塞来昔布联合盐酸氨基葡萄糖治疗膝骨性关节炎

[摘要] 目的 探讨塞来昔布联合盐酸氨基葡萄糖治疗膝骨性关节炎的临床效果和安全性。 方法 选择我院2008～2011年收治的膝骨性关节炎患者64例，随机分为两组，每组各32例，观察组给予塞来昔布联合盐酸氨基葡萄糖治疗，对照组仅给予塞来昔布治疗，分别于治疗前、治疗后应用Lequesne评分标准指数评价关节功能改善情况，并对两组患者不良反应情况进行比较。 结果 两组患者经过治疗后Lequesne均显著下降，但观察组各项指标下降幅度显著好于对照组（P ＜ 0.05），且观察组在治疗6和12个月后关节软骨磨损阳性征象数目减少程度显著好于对照组（P ＜ 0.05）。两组患者治疗期间均有不良反应情况发生，但发生率无显著性差别（P ＞ 0.05）。 结论 塞来昔布联合盐酸氨基葡萄糖治疗膝骨性关节炎临床效果显著，可在控制症状、改善关节功能同时，长期维持疗效，并具有良好的胃肠道耐受性。

[关键词] 膝关节骨关节炎；塞来昔布；氨基葡萄糖

[中图分类号] R684.3 [文献标识码] A [文章编号] 1673-7210（2012）07（c）-0087-02

Evaluation of Celecoxib combined with Glucosamine Hydrochloride in treating patients with knee osteoarthrifis

LI Yandong

Department of Western Medicine Bureau, the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang Province, Harbin 150026, China

[Abstract] Objective To investigate the clinical effect and safety of Celecoxib combined with Glucosamine Hydrochloride in treating patients with knee osteoarthrifis. Methods 64 patients with knee osteoarthrifis were selected and divided into two groups for each 32, patients in observation group were given Celecoxib combined with glucosamine hydrochloride, other patients in control group were given Celecoxib, the score index of Lequesne and bad reaction were compared. Results The scores index of all the patients were all decreased, however, the improvement of observation group was significantly better than that of control group (P ＜ 0.05), and the number of articular cartilage wear positive signs of observation group were also better than control group after 6 and 12 months (P ＜ 0.05), there was no difference between two groups in bad reaction (P ＞ 0.05). Conclusion The method of Celecoxib combined with glucosamine hydrochloride has a good effect, and also has a virtue of safety long efficiency, which is deserve to be used in clinic.

[Key words] Knee osteoarthrifis; Celecoxib; Glucosamine Hydrochloride

膝骨性关节炎（knee osteoarthrifis，KOA）是一种以关节软骨的变化、破坏及骨质增生为特征的慢性退行性关节病，多发于中老年人群，主要表现为膝关节疼痛、肿胀、活动受限，晚期关节出现畸形，关节功能明显障碍，有较高的致残率，严重影响了患者的生活质量[1]。临床上目前主要采取保守治疗，多应用非甾体抗炎药、关节内注射以及物理治疗，仅可缓解症状，无法阻止骨关节炎的病理性进展，且长期应用易引发严重的胃肠道反应和软骨损伤[2]。本文旨在探讨塞来昔布联合盐酸氨基葡萄糖治疗膝骨性关节炎的临床效果和安全性，现报道如下：

1 资料与方法

1.1 一般资料

选择我院2008～2011年收治的膝骨性关节炎患者64例，其中，男33例，女31例；年龄42～81岁，平均（54.1±8.9）岁。所有患者随机分为观察组和对照组，每组各32例，两组患者在年龄、性别等方面差异无统计学意义（P ＞ 0.05），具有可比性。

1.2 诊断和入选标准

所有患者诊断参照国风湿病学会（ACR）诊断标准，X线分级采用Kellgren-Lawrance的分级标准为1～3级[3]。并满足：①1个月内有膝关节反复疼痛；②2周内未接受过药物治疗；③X线片提示骨赘形成；④排除伴有活动性胃肠道、肾脏、肝脏疾病或凝血功能障碍以及诊断有炎性关节炎、痛风或急性膝关炎创伤者；⑤排除NSAIDs或磺胺类药物过敏史者；⑥经本人或家属同意。