Effect of Self-behavior Management Combined with Glucosamine Hydrochloride in Treating Patients with Early Knee Osteoarthritis_West China Medical Journal

Authors：

 ZhangJing , SuJiang , ChenXixi , LongLi , TianJuan ,  ZhouBin

Department of Rheumatology and Immunology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

ZhangJing, Email: 594664@qq.com; ZhouBin, Email: bingb2917@126.com

Keywords：

Osteoarthritis, knee; Self-behavior management; Glucosamine hydrochloride

DOI：

10.7507/1002-0179.201600220

Video：

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Objective To observe the efficacy of self-behavior management combined with glucosamine hydrochloride for patients with early knee osteoarthritis. Methods Between October 2013 and March 2015, 240 patients with early knee osteoarthritis were randomly assigned to behavior therapy group (n=80) , drug treatment group (n=80) and combined treatment group (n=80) . Patients in the behavior therapy group were treated only by self-behavior management; patients in the drug treatment group were treated by glucosamine hydrochloride (0.48 g, three times per day); patients in the combined treatment group were treated by self-behavior management combined with glucosamine hydrochloride. The effect of treatment, adverse reactions, efficiency and expulsion rate were assessed 4, 8 and 12 weeks after treatment. Results The Lequesne index and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) significantly decreased from week 4 when compared with week 0 after treatment in the combined treatment group, and there was a significant difference between the combined treatment group and single therapy group at week 8 and 12 (P ＜ 0.05) . The Lequesne index in the behavior therapy group and drug treatment group began to significantly decrease from week 8, and the WOMAC score significantly decreased from week 4 in the drug treatment group and from week 8 in the behavior therapy group. The efficiency increased with the treatment time prolonged in all three groups, but the efficiency in the combined treatment group was significantly higher than the single therapy group (P ＜ 0.05) . The shedding rates in the behavior therapy group, drug treatment group and combined treatment group were respectively 12.5%, 7.5% and 6.3%, without statistically significant difference (P ＞ 0.05) . The adverse reaction rate was low in all the three groups. Conclusion The self-behavior management combined with glucosamine hydrochloride is an effective, safe and well-tolerated treatment for early knee osteoarthritis.

Citation： ZhangJing, SuJiang, ChenXixi, LongLi, TianJuan, ZhouBin. Effect of Self-behavior Management Combined with Glucosamine Hydrochloride in Treating Patients with Early Knee Osteoarthritis. West China Medical Journal, 2016, 31(5): 803-807. doi: 10.7507/1002-0179.201600220 Copy

1.	Flugsrud GB, Nordsletten L, Reinholt FP, et al. Osteoarthritis[J]. Tidsskr Nor Laegeforen, 2010, 130 (21) : 2136-2140.
2.	中华医学会骨科学分会. 骨关节炎诊治指南（草案）[J]. 中华医学信息导报, 2002, 1(24) : 15-16.
3.	Pallu S, Francin PJ, Guillaume C, et al. Obesity affects the chondrocyte responsiveness to leptin in patients with osteoarthritis[J]. Arthritis Res Ther, 2010, 12(3) : R112.
4.	Mcalindon TE, Bannuru RR, Sullivan MC, et al. Response to letter to the editor entitled “comments on ‘OARSI guidelines for the nonsurgical management of knee osteoarthritis’ ”[J]. Osteoarthritis Cartilage, 2014, 22(6) : 890-891.
5.	Pavelká K, Gatterová J, Olejarová M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study[J]. Arch Intern Med, 2002, 162(18) : 2113-2123.
6.	Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro[J]. Osteoarthritis Cartilage, 1998, 6(6) : 427-434.
7.	Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis[J]. Arthritis Rheum, 2004, 51(5) : 738-745.
8.	Hughes R, Carr A. A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee[J]. Rheumatology (Oxford), 2002, 41(3) : 279-284.
9.	中华医学会风湿病学分会. 骨关节炎诊断及治疗指南[J]. 中华风湿病学杂志, 2010, 14(6) : 416-419.
10.	Kazemi B, Ashraf A, Namazi MR, et al. Evaluation of the degree of knee joint osteoarthritis in atients with early gray hair[J]. Int J Trichology, 2013, 5(2) : 77-80.
11.	Hochberg MC, Altman RD, April KT, et al. American college of rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee[J]. Arthritis Care Res (Hoboken), 2012, 64(4) : 465-474.
12.	Lequesne MG, Mery C, Samson M, et al. Indexes of severity for osteoarthritis of the hip and knee. Validation--value in comparison with other assessment tests[J]. Scand J Rheumatol Suppl, 1987, 65(16) : 85-89.
13.	Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J]. J Rheumatol, 1988, 15(12) : 1833-1840.
14.	Felson DT. Osteoarthritis as a disease of mechanics[J]. Osteoarthritis Cartilage, 2013, 21(1) : 10-15.
15.	Hiyama Y, Yamada M, Kitagawa A, et al. A four-week walking exercise programme in patients with knee osteoarthritis improves the ability of dual-task performance: a randomized controlled trial[J]. Clin Rehabil, 2012, 26(5) : 403-412.
16.	Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial[J]. Arthritis Rheum, 2005, 52(3) : 779-786.
17.	Shikhman AR, Amiel D, D’lima D, et al. Chondroprotective activity of N-acetylglucosamine in rabbits with experimental osteoarthritis[J]. Ann Rheum Dis, 2005, 64(1) : 89-94.
18.	Biggee BA, Blinn CM, Mcalindon TE, et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness[J]. Ann Rheum Dis, 2006, 65(2) : 222-226.
19.	Kloek CJ, Bossen D, Veenhof C, et al. Effectiveness and costeffectiveness of a blended exercise intervention for patients with hip and/or knee osteoarthritis: study protocol of a randomized controlled trial[J]. BMC Musculoskelet Disord, 2014, 15(8) : 269.
20.	Scott D, Kowalczyk A. Osteoarthritis of the knee[J]. Am Fam Physician, 2008, 77(8) : 1149-1150.

1. Flugsrud GB, Nordsletten L, Reinholt FP, et al. Osteoarthritis[J]. Tidsskr Nor Laegeforen, 2010, 130 (21) : 2136-2140.
2. 中华医学会骨科学分会. 骨关节炎诊治指南（草案）[J]. 中华医学信息导报, 2002, 1(24) : 15-16.
3. Pallu S, Francin PJ, Guillaume C, et al. Obesity affects the chondrocyte responsiveness to leptin in patients with osteoarthritis[J]. Arthritis Res Ther, 2010, 12(3) : R112.
4. Mcalindon TE, Bannuru RR, Sullivan MC, et al. Response to letter to the editor entitled “comments on ‘OARSI guidelines for the nonsurgical management of knee osteoarthritis’ ”[J]. Osteoarthritis Cartilage, 2014, 22(6) : 890-891.
5. Pavelká K, Gatterová J, Olejarová M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study[J]. Arch Intern Med, 2002, 162(18) : 2113-2123.
6. Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro[J]. Osteoarthritis Cartilage, 1998, 6(6) : 427-434.
7. Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis[J]. Arthritis Rheum, 2004, 51(5) : 738-745.
8. Hughes R, Carr A. A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee[J]. Rheumatology (Oxford), 2002, 41(3) : 279-284.
9. 中华医学会风湿病学分会. 骨关节炎诊断及治疗指南[J]. 中华风湿病学杂志, 2010, 14(6) : 416-419.
10. Kazemi B, Ashraf A, Namazi MR, et al. Evaluation of the degree of knee joint osteoarthritis in atients with early gray hair[J]. Int J Trichology, 2013, 5(2) : 77-80.
11. Hochberg MC, Altman RD, April KT, et al. American college of rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee[J]. Arthritis Care Res (Hoboken), 2012, 64(4) : 465-474.
12. Lequesne MG, Mery C, Samson M, et al. Indexes of severity for osteoarthritis of the hip and knee. Validation--value in comparison with other assessment tests[J]. Scand J Rheumatol Suppl, 1987, 65(16) : 85-89.
13. Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J]. J Rheumatol, 1988, 15(12) : 1833-1840.
14. Felson DT. Osteoarthritis as a disease of mechanics[J]. Osteoarthritis Cartilage, 2013, 21(1) : 10-15.
15. Hiyama Y, Yamada M, Kitagawa A, et al. A four-week walking exercise programme in patients with knee osteoarthritis improves the ability of dual-task performance: a randomized controlled trial[J]. Clin Rehabil, 2012, 26(5) : 403-412.
16. Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial[J]. Arthritis Rheum, 2005, 52(3) : 779-786.
17. Shikhman AR, Amiel D, D’lima D, et al. Chondroprotective activity of N-acetylglucosamine in rabbits with experimental osteoarthritis[J]. Ann Rheum Dis, 2005, 64(1) : 89-94.
18. Biggee BA, Blinn CM, Mcalindon TE, et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness[J]. Ann Rheum Dis, 2006, 65(2) : 222-226.
19. Kloek CJ, Bossen D, Veenhof C, et al. Effectiveness and costeffectiveness of a blended exercise intervention for patients with hip and/or knee osteoarthritis: study protocol of a randomized controlled trial[J]. BMC Musculoskelet Disord, 2014, 15(8) : 269.
20. Scott D, Kowalczyk A. Osteoarthritis of the knee[J]. Am Fam Physician, 2008, 77(8) : 1149-1150.

West China Medical Journal

Effect of Self-behavior Management Combined with Glucosamine Hydrochloride in Treating Patients with Early Knee Osteoarthritis

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