自我行为管理联合盐酸氨基葡萄糖治疗早期膝骨关节炎的疗效评估  

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

作　　者：张晶[1] 苏江[1] 陈栖栖[1] 龙丽[1] 田娟[1] 周彬[1] 

机构地区：[1]四川省医学科学院.四川省人民医院风湿免疫科,成都610072

出　　处：《华西医学》2016年第5期803-807,共5页West China Medical Journal

摘　　要：目的探讨自我行为管理联合盐酸氨基葡萄糖治疗早期膝骨关节炎的临床疗效。方法 2013年10月-2015年3月,将确诊的早期膝骨关节炎患者240例随机分为行为组(80例)、药物组(80例)及联合组(80例)。行为组采用单纯自我行为管理治疗;药物组采用口服盐酸氨基葡萄糖0.48 g/次,3次/d;联合组则采用行为管理与药物治疗相结合。分别于治疗后第4、8、12周时进行疗效评价,并对不良反应、有效率及脱落率进行观察。结果联合组的Lequesne指数和西安大略和麦克马斯特大学骨关节炎指数(WOMAC评分)从第4周开始较0周明显下降,第8、12周时较行为组和药物组下降有明显差异(P<0.05)。药物组和行为组的Lequesne指数从第8周开始下降明显,而药物组的WOMAC评分从第4周开始下降明显,行为组仍从第8周才下降明显。3组有效率均随着时间延长而增加,联合组的有效率均高于其余两组,差异有统计学意义(P<0.05)。3组脱落率依次为行为组(12.5%)、药物组(7.5%)、联合组(6.3%),差异无统计学意义(P>0.05)。总不良反应发生率低。结论自我行为管理联合口服盐酸氨基葡萄糖是治疗早期膝骨关节炎的一种有效、安全且耐受性好的方法。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 respectively12.5%, 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

关 键 词：骨关节炎 膝 自我行为管理 盐酸氨基葡萄糖 

分 类 号：R684.3[医药卫生—骨科学]