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：

盐酸氨基葡萄糖; 硫酸软骨素; 骨关节炎，腰椎小关节

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目的　观察比较盐酸氨基葡萄糖单独使用及与硫酸软骨素联合使用治疗腰椎小关节骨关节炎（LFOA）的临床疗效。方法　2009年1月－2011年1月，将80例LFOA患者随机分成两组，A组口服盐酸氨基葡萄糖，B组口服盐酸氨基葡萄糖和硫酸软骨素两种药物，6周为1个疗程，间断治疗4个疗程。分别比较用药前与用药后3、6周及5、8、11个月时的日本骨科协会（JOA）评分、晨僵和压痛程度变化。结果　治疗后，两组的JOA评分在各观察时点均增加，与治疗前比较差异有统计学意义（P＜0.05）。组间行JOA评分治疗改善率的比较，在各观察时点差异均有统计学意义（P＜0.05），B组JOA评分改善率优于A组。治疗3周后，两组晨僵和压痛评分均降低，与本组治疗前比较差异有统计学意义（P＜0.05）；组间比较，差异亦有统计学意义（P＜0.05），B组晨僵和压痛程度均低于A组。第6周，第5、8、11个月，两组组间比较晨僵和压痛程度差异均无统计学意义（P＞0.05），但各疗程结束后两组晨僵和压痛程度均呈持续降低趋势。结论　单独应用盐酸氨基葡萄糖及盐酸氨基葡萄糖与硫酸软骨素的联合应用治疗LFOA疗效确切，联合用药优于单独应用盐酸氨基葡萄糖。

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.	李宁华, 张耀南, 张毅, 等. 中国六城市中老年人群X射线腰椎骨关节炎流行病学分析[J]. 中国临床康复, 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.	张施展, 蒋林. 盐酸氨基葡萄糖治疗腰椎关节突关节骨性关节炎的临床观察[J]. 华西医学, 2011, 26(12): 1832-1835.
7.	石锐, 刘浩, 胡韬, 等. 盐酸氨基葡萄糖联合非类固醇类抗炎药治疗小关节退变伴下腰痛[J]. 中国组织工程研究与临床康复, 2011, 15(26): 4895-4898.
8.	周广军, 宓士军, 田晓芳, 等. 氨基葡萄糖治疗腰椎小关节骨性关节炎的临床体会[J]. 中国骨肿瘤骨病, 2009, 8(4): 133-235.
9.	张青, 凌沛学, 陈磊. 硫酸软骨素在骨科中的应用[J]. 食品与药品, 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.	庄心良, 曾因明, 陈伯銮. 现代麻醉学[M]. 3版.北京: 人民卫生出版社, 2004: 2546-2547.
13.	井上俊一. 腰腿疾患治疗成绩制定基准[J]. 日整会志, 1984, 58(3): 925.
14.	卢锋, 郭红卫. 盐酸氨基葡萄糖对骨关节炎作用机制的初步探讨[J]. 卫生研究, 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.	贾连顺. 腰椎关节突关节骨关节炎的认识[J]. 中华骨科杂志, 2008, 28(10): 868-869.
18.	中华医学会风湿病分会. 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.
19.	王蕾, 王健, 王惠珍. 氨基葡萄糖与美洛昔康治疗老年膝骨关节炎疗效的对比观察[J]. 中国老年学杂志, 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.	张伟滨, 庄澄宇, 李建民, 等. 盐酸氨基葡萄糖治疗骨性关节炎有效性与安全性评价[J]. 中华外科杂志, 2007, 45(14): 998-1001.
23.	黄晓东, 张炜. 简述骨关节炎特异性药物治疗的前景[J]. 中国现代药物应用, 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.	陈德生, 张志刚, 曹靖, 等. 盐酸氨基葡萄糖对兔膝骨关节炎的影响[J]. 中国修复重建杂志, 2010, 24(3): 287-291.
26.	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.
27.	刘念. 氨基葡萄糖, 硫酸软骨素及两药联合用于膝骨关节炎疼痛的治疗[J]. 国外医学·药学分册, 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, 魏学磊, 等. 氨基葡萄糖和硫酸软骨素联合用药对兔骨关节炎治疗作用实验研究[J]. 中国运动医学杂志, 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. 　李宁华, 张耀南, 张毅, 等. 中国六城市中老年人群X射线腰椎骨关节炎流行病学分析[J]. 中国临床康复, 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. 　张施展, 蒋林. 盐酸氨基葡萄糖治疗腰椎关节突关节骨性关节炎的临床观察[J]. 华西医学, 2011, 26(12): 1832-1835.
7. 　石锐, 刘浩, 胡韬, 等. 盐酸氨基葡萄糖联合非类固醇类抗炎药治疗小关节退变伴下腰痛[J]. 中国组织工程研究与临床康复, 2011, 15(26): 4895-4898.
8. 　周广军, 宓士军, 田晓芳, 等. 氨基葡萄糖治疗腰椎小关节骨性关节炎的临床体会[J]. 中国骨肿瘤骨病, 2009, 8(4): 133-235.
9. 　张青, 凌沛学, 陈磊. 硫酸软骨素在骨科中的应用[J]. 食品与药品, 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. 　庄心良, 曾因明, 陈伯銮. 现代麻醉学[M]. 3版.北京: 人民卫生出版社, 2004: 2546-2547.
13. 　井上俊一. 腰腿疾患治疗成绩制定基准[J]. 日整会志, 1984, 58(3): 925.
14. 　卢锋, 郭红卫. 盐酸氨基葡萄糖对骨关节炎作用机制的初步探讨[J]. 卫生研究, 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. 　贾连顺. 腰椎关节突关节骨关节炎的认识[J]. 中华骨科杂志, 2008, 28(10): 868-869.
18. 　中华医学会风湿病分会. 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.
19. 　王蕾, 王健, 王惠珍. 氨基葡萄糖与美洛昔康治疗老年膝骨关节炎疗效的对比观察[J]. 中国老年学杂志, 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. 　张伟滨, 庄澄宇, 李建民, 等. 盐酸氨基葡萄糖治疗骨性关节炎有效性与安全性评价[J]. 中华外科杂志, 2007, 45(14): 998-1001.
23. 　黄晓东, 张炜. 简述骨关节炎特异性药物治疗的前景[J]. 中国现代药物应用, 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. 　陈德生, 张志刚, 曹靖, 等. 盐酸氨基葡萄糖对兔膝骨关节炎的影响[J]. 中国修复重建杂志, 2010, 24(3): 287-291.
26. 　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.
27. 　刘念. 氨基葡萄糖, 硫酸软骨素及两药联合用于膝骨关节炎疼痛的治疗[J]. 国外医学·药学分册, 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, 魏学磊, 等. 氨基葡萄糖和硫酸软骨素联合用药对兔骨关节炎治疗作用实验研究[J]. 中国运动医学杂志, 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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