Combination of Glucosamine Hydrochloride and Non-Steroidal Anti-Inflammatory Drugs versus Non-Steroidal Anti-Inflammatory Drugs in the Treatment of Hip Osteoarthritis: A Prospective, Randomized and Controlled Clinical Study_West China Medical Journal

Authors：

ZENG Weinan ,  ZHOU Zongke , LI Hai , SHEN Bin , YANG Jing , KANG Pengde , PEI Fuxing

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHOU Zongke, Email: weinanzeng@163.com

Keywords：

氨基葡萄糖; 布洛芬; 骨关节炎，髋

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目的　探讨氨基葡萄糖联合布洛芬治疗髋关节骨关节炎的临床疗效。方法　2011年9月－2012年1月采用前瞻性随机对照临床试验，将198例轻、中度髋关节骨关节炎患者随机分入试验组及对照组。试验组采用氨基葡萄糖（750 mg， 2次/d口服，疗程1个月）联合布洛芬（0.3 g，2次/d口服，疗程2周），对照组则单用布洛芬（0.3 g，2次/d口服，疗程2周）；分别于服药后0、2、4、8及12周时采用加拿大西安大略和麦克玛斯特大学骨关节炎指数（WOMAC）进行疗效评价。并对恶心、呕吐、皮疹等药物不良反应进行观察。结果　试验组与对照组WOMAC各项评分从第2周开始较0周明显下降，而两组患者间在0周及2周时WOMAC评分无统计学差异：0周总评分（45.3、45.0分，P=0.225），2周总评分（37.3、37.6分，P=0.329）。但对照组WOMAC各项评分从第4周开始逐渐呈现上升趋势，而试验组到第12周仍呈现持续性下降趋势。总不良反应发生率为7.0%，其中试验组总不良反应发生率为9.5%，但不良反应轻微，未予特殊处理而自行消失。结论　氨基葡萄糖联合布洛芬可有效缓解早、中期髋关节骨关节炎各项临床症状，疗效确切，不良反应较少，且停药后仍持续表现出治疗效果。而单用布洛芬可短期缓解骨关节炎症，但停药后症状逐渐复现。

Citation： ZENG Weinan,ZHOU Zongke,LI Hai,SHEN Bin,YANG Jing,KANG Pengde,PEI Fuxing. Combination of Glucosamine Hydrochloride and Non-Steroidal Anti-Inflammatory Drugs versus Non-Steroidal Anti-Inflammatory Drugs in the Treatment of Hip Osteoarthritis: A Prospective, Randomized and Controlled Clinical Study. West China Medical Journal, 2012, 27(12): 1805-1808. doi: Copy

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2.	Pallu S, Francin PJ, Guillaume C, et al. Obesity affects the chondrocyte responsiveness to leptin in patients with osteoarthritis [J]. Arthritis Res Ther, 2010, 12(3): 112.
3.	Muller-Fassbender H, Bach GL, Haase W, et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee [J]. Osteoarthr Cartil,1994, 2(1): 61-69.
4.	Pavelka K, Gatterova J, Olejarova M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3 year, randomized, placebo-controlled, double-blind study [J]. Arch Intern Med, 2002, 162(18): 2113-2123.
5.	Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro [J]. Osteoarthr Cartil, 1998, 6(6): 427-434.
6.	中华医学会风湿病学分会.骨关节炎诊治指南[J]. 中华风湿病学杂志, 2003, 7(11): 702.
7.	Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patientrelevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee [J]. J Rheumatol 1988, 15(12):1833-1840.
8.	Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a andomized, placebo-controlled clinical trial [J]. Lancet, 2001, 357 (9252): 251-256.
9.	Uebelhart D, Malaise M, Marcolongo R, et al. Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo [J]. Osteoarthr Cartil, 2004, 12(4): 269-276.
10.	Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial [J]. Arthritis Rheum, 2005, 52(3): 779-786.
11.	Shikhman AR, Amiel D, D’Lima D, et al. Chondroprotective activity of N-acetylglucosamine in rabbits with experimental osteoarthritis [J]. Ann Rheum Dis, 2005, 64(1): 89-94.
12.	Chan PS, Caron JP, Rosa GJ, et al. Glucosamine and chondroitin sulfate regulate gene expression and synthesis of nitric oxide and prostaglandin E2 in articular cartilage explants [J]. Osteoarthr Cartil, 2005, 13(5): 387-394.
13.	Largo R, Alvarez-Soria MA, Diez-Ortego I, et al. Glucosamine inhibits IL-1beta-induced N fkappa B activation in human osteoarthritic chondrocytes [J]. Osteoarthr Cartil, 2003, 11(4): 290-298.
14.	Raiss R. Effect of D-glucosamine sulfate on experimentally injured articular cartilage. Comparative morphometry of the ultrastructure of chondrocytes [J]. Fortschr Med, 1985, 103(24): 658-662.
15.	Varghese S, Theprungsirikul P, Sahani S, et al. Glucosamine modulates chondrocyte proliferation, matrix synthesis, and gene expression [J]. Osteoarthr Cartil, 2007, 15(1): 59-68.
16.	Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis [J]. Arthritis Rheum, 2004, 51(5): 738-745.
17.	Hughes R, Carr A. A randomized double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee [J]. Rheumatology (Oxford), 2002, 41(3): 279-284.
18.	Cibere J, Thorne A, Kopec JA, et al. Glucosamine sulfate and cartilage type II collagen degradation in patients with knee osteoarthritis: randomized discontinuation trial results employing biomarkers [J]. J Rheumatol, 2005, 32(5): 896-902.
19.	Aghazadeh-Habashi A, Jamali F. The glucosamine controversy: a pharmacokinetic issue [J]. J Pharm Pharm Sci, 2011, 14(2): 264-273.
20.	Laverty S, Sandy JD, Celeste C, et al. Synovial ﬂuid levels and serum pharmaco-kinetics in a large animal model following treatment with oral glucosamine at clinically relevant doses [J]. Arthritis Rheum, 2005, 52(1): 181-191.
21.	Biggee BA, Blinn CM, McAlindon TE, et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness [J]. Ann Rheum Dis, 2006, 65(2): 222-226.
22.	Glucosamine: reports of allergic skin reactions [R]. Austalian adverse drug reaction bulletin, 2005, 24 (6): 231.
23.	邱贵兴, 翁习生, 张克, 等. 盐酸/硫酸氨基葡萄糖治疗骨关节炎的平行对照临床研究 [J].中华医学杂志, 2005, 85 (43): 3067-3070.

1. 　中华医学会骨科学分会. 骨关节炎诊治指南(2007年版) [J]. 中华关节外科杂志，2007, 1(4):281- 285.
2. 　Pallu S, Francin PJ, Guillaume C, et al. Obesity affects the chondrocyte responsiveness to leptin in patients with osteoarthritis [J]. Arthritis Res Ther, 2010, 12(3): 112.
3. 　Muller-Fassbender H, Bach GL, Haase W, et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee [J]. Osteoarthr Cartil,1994, 2(1): 61-69.
4. 　Pavelka K, Gatterova J, Olejarova M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3 year, randomized, placebo-controlled, double-blind study [J]. Arch Intern Med, 2002, 162(18): 2113-2123.
5. 　Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro [J]. Osteoarthr Cartil, 1998, 6(6): 427-434.
6. 　中华医学会风湿病学分会.骨关节炎诊治指南[J]. 中华风湿病学杂志, 2003, 7(11): 702.
7. 　Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patientrelevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee [J]. J Rheumatol 1988, 15(12):1833-1840.
8. 　Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a andomized, placebo-controlled clinical trial [J]. Lancet, 2001, 357 (9252): 251-256.
9. 　Uebelhart D, Malaise M, Marcolongo R, et al. Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo [J]. Osteoarthr Cartil, 2004, 12(4): 269-276.
10. 　Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial [J]. Arthritis Rheum, 2005, 52(3): 779-786.
11. 　Shikhman AR, Amiel D, D’Lima D, et al. Chondroprotective activity of N-acetylglucosamine in rabbits with experimental osteoarthritis [J]. Ann Rheum Dis, 2005, 64(1): 89-94.
12. 　Chan PS, Caron JP, Rosa GJ, et al. Glucosamine and chondroitin sulfate regulate gene expression and synthesis of nitric oxide and prostaglandin E2 in articular cartilage explants [J]. Osteoarthr Cartil, 2005, 13(5): 387-394.
13. 　Largo R, Alvarez-Soria MA, Diez-Ortego I, et al. Glucosamine inhibits IL-1beta-induced N fkappa B activation in human osteoarthritic chondrocytes [J]. Osteoarthr Cartil, 2003, 11(4): 290-298.
14. 　Raiss R. Effect of D-glucosamine sulfate on experimentally injured articular cartilage. Comparative morphometry of the ultrastructure of chondrocytes [J]. Fortschr Med, 1985, 103(24): 658-662.
15. 　Varghese S, Theprungsirikul P, Sahani S, et al. Glucosamine modulates chondrocyte proliferation, matrix synthesis, and gene expression [J]. Osteoarthr Cartil, 2007, 15(1): 59-68.
16. 　Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis [J]. Arthritis Rheum, 2004, 51(5): 738-745.
17. 　Hughes R, Carr A. A randomized double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee [J]. Rheumatology (Oxford), 2002, 41(3): 279-284.
18. 　Cibere J, Thorne A, Kopec JA, et al. Glucosamine sulfate and cartilage type II collagen degradation in patients with knee osteoarthritis: randomized discontinuation trial results employing biomarkers [J]. J Rheumatol, 2005, 32(5): 896-902.
19. 　Aghazadeh-Habashi A, Jamali F. The glucosamine controversy: a pharmacokinetic issue [J]. J Pharm Pharm Sci, 2011, 14(2): 264-273.
20. 　Laverty S, Sandy JD, Celeste C, et al. Synovial ﬂuid levels and serum pharmaco-kinetics in a large animal model following treatment with oral glucosamine at clinically relevant doses [J]. Arthritis Rheum, 2005, 52(1): 181-191.
21. 　Biggee BA, Blinn CM, McAlindon TE, et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness [J]. Ann Rheum Dis, 2006, 65(2): 222-226.
22. 　Glucosamine: reports of allergic skin reactions [R]. Austalian adverse drug reaction bulletin, 2005, 24 (6): 231.
23. 　邱贵兴, 翁习生, 张克, 等. 盐酸/硫酸氨基葡萄糖治疗骨关节炎的平行对照临床研究 [J].中华医学杂志, 2005, 85 (43): 3067-3070.

West China Medical Journal

Combination of Glucosamine Hydrochloride and Non-Steroidal Anti-Inflammatory Drugs versus Non-Steroidal Anti-Inflammatory Drugs in the Treatment of Hip Osteoarthritis: A Prospective, Randomized and Controlled Clinical Study

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