Clinical Observation of Glucosamine Hydrochloride Combined with Chondroitin Sulfate in the Treatment of Lumbar Facet Joint Osteoarthritis_West China Medical Journal

Authors：

YANG Yong ¹ , CHEN Xu ² , ZAN Zhongxue ³ , GOU Jinping ¹ , WU Wanjun ¹ , GU Qijun. ¹

1. Department of Orthopedics, Gaoxin Pingkang Hospital, Chengdu, Sichuan 610212, P. R. China; 2. Department of Anesthesia, Sichuan Provincial Hospital for Women and Children, Chengdu, Sichuan 610013, P. R. China; 3. Department of Orthopedics, Chengdu Modern Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

Keywords：

鹽酸氨基葡萄糖; 硫酸軟骨素; 骨關節炎，腰椎小關節

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目的　觀察比較鹽酸氨基葡萄糖單獨使用及與硫酸軟骨素聯合使用治療腰椎小關節骨關節炎（LFOA）的臨床療效。方法　2009年1月－2011年1月，將80例LFOA患者隨機分成兩組，A組口服鹽酸氨基葡萄糖，B組口服鹽酸氨基葡萄糖和硫酸軟骨素兩種藥物，6周為1個療程，間斷治療4個療程。分別比較用藥前與用藥后3、6周及5、8、11個月時的日本骨科協會（JOA）評分、晨僵和壓痛程度變化。結果　治療后，兩組的JOA評分在各觀察時點均增加，與治療前比較差異有統計學意義（P＜0.05）。組間行JOA評分治療改善率的比較，在各觀察時點差異均有統計學意義（P＜0.05），B組JOA評分改善率優于A組。治療3周后，兩組晨僵和壓痛評分均降低，與本組治療前比較差異有統計學意義（P＜0.05）；組間比較，差異亦有統計學意義（P＜0.05），B組晨僵和壓痛程度均低于A組。第6周，第5、8、11個月，兩組組間比較晨僵和壓痛程度差異均無統計學意義（P＞0.05），但各療程結束后兩組晨僵和壓痛程度均呈持續降低趨勢。結論　單獨應用鹽酸氨基葡萄糖及鹽酸氨基葡萄糖與硫酸軟骨素的聯合應用治療LFOA療效確切，聯合用藥優于單獨應用鹽酸氨基葡萄糖。

Citation： YANG Yong,CHEN Xu,ZAN Zhongxue,GOU Jinping,WU Wanjun,GU Qijun.. Clinical Observation of Glucosamine Hydrochloride Combined with Chondroitin Sulfate in the Treatment of Lumbar Facet Joint Osteoarthritis. West China Medical Journal, 2012, 27(12): 1809-1813. doi: Copy

1.	Fujiwara A, Tamai K, An HS, et al. Orientation and osteoarthritis of the lumbar facet joint [J]. Clin Orthop Relat Res, 2001, 4(385): 88-94.
2.	Manchikanti L, Singh V, Falco FJ, et al. Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain: a randomized, doudle-blind, controlled trial with a 2-year follow-up[J]. Int J Med Sci, 2010, 7(3): 124-135.
3.	Pampati S, Cash KA, Manchikanti L. Accuracy of diagnostic lumbar facet joint nerve blocks: a 2-year follow-up of 152 patients diagnosed with controlled diagnostic blocks[J]. Pain Physician, 2009, 12(15): 855-866.
4.	李寧華, 張耀南, 張毅, 等. 中國六城市中老年人群X射線腰椎骨關節炎流行病學分析[J]. 中國臨床康復, 2006, 10(40): 12-14.
5.	Juniper M, Le TK, epidemiology MT, et al. And pharmacological treatment of chromic low back pain in France, Germany, Italy, Spain and the UK: a literature-based review[J]. Expert Opine Pharmacother, 2009, 10(16): 2581-2592.
6.	張施展, 蔣林. 鹽酸氨基葡萄糖治療腰椎關節突關節骨性關節炎的臨床觀察[J]. 華西醫學, 2011, 26(12): 1832-1835.
7.	石銳, 劉浩, 胡韜, 等. 鹽酸氨基葡萄糖聯合非類固醇類抗炎藥治療小關節退變伴下腰痛[J]. 中國組織工程研究與臨床康復, 2011, 15(26): 4895-4898.
8.	周廣軍, 宓士軍, 田曉芳, 等. 氨基葡萄糖治療腰椎小關節骨性關節炎的臨床體會[J]. 中國骨腫瘤骨病, 2009, 8(4): 133-235.
9.	張青, 凌沛學, 陳磊. 硫酸軟骨素在骨科中的應用[J]. 食品與藥品, 2010, 12(4): 292-294.
10.	Wilkens P, Scheel IB, Grundnes O, et al. Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial[J]. JAMA, 2010, 304(1): 45-52.
11.	Kettler A, Wilke HJ. Review of existing grading systems for cervical or lumbar disc and facet joint degeneration[J]. Eur Spine J, 2006, 15(6): 705-718.
12.	莊心良, 曾因明, 陳伯鑾. 現代麻醉學[M]. 3版.北京: 人民衛生出版社, 2004: 2546-2547.
13.	井上俊一. 腰腿疾患治療成績制定基準[J]. 日整會志, 1984, 58(3): 925.
14.	盧鋒, 郭紅衛. 鹽酸氨基葡萄糖對骨關節炎作用機制的初步探討[J]. 衛生研究, 2003, 32(6): 594-597.
15.	Leslie M. Knee osteoarthritis management therapies[J]. Pain Management Nursing, 2000, 1(2): 51-57.
16.	Mcalindon TE, Lavalley MP, Gulin JP, et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis[J]. JAMA, 2000, 283(11): 1469-1475.
17.	賈連順. 腰椎關節突關節骨關節炎的認識[J]. 中華骨科雜志, 2008, 28(10): 868-869.
18.	中華醫學會風濕病分會. 骨關節炎診斷及治療指南[J]. 中華風濕病學雜志, 2010, 14(6): 416-419.
19.	王蕾, 王健, 王惠珍. 氨基葡萄糖與美洛昔康治療老年膝骨關節炎療效的對比觀察[J]. 中國老年學雜志, 2010, 30(18): 2691-2692.
20.	Oegema TJ, Deloria LB, Sandy JD, et al. Effect of oral glucosamine on cartilage and meniscus in normal and chymopapain-injected knees of young rabbits[J]. Arthritis Rheum, 2002, 46(9): 2495-2503.
21.	Clegg DO, Reda E, Harris CL, et al. G1ucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis[J]. N Engl J Med, 2006, 354(8): 795-808.
22.	張偉濱, 莊澄宇, 李建民, 等. 鹽酸氨基葡萄糖治療骨性關節炎有效性與安全性評價[J]. 中華外科雜志, 2007, 45(14): 998-1001.
23.	黃曉東, 張煒. 簡述骨關節炎特異性藥物治療的前景[J]. 中國現代藥物應用, 2009, 3(20): 190-191.
24.	Fox BA, Schmitz ED, Wallace R. FPIN’ s clinical inquires. Glucosamine and chondroitin for osteoarthritis[J]. Am Fam Physician, 2006, 73(7): 1245-1246.
25.	陳德生, 張志剛, 曹靖, 等. 鹽酸氨基葡萄糖對兔膝骨關節炎的影響[J]. 中國修復重建雜志, 2010, 24(3): 287-291.
26.	中華醫學會風濕病學分會. 骨關節炎診斷及治療指南[J]. 中華風濕病學雜志, 2010, 14(6): 416-419.
27.	劉念. 氨基葡萄糖, 硫酸軟骨素及兩藥聯合用于膝骨關節炎疼痛的治療[J]. 國外醫學·藥學分冊, 2006, 33(4): 254.
28.	Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for fainful knee osteoarthritis[J]. N Engl J Med, 2006, 354(8): 795-808.
29.	傅欣, 林霖, 魏學磊, 等. 氨基葡萄糖和硫酸軟骨素聯合用藥對兔骨關節炎治療作用實驗研究[J]. 中國運動醫學雜志, 2008, 27(5): 588-592.

1. 　Fujiwara A, Tamai K, An HS, et al. Orientation and osteoarthritis of the lumbar facet joint [J]. Clin Orthop Relat Res, 2001, 4(385): 88-94.
2. 　Manchikanti L, Singh V, Falco FJ, et al. Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain: a randomized, doudle-blind, controlled trial with a 2-year follow-up[J]. Int J Med Sci, 2010, 7(3): 124-135.
3. 　Pampati S, Cash KA, Manchikanti L. Accuracy of diagnostic lumbar facet joint nerve blocks: a 2-year follow-up of 152 patients diagnosed with controlled diagnostic blocks[J]. Pain Physician, 2009, 12(15): 855-866.
4. 　李寧華, 張耀南, 張毅, 等. 中國六城市中老年人群X射線腰椎骨關節炎流行病學分析[J]. 中國臨床康復, 2006, 10(40): 12-14.
5. 　Juniper M, Le TK, epidemiology MT, et al. And pharmacological treatment of chromic low back pain in France, Germany, Italy, Spain and the UK: a literature-based review[J]. Expert Opine Pharmacother, 2009, 10(16): 2581-2592.
6. 　張施展, 蔣林. 鹽酸氨基葡萄糖治療腰椎關節突關節骨性關節炎的臨床觀察[J]. 華西醫學, 2011, 26(12): 1832-1835.
7. 　石銳, 劉浩, 胡韜, 等. 鹽酸氨基葡萄糖聯合非類固醇類抗炎藥治療小關節退變伴下腰痛[J]. 中國組織工程研究與臨床康復, 2011, 15(26): 4895-4898.
8. 　周廣軍, 宓士軍, 田曉芳, 等. 氨基葡萄糖治療腰椎小關節骨性關節炎的臨床體會[J]. 中國骨腫瘤骨病, 2009, 8(4): 133-235.
9. 　張青, 凌沛學, 陳磊. 硫酸軟骨素在骨科中的應用[J]. 食品與藥品, 2010, 12(4): 292-294.
10. 　Wilkens P, Scheel IB, Grundnes O, et al. Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial[J]. JAMA, 2010, 304(1): 45-52.
11. 　Kettler A, Wilke HJ. Review of existing grading systems for cervical or lumbar disc and facet joint degeneration[J]. Eur Spine J, 2006, 15(6): 705-718.
12. 　莊心良, 曾因明, 陳伯鑾. 現代麻醉學[M]. 3版.北京: 人民衛生出版社, 2004: 2546-2547.
13. 　井上俊一. 腰腿疾患治療成績制定基準[J]. 日整會志, 1984, 58(3): 925.
14. 　盧鋒, 郭紅衛. 鹽酸氨基葡萄糖對骨關節炎作用機制的初步探討[J]. 衛生研究, 2003, 32(6): 594-597.
15. 　Leslie M. Knee osteoarthritis management therapies[J]. Pain Management Nursing, 2000, 1(2): 51-57.
16. 　Mcalindon TE, Lavalley MP, Gulin JP, et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis[J]. JAMA, 2000, 283(11): 1469-1475.
17. 　賈連順. 腰椎關節突關節骨關節炎的認識[J]. 中華骨科雜志, 2008, 28(10): 868-869.
18. 　中華醫學會風濕病分會. 骨關節炎診斷及治療指南[J]. 中華風濕病學雜志, 2010, 14(6): 416-419.
19. 　王蕾, 王健, 王惠珍. 氨基葡萄糖與美洛昔康治療老年膝骨關節炎療效的對比觀察[J]. 中國老年學雜志, 2010, 30(18): 2691-2692.
20. 　Oegema TJ, Deloria LB, Sandy JD, et al. Effect of oral glucosamine on cartilage and meniscus in normal and chymopapain-injected knees of young rabbits[J]. Arthritis Rheum, 2002, 46(9): 2495-2503.
21. 　Clegg DO, Reda E, Harris CL, et al. G1ucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis[J]. N Engl J Med, 2006, 354(8): 795-808.
22. 　張偉濱, 莊澄宇, 李建民, 等. 鹽酸氨基葡萄糖治療骨性關節炎有效性與安全性評價[J]. 中華外科雜志, 2007, 45(14): 998-1001.
23. 　黃曉東, 張煒. 簡述骨關節炎特異性藥物治療的前景[J]. 中國現代藥物應用, 2009, 3(20): 190-191.
24. 　Fox BA, Schmitz ED, Wallace R. FPIN’ s clinical inquires. Glucosamine and chondroitin for osteoarthritis[J]. Am Fam Physician, 2006, 73(7): 1245-1246.
25. 　陳德生, 張志剛, 曹靖, 等. 鹽酸氨基葡萄糖對兔膝骨關節炎的影響[J]. 中國修復重建雜志, 2010, 24(3): 287-291.
26. 　中華醫學會風濕病學分會. 骨關節炎診斷及治療指南[J]. 中華風濕病學雜志, 2010, 14(6): 416-419.
27. 　劉念. 氨基葡萄糖, 硫酸軟骨素及兩藥聯合用于膝骨關節炎疼痛的治療[J]. 國外醫學·藥學分冊, 2006, 33(4): 254.
28. 　Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for fainful knee osteoarthritis[J]. N Engl J Med, 2006, 354(8): 795-808.
29. 　傅欣, 林霖, 魏學磊, 等. 氨基葡萄糖和硫酸軟骨素聯合用藥對兔骨關節炎治療作用實驗研究[J]. 中國運動醫學雜志, 2008, 27(5): 588-592.

West China Medical Journal

Clinical Observation of Glucosamine Hydrochloride Combined with Chondroitin Sulfate in the Treatment of Lumbar Facet Joint Osteoarthritis

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