特异性COX-2抑制剂保护骨关节炎软骨的临床观察  

The Clinical Study on the Protection of Articular Cartilage for the Osteoarthritis with the Treatment of Celecoxib

作　　者：方忠[1] 李锋[1] 熊伟[1] 李光辉[1] 敦先礼[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院骨科,湖北武汉430030

出　　处：《实用骨科杂志》2006年第1期29-32,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨特异性COX-2抑制剂对骨关节炎的关节软骨保护作用的临床研究。方法门诊选取膝关节骨关节炎患者80例,随机分为特异性COX-2抑制剂组和维骨力对照组,各40例,单盲给药。应用平均Womac关节炎指数评分和平均OA严重程度指数评定两组用药前后临床症状改善情况及使用血清软骨代谢标志物蛋白聚糖与型胶原和关节MRI进行检测关节软骨结构与功能的改变情况,并作统计学分析。结果经12个月治疗观察,特异性COX-2抑制剂组的平均Womac关节炎指数评分和平均OA严重程度指数在前3个月改善明显优于维骨力对照组(P<0.01),但在治疗12个月后,两组差异不显著(P>0.05);治疗12个月后特异性COX-2抑制剂组的软骨代谢指标蛋白聚糖和型胶原及关节MRI均显示组内变化显著(P<0.01),而与维骨力组对比结果无显著性差异(P>0.05)。结论特异性COX-2抑制剂对骨关节炎的软骨有保护和促进修复作用,兼有抗炎与保护软骨双重疗效,它是一类既能改善关节炎症状又能改善关节软骨结构的药物,值得临床广泛应用。同时本研究为其在临床应用和进一步研究此类药物提供了更好的理论基础和依据。Objective To evaluate the clinical effects of the protection of articular cartilage for the osteoarthritis with the treatment celecoxib. Methods 80 patients with knee osteoarthritis were divided into 2 groups randomly, Each group had 40 patients. The experiment group was treated with celecoxib and the control group was treated with the glucosamine sulfate （Viartril-S）. The Womac and osteoarthritis severity index, the proteoglycan and collagen type Ⅱfor the cartilage metabolism and the knee MRI should been used for the evaluation of the protection of the articular cartilage. All patients were treated for one year. Results Among the first 3 months, the efficacy rate of the experiment group was superior to the control groups in efficacy both womac and osteoarthritis severity index（P〈0.01）, but there were not the difference （P〉0.05） between the two groups at the last. At the end of the trail, the Proteoglycan, Collagen type Ⅱand the knee MRIs all showed the significant diffrence （P〈0.01） among the experiment group. The Proteoglycan and Collagen type Ⅱ have the same results between the two groups（P〉0.05）, and the knee MRIs had showed the non-significant difference for the restore of the articular cartilage between the two groups （P〉0.05）. Conclusion Celecoxib have the function for the protection of the articular cartilage on the osteoarthritis and that should be the basis for the deep research and complication on the drug. At the same time it should been widely used for the treatment of the osteoarthritis in clinic.

关 键 词：消炎药 非甾类 膝关节骨关节炎 关节软骨 

分 类 号：R684.3[医药卫生—骨科学]