外用NSAIDs联合玻璃酸钠和氨基葡萄糖治疗膝骨性关节炎的临床效果及安全性  

Clinical efficacy and safety of NSAIDs combined with sodium hyaluronate and glucosamine in the treatment of knee osteoarthritis

作　　者：刘平 李涛生 朱敏 LIU Ping;LI Taosheng;ZHU Min(Department of Orthopaedics,the Second Hospital of Gaoping District,Sichuan Province,Nanchong 637100,China;不详)

机构地区：[1]四川省南充市高坪区第二医院骨科,637100 [2]四川省营山县第三医院骨科,637700 [3]四川省蓬安县中心医院骨科,637800

出　　处：《临床合理用药杂志》2023年第4期20-22,26,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察外用非甾体类抗炎药(NSAIDs)联合玻璃酸钠和氨基葡萄糖治疗膝骨性关节炎(KOA)的临床效果及安全性。方法选取2019年1—12月四川省南充市高坪区第二医院、四川省营山县第三医院及四川省蓬安县中心医院收治的KOA患者420例,完成治疗和随访病例403例,脱落17例,采用随机数列表法分为5组。5组患者分别在注射玻璃酸钠和口服氨基葡萄糖基础上,联合使用洛索洛芬钠凝胶贴膏(A组)、氟比洛芬凝胶贴膏(B组)、吲哚美辛巴布膏(C组)、洛索洛芬钠贴剂(D组)、吡罗昔康贴片(E组)外用制剂治疗。治疗前与治疗第2、4周记录5组患者临床疗效、VAS评分、WOMAC总积分及不良反应。结果A、B、C、D、E组患者的总有效率分别为95.1%、90.1%、90.0%、90.0%、91.4%,各组间比较差异均无统计学意义(P>0.05)。治疗第2、4周5组患者VAS评分与WOMAC积分均显著降低,且治疗第4周VAS评分、WOMAC积分低于治疗第2周(P<0.05),但组间比较差异无统计学意义(P>0.05);5组患者不良反应总发生率分别为3.7%、4.9%、5.0%、5.0%、3.7%,组间比较差异无统计学意义(P>0.05)。结论外用NSAIDs联合玻璃酸钠和氨基葡萄糖治疗KOA有效、安全,5种药物疗效、安全性无明显差异。Objective To observe the clinical efficacy and safety of non steroidal anti-inflammatory drugs(NSAIDs)combined with sodium hyaluronate and glucosamine in the treatment of knee osteoarthritis(KOA).Methods 420 patients with KOA were selected from the Second Hospital of Gaoping District,Nanchong City,Sichuan Province,the Third Hospital of Yingshan County,Sichuan Province,and the Central Hospital of Peng′an County,Sichuan Province from January to December 2019.403 patients were treated and followed up,and 17 patients fell off.They were randomly divided into 5 groups.On the basis of injection of sodium hyaluronate and oral glucosamine,five groups of patients were treated with topical preparations of loxoprofen sodium gel patch(Group A),flurbiprofen gel patch(Group B),indomethacin cataplasm(Group C),loxoprofen sodium patch(Group D),piroxicam patch(Group E).The clinical efficacy,VAS score,WOMAC total score and adverse reactions of patients in 5 groups were recorded before treatment and at the 2nd and 4th week of treatment.Results The total effective rates of patients in groups A,B,C,D and E were 95.1%,90.1%,90.0%,90.0%and 91.4%respectively,and there were no significant difference between the groups(P>0.05).At the second and fourth week of treatment,the VAS score and WOMAC score of the patients in the 5 groups were significantly reduced,and the VAS score and WOMAC score at the fourth week of treatment were lower than those in the second week of treatment(P<0.05),but there were no significant difference between the groups(P>0.05);The total incidence of adverse reactions in the five groups were 3.7%,4.9%,5.0%,5.0%and 3.7%respectively,there were no significant difference between the groups(P>0.05).Conclusion NSAIDs combined with sodium hyaluronate and glucosamine are effective and safe in the treatment of KOA,and there is no significant difference between the efficacy and safety of the five drugs.

关 键 词：膝骨性关节炎 洛索洛芬 氟比洛芬 吲哚美辛 吡罗昔康 治疗效果 安全性 

分 类 号：R684.3[医药卫生—骨科学]