Clinical study of Glucosamine Hydrochloride as An Adjuvant therapy for Pilon Fractures_West China Medical Journal

Authors：

PU Yu , ZHANG Yiwu , CHEN Yonglong , GAO Weimin , DENG Tianqiong , WANG Qing.

Department of Orthopedics, No. 324 Hospital of CPLA, Chongqing, 400020, P. R. China;

Corresponding author：

Keywords：

盐酸氨基葡萄糖; 胫骨骨折; 创伤性关节炎

DOI：

10.7507/1002-0179.20130114

Video：

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目的　观察盐酸氨基葡萄糖对Pilon骨折的辅助治疗作用。方法　 2007年6月－2010年9月，将43例接受手术治疗的Pilon骨折患者随机分成两组，A组术后口服盐酸氨基葡萄糖，B组作为对照组（仅服用安慰剂）。A组21例患者，平均年龄（35.7± 8.0）岁，B组22例患者，平均年龄（36.7 ± 7.1）岁。两组患者年龄、性别、骨折分型及手术时机相比较，无统计学差异（P＞0.05）。定期随诊（术后6、12、18个月），根据美国足与踝关节协会踝与后足功能评分（AOFAS）评分系统对患者进行功能评分，进行前瞻、对照、双盲研究。结果　术后6、12、18个月，A组患者的AOFAS评分均明显高于B组，差异有统计学意义（t=2.530，2.856，2.881；P=0.015，0.007，0.006）；术后18个月，A组临床疗效优良率为95.2%，B组优良率为72.3%，差异有统计学意义（χ2=3.995，P=0.046）。A组2例患者分别发生轻度头晕及恶心，无严重不良反应发生。结论　盐酸氨基葡萄糖辅助治疗Pilon骨折可改善踝关节功能，减少创伤性骨关节炎的发生。

Citation： PU Yu,ZHANG Yiwu,CHEN Yonglong,GAO Weimin,DENG Tianqiong,WANG Qing.. Clinical study of Glucosamine Hydrochloride as An Adjuvant therapy for Pilon Fractures. West China Medical Journal, 2013, 28(3): 352-355. doi: 10.7507/1002-0179.20130114 Copy

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2.	Ruedi TP, Allgower M. The operative treatment of intra-articular frac tures of the lower end of the tibia[J]. Clin Orthop Relat Res, 1979, 1(13): 105-110.
3.	Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating system for the ankle-hindfoot midfoot hallux and lesser toes[J]. Foot Ankle Int, 1994, 15(7):349-353.
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7.	Largo R, Alvarez-Soria MA, Díez-Ortego I, et al. Glucosamine inhibits IL-1beta-induced NFkappaB activation in human osteoarthritic chondrocytes [J] . Osteoarthritis Cartilage, 2003, 11(4): 290-298.
8.	杨南萍, 李江涛, 陈永涛, 等．多中心随机双盲双模拟阳性药平行对照临床研究：评价国产盐酸氨基葡萄糖片在治疗骨关节炎中的有效性和安全性[J] . 华西医学, 2005, 20(4): 668-670．.
9.	张伟滨, 庄澄宇, 李建民, 等．盐酸氨基葡萄糖治疗骨性关节炎有效性与安全性评价[J]. 中华外科杂志, 2007, 45(14): 998-1001.
10.	Meulyzer M, Vachon P, Beaudry F, et al. Joint inflammation increases glucosamine levels attained in synovial fluid following oral administration of glucosamine hydrochloride[J]. Osteoarthritis Cartilage, 2009, 17(2): 228-234.
11.	Rovati LC, Girolami F, Persiani S. Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties[J]. Ther Adv Musculoskelet Dis, 2012, 4(3): 167-180.
12.	陈德生, 张志刚, 曹靖, 等．盐酸氨基葡萄糖对兔膝关节炎的影响 [J]. 中国修复重建外科杂志, 2010, 24(3): 287-291．.
13.	Naito K, Watari T, Furuhata A, et al. Evaluation of the effect of glucosamine on an experimental rat osteoarthritis model[J] . Life Sci, 2010, 27(3): 538-543.
14.	中华医学会风湿病学分会．骨关节炎诊断及治疗指南 [J]. 中华风湿病学杂志, 2010, 14(6): 416-419．.
15.	Zhang W, Nuki G, Moskowitz RW, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part Ⅲ: Changes in evidence following systematic cumulative update of research published through January 2009[J]. Osteoarthritis Cartilage, 2010, 18(4): 476-499.

1. 　Kilian O, Bündner MS, Horas U, et al. Long-term results in the surgical treatment of pilon tibial fractures. A retrospective study[J]．Chimrg, 2002, 73(1): 65-72．.
2. 　Ruedi TP, Allgower M. The operative treatment of intra-articular frac tures of the lower end of the tibia[J]. Clin Orthop Relat Res, 1979, 1(13): 105-110.
3. 　Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating system for the ankle-hindfoot midfoot hallux and lesser toes[J]. Foot Ankle Int, 1994, 15(7):349-353.
4. 　Horisberger M, Valderrabano V, Hintermann B. Posttraumatic ankle osteoarthritis after ankle-related fractures[J] . Orthop Trauma, 2009, 23(1): 60-67.
5. 　张加良．限期手术内固定治疗Pilon骨折[J]. 浙江创伤外科, 2011, 16(6): 766-767．.
6. 　鲍晓毅, 钟小明. 盐酸氨基葡萄糖治疗膝关节骨性关节炎的临床观察 [J]．中国骨肿瘤骨病, 2010, 9(4): 339-341．.
7. 　Largo R, Alvarez-Soria MA, Díez-Ortego I, et al. Glucosamine inhibits IL-1beta-induced NFkappaB activation in human osteoarthritic chondrocytes [J] . Osteoarthritis Cartilage, 2003, 11(4): 290-298.
8. 　杨南萍, 李江涛, 陈永涛, 等．多中心随机双盲双模拟阳性药平行对照临床研究：评价国产盐酸氨基葡萄糖片在治疗骨关节炎中的有效性和安全性[J] . 华西医学, 2005, 20(4): 668-670．.
9. 　张伟滨, 庄澄宇, 李建民, 等．盐酸氨基葡萄糖治疗骨性关节炎有效性与安全性评价[J]. 中华外科杂志, 2007, 45(14): 998-1001.
10. 　Meulyzer M, Vachon P, Beaudry F, et al. Joint inflammation increases glucosamine levels attained in synovial fluid following oral administration of glucosamine hydrochloride[J]. Osteoarthritis Cartilage, 2009, 17(2): 228-234.
11. 　Rovati LC, Girolami F, Persiani S. Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties[J]. Ther Adv Musculoskelet Dis, 2012, 4(3): 167-180.
12. 　陈德生, 张志刚, 曹靖, 等．盐酸氨基葡萄糖对兔膝关节炎的影响 [J]. 中国修复重建外科杂志, 2010, 24(3): 287-291．.
13. 　Naito K, Watari T, Furuhata A, et al. Evaluation of the effect of glucosamine on an experimental rat osteoarthritis model[J] . Life Sci, 2010, 27(3): 538-543.
14. 　中华医学会风湿病学分会．骨关节炎诊断及治疗指南 [J]. 中华风湿病学杂志, 2010, 14(6): 416-419．.
15. 　Zhang W, Nuki G, Moskowitz RW, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part Ⅲ: Changes in evidence following systematic cumulative update of research published through January 2009[J]. Osteoarthritis Cartilage, 2010, 18(4): 476-499.

West China Medical Journal

Clinical study of Glucosamine Hydrochloride as An Adjuvant therapy for Pilon Fractures

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