• 武漢市中心醫(yī)院骨科（武漢，430014）;

【摘要】　目的　 觀察鹽酸氨基葡萄糖治療腰椎關(guān)節(jié)突關(guān)節(jié)骨性關(guān)節(jié)炎（lumbar zygapophyseal joint osteoarthritis，LZOA）的臨床療效及安全性。　方法　 2009年1月-2010年1月，對(duì)90例LZOA患者隨機(jī)分成治療組和對(duì)照組，各45例。治療組口服鹽酸氨基葡萄糖，6周為1個(gè)療程，治療3個(gè)療程，前2周均加用洛索洛芬鈉；對(duì)照組患者僅給予洛索洛芬鈉口服12周。比較兩組治療后2、6周及3、6、12個(gè)月的療效及安全性。　結(jié)果　 治療后6周、3個(gè)月，治療組與對(duì)照組癥狀均明顯改善，對(duì)照組改善更明顯。治療6個(gè)月后，治療組評(píng)分持續(xù)下降，到12個(gè)月時(shí)與治療前比較差異有統(tǒng)計(jì)學(xué)意義（P lt;0.01）；而對(duì)照組評(píng)分則逐漸增高，到12個(gè)月時(shí)與其治療前比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。兩組的不良反應(yīng)率分別為6.67%、15.56%，差異有統(tǒng)計(jì)學(xué)意義（P lt;0.01）。　結(jié)論　 鹽酸氨基葡萄糖治療LZOA療效確切，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（P lt;0.01）. The scoring in comparative group kept increasing, which showed no significant difference after 12-month treatment（P gt;0.05）. The adverse effect rate was 6.67% and 15.56% respectively in two groups, which was significant different（P lt;0.01）.　Conclusions　 Glucosamine hydrochloride provides good efficacy and safety for patients with LZOA.

引用本文： 張施展,蔣林. 鹽酸氨基葡萄糖治療腰椎關(guān)節(jié)突關(guān)節(jié)骨性關(guān)節(jié)炎的臨床觀察. 華西醫(yī)學(xué), 2011, 26(12): 1832-1835. doi: 復(fù)制

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2. 　王麗華, 王利民. 風(fēng)濕骨痛膠囊聯(lián)合鹽酸氨基葡萄糖治療膝骨關(guān)節(jié)炎臨床體會(huì)[J]. 中國(guó)中醫(yī)急癥, 2009, 18(1): 132-133.
3. 　詹玉林, 范家倫. 腰椎小關(guān)節(jié)病的診斷與治療[J]. 中華矯形外科雜志, 2002, 10(8): 822-823.
4. 　Hayes KW, Falconer J. Differential muscle strength decline in osteoarthritis of knee. A developing hypothesis[J]. Arthritis Care Res, 1992, 5(1): 24-28.
5. 　Gorbach C, Schmid MR, Elfering A, et al. Therapeutic efficacy of facet joint blocks[J]. AJR Am J Roentgenol, 2006, 186(5): 1228-1233.
6. 　Borenstein D. Does osteoarthritis of the lumbar spine cause chronic low back pain?[J]. Curr Pain Headache Rep, 2004, 8(6): 512-517.
7. 　Hancock MJ, Maher CG, Latimer J, et al. Systemic review of tests to identify the disc, SlJ or facet joint as the source of low back pain[J]. Eur Spine J, 2007, 16(10): 1539-1550.
8. 　Manchikanti L, Singh V, Falco FJ, et al. Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain:a randomized, double-blind, controlled trial with a 2-year follow-up[J]. Int J Med Sci, 2010, 7(3): 124-135.
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10. 　江相保, 高李俠. 鹽酸氨基葡萄糖治療膝退行性骨關(guān)節(jié)炎的臨床觀察[J]. 中國(guó)修復(fù)重建外科雜志, 2008, 22(1): 29-31.
11. 　中華醫(yī)學(xué)會(huì)風(fēng)濕病學(xué)分會(huì). 骨關(guān)節(jié)炎診斷及治療指南[J]. 中華風(fēng)濕病學(xué)雜志, 2010, 14(6): 416-419.
12. 　Gatti JC. Glucosamine treatment for osteoarthritis[J]. Am Fam Physician, 2006, 73(7):1189-1191.
13. 　Fox BA, Schmitz ED, Wallace R. FPIN′s clinical inquiries. Glucosamine and chondroitin for osteoarthritis[J]. Am Fam Physician, 2006, 73(7): 1245-1246.
14. 　陳德生, 張志剛, 曹靖,等. 鹽酸氨基葡萄糖對(duì)兔膝骨性關(guān)節(jié)炎的影響[J]. 中國(guó)修復(fù)重建外科雜志, 2010, 24(3): 287-291.
15. 　Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine Sulfate in chondrocytes isolated from human osteoarthritis articular Cartilage in vitro[J]. Osteoarthritis Cartilage, 1998, 6(6): 427-434.
16. 　Qiu GX, Gao SN, Gacovelli G, et al. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis[J]. Arzneimittelforschung, 1998, 48(5): 469-474.
  1. 1. 　Kalichman L, Hunter DJ. Lumbar facet joint osteoarthritis: a review[J]. Semin Arthritis Rheum, 2007, 37(2): 69-80.
  2. 2. 　王麗華, 王利民. 風(fēng)濕骨痛膠囊聯(lián)合鹽酸氨基葡萄糖治療膝骨關(guān)節(jié)炎臨床體會(huì)[J]. 中國(guó)中醫(yī)急癥, 2009, 18(1): 132-133.
  3. 3. 　詹玉林, 范家倫. 腰椎小關(guān)節(jié)病的診斷與治療[J]. 中華矯形外科雜志, 2002, 10(8): 822-823.
  4. 4. 　Hayes KW, Falconer J. Differential muscle strength decline in osteoarthritis of knee. A developing hypothesis[J]. Arthritis Care Res, 1992, 5(1): 24-28.
  5. 5. 　Gorbach C, Schmid MR, Elfering A, et al. Therapeutic efficacy of facet joint blocks[J]. AJR Am J Roentgenol, 2006, 186(5): 1228-1233.
  6. 6. 　Borenstein D. Does osteoarthritis of the lumbar spine cause chronic low back pain?[J]. Curr Pain Headache Rep, 2004, 8(6): 512-517.
  7. 7. 　Hancock MJ, Maher CG, Latimer J, et al. Systemic review of tests to identify the disc, SlJ or facet joint as the source of low back pain[J]. Eur Spine J, 2007, 16(10): 1539-1550.
  8. 8. 　Manchikanti L, Singh V, Falco FJ, et al. Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain:a randomized, double-blind, controlled trial with a 2-year follow-up[J]. Int J Med Sci, 2010, 7(3): 124-135.
  9. 9. 　Nath S, Nath CA, Pettersson K. Percutaneous lumbar zygapophysial(Facet)joint neurotomy using radiofrequency current, in the management of chronic low back bain: a randomized double-blind trial[J]. Spine(Phila Pa 1976), 2008, 33(12): 1291-1297.
  10. 10. 　江相保, 高李俠. 鹽酸氨基葡萄糖治療膝退行性骨關(guān)節(jié)炎的臨床觀察[J]. 中國(guó)修復(fù)重建外科雜志, 2008, 22(1): 29-31.
  11. 11. 　中華醫(yī)學(xué)會(huì)風(fēng)濕病學(xué)分會(huì). 骨關(guān)節(jié)炎診斷及治療指南[J]. 中華風(fēng)濕病學(xué)雜志, 2010, 14(6): 416-419.
  12. 12. 　Gatti JC. Glucosamine treatment for osteoarthritis[J]. Am Fam Physician, 2006, 73(7):1189-1191.
  13. 13. 　Fox BA, Schmitz ED, Wallace R. FPIN′s clinical inquiries. Glucosamine and chondroitin for osteoarthritis[J]. Am Fam Physician, 2006, 73(7): 1245-1246.
  14. 14. 　陳德生, 張志剛, 曹靖,等. 鹽酸氨基葡萄糖對(duì)兔膝骨性關(guān)節(jié)炎的影響[J]. 中國(guó)修復(fù)重建外科雜志, 2010, 24(3): 287-291.
  15. 15. 　Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine Sulfate in chondrocytes isolated from human osteoarthritis articular Cartilage in vitro[J]. Osteoarthritis Cartilage, 1998, 6(6): 427-434.
  16. 16. 　Qiu GX, Gao SN, Gacovelli G, et al. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis[J]. Arzneimittelforschung, 1998, 48(5): 469-474.