.13, 7.97 ± 0.12, and 2.81 ± 0.36 in groups A, B, and C, respectively; showing significant difference between 3 groups (P lt; 0.05). The result of immunohistochemistry showed that the expressions of TGF-β1 were 50.62 ± 1.51, 24.81 ± 1.28, and 41.57 ± 1.69 and the expressions of IL-1β were 13.12 ± 1.21, 62.53 ±2.37, and 30.67 ± 1.28; showing significant differences between 3 groups (P lt; 0.05). Conclusion A daily administration ofOTL at a dose of 150 mg/kg for 12 weeks can partially decrease the expression levels of IL-1β and increase the expression levels of TGF-β1, which delays the development of osteoarthritis.
【摘要】 目的 观察盐酸氨基葡萄糖治疗腰椎关节突关节骨性关节炎（lumbar zygapophyseal joint osteoarthritis，LZOA）的临床疗效及安全性。 方法 2009年1月-2010年1月，对90例LZOA患者随机分成治疗组和对照组，各45例。治疗组口服盐酸氨基葡萄糖，6周为1个疗程，治疗3个疗程，前2周均加用洛索洛芬钠；对照组患者仅给予洛索洛芬钠口服12周。比较两组治疗后2、6周及3、6、12个月的疗效及安全性。 结果 治疗后6周、3个月，治疗组与对照组症状均明显改善，对照组改善更明显。治疗6个月后，治疗组评分持续下降，到12个月时与治疗前比较差异有统计学意义（Plt;0.01）；而对照组评分则逐渐增高，到12个月时与其治疗前比较差异无统计学意义（Pgt;0.05）。两组的不良反应率分别为6.67%、15.56%，差异有统计学意义（Plt;0.01）。 结论 盐酸氨基葡萄糖治疗LZOA疗效确切，且安全性良好。【Abstract】 Objective To observe the clinical efficacy and safety of glucosamine hydrochloride on lumbar zygapophyseal joint osteoarthritis (LZOA). Methods From January 2009 to January 2010, 90 patients with LZOA were randomly divided into therapeutic group and comparative group, with 45 patients in each group. Patients in therapeutic group were treated with oral administration of glucosamine hydrochloride for 3 courses (6 weeks for one course; adding loxoprofen for the early 2 weeks). Patients in comparative group were treated with oral administration of loxoprofen for 12 weeks. The efficacy and safety between the two groups was compared. Results Symptoms in both group were relieved after 6-week and 3-month treatment. More obvious relief was observed in the comparative group. The scoring of therapeutic group kept decreasing after 6-month treatment. The efficacy showed significant improvement after 12-month treatment compared with which before the treatment was significant（Plt;0.01）. The scoring in comparative group kept increasing, which showed no significant difference after 12-month treatment（Pgt;0.05）. The adverse effect rate was 6.67% and 15.56% respectively in two groups, which was significant different（Plt;0.01）. Conclusions Glucosamine hydrochloride provides good efficacy and safety for patients with LZOA.
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。
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: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。