氨基葡萄糖联合依托考昔治疗膝骨关节炎的临床疗效及对患者炎症因子、软骨代谢、基质金属蛋白酶的影响  

Clinical Efficacy of Glucosamine Combined with Etoricoxib in the Treatment of Knee Osteoarthritis and Its Effects on Inflammatory Factors,Cartilage Metabolism and Matrix Metalloproteinases

作　　者：方心 张晓奎 胡周磊 FANG Xin;ZHANG Xiao-kui;HU Zhou-lei(Department of Orthopedics,Nanshi Hospital of Nanyang,Nanyang 473000,China)

机构地区：[1]南阳南石医院骨科,南阳473000

出　　处：《中国合理用药探索》2024年第5期103-108,共6页Chinese Journal of Rational Drug Use

摘　　要：目的:探讨氨基葡萄糖联合依托考昔治疗膝骨关节炎(KOA)的临床疗效及对患者炎症因子、软骨代谢、基质金属蛋白酶的影响。方法:选取2020年7月~2023年6月期间于某院治疗的106例KOA患者作为研究对象,采用随机数字表法分为对照组和观察组,每组53例。对照组患者口服依托考昔片,观察组患者在对照组治疗基础上加用盐酸氨基葡萄糖颗粒,两组均连续治疗4周。比较两组患者炎症因子[Toll样受体4(TLR4)、白介素-1β(IL-1β)及肿瘤坏死因子-ɑ(TNF-ɑ)]、软骨代谢指标[软骨寡聚基质蛋白(COMP)、IIA型前胶原氨基端前肽(PIIANP)及II型胶原羧基端肽(CTX-II)]、基质金属蛋白酶[基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)]、临床疗效及不良反应发生情况。结果:治疗后,两组患者血清TLR4、IL-1β和TNF-ɑ水平均降低(P<0.05),且观察组低于对照组(P<0.05);COMP和CTX-II水平均降低(P<0.05),且观察组低于对照组(P<0.05);PIIANP水平均升高(P<0.05),且观察组高于对照组(P<0.05);MMP-3和MMP-9水平均降低(P<0.05),且观察组低于对照组(P<0.05)。观察组患者治疗总有效率(94.34%)高于对照组(79.25%,P<0.05);两组患者治疗期间不良反应发生情况比较无统计学差异(P>0.05)。结论:氨基葡萄糖联合依托考昔治疗KOA临床疗效较好,可有效抑制患者炎症因子、基质金属蛋白酶生成,改善软骨代谢指标,且不会增加不良反应的发生风险。Objective:To investigate the clinical efficacy of glucosamine combined with etoricoxib in the treatment of knee osteoarthritis(KOA)and its effects on inflammatory factors,cartilage metabolism and matrix metalloproteinases.Methods:A total of 106 KOA patients treated in a hospital from July 2020 to June 2023 were selected and assigned to the control group and observation group by random number table methed,with 53 patients in each group.The control group was treated with oral etoricoxib tablets,whereas the observation group was treated with glucosamine hydrochloride granules in addition to the treatment given in the control group,and both groups were treated for 4 weeks.The inflammatory factors[Toll-like receptor 4(TLR4),interleukin-1β(IL-1β)and tumor necrosis factor-ɑ(TNF-ɑ)],biomarkers of cartilage metabolism[cartilage oligomeric matrix protein(COMP),procollagen IIA of N-propeptide(PIIANP)and C-telopeptide of type II collagen(CTX-II)],matrix metalloproteinases[matrix metalloproteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9)],clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results:After treatment,the levels of serum TLR4,IL-1βand TNF-ɑwere decreased in both groups(P<0.05),and were lower in the observation group than those in the control group(P<0.05).The levels of serum COMP and CTX-II were decreased in both groups(P<0.05),and were lower in the observation group than those in the control group(P<0.05).The level of serum PIIANP was increased in both groups(P<0.05),and was higher in the observation group than that in the control group(P<0.05).The levels of serum MMP-3 and MMP-9 were decreased in both groups(P<0.05),and was lower in the observation group than that in the control group(P<0.05).The total response rate in the observation group(94.34%)was higher than that in the control group(79.25%,P<0.05).There was no statistically significant difference in the incidence of treatment-emergent adverse reactions between the two groups(P>0.05).Conclusion:Glucosamine comb

关 键 词：依托考昔 氨基葡萄糖 膝骨关节炎 炎症因子 软骨代谢 基质金属蛋白酶 

分 类 号：R684.3[医药卫生—骨科学]