双醋瑞因与塞来昔布联合硫酸氨基葡萄糖对骨性膝关节炎疗效比较

Effect of diacerein versus celecoxib combined with glucosamine sulfate on knee osteoarthritis

  • 摘要: 目的 了解双醋瑞因与塞来昔布联合硫酸氨基葡萄糖胶囊在缓解骨性膝关节炎(knee osteoarthritis,KOA)患者疼痛症状及提高膝关节功能方面的效果。 方法 选取2014年9月- 2015年6月于我院门诊就诊的KOA患者52例,随机分为塞来昔布组及双醋瑞因组,两组分别给予塞来昔布(45 mg,1次/d)+硫酸氨基葡萄糖胶囊(50 mg,3次/d)与双醋瑞因(50 mg,2次/d)+硫酸氨基葡萄糖胶囊(50 mg,3次/d),治疗时间持续1个月,别于治疗前、治疗后2周、4周及12周门诊及电话随访患者,并统计膝关节疼痛视觉模拟评分(visual analogue scale,VAS)及西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)。 结果 塞来昔布组与双醋瑞因组治疗后2周、4周、12周的VAS评分:2.71±1.11 vs 4.27±1.15,P=0.01;2.71±0.76 vs 3.59±0.69,P=0.03;2.29±1.11 vs 3.58±0.98,P=0.02。塞来昔布组与双醋瑞因组治疗后2周、4周、12周WOMAC指数:57.43±13.65 vs 49.27±12.63,P=0.03;51.43±10.60 vs 45.43±16.61,P=0.01;52.71±15.99 vs 46.86±13.19,P=0.01。与双醋瑞因组相比,塞来昔布组VAS评分较低而WOMAC指数较高。 结论 塞来昔布在患者膝关节疼痛的控制上效果更好,但在膝关节功能的提升方面效果不如双醋瑞因。我们认为双醋瑞因联合硫酸氨基葡萄糖胶囊能够作为KOA的治疗方案之一。

     

    Abstract: Objective To understand the effect of diacerein versus celecoxib combined with glucosamine sulfate for the treatment of knee osteoarthritis (OA). Methods Fifty-two patients with knee osteoarthritis admitted to outpatient department in our hospital from September 2014 to June 2016 were enrolled in this study. All the patients were randomly divided into two groups: celecoxib (45 mg, 1/d) combined with glucosamine sulfate (50 mg, 3/d) group and diacerein (50 mg, 2/d) combined with glucosamine sulfate (50 mg, 3/d) group. The VAS score and WOMAC score were collected at 2, 4 and 12 weeks after the initial treatment. Results The VAS scores of celecoxib group and diacerein group at 2, 4, 12 weeks after operation were (2.71±1.11 vs 4.27±1.15, P=0.01), (2.71±0.76 vs 3.59±0.69, P=0.03), (2.29±1.11 vs 3.58±0.98, P=0.02), respectively. The WOMAC scores of celecoxib group and diacerein group at 2, 4, 12 weeks after operation were (57.43±13.65 vs 49.27±12.63, P=0.03), (51.43±10.60 vs 45.43±16.61, P=0.01), (52.71±15.99) vs (46.86±13.19) (P=0.01), respectively. Compared with diacerein group, celecoxib group showed decrease of VAS score while increase of WOMAC score at each time point of treatment. Conclusion Celecoxib or diacerein combined with the usage of glucosamine sulfate can significantly relieve the symptoms of KOA patients. However, diacerein shows greater improvement on function recovery while celecoxib presents better result on pain relief. The combination of diacerein and glucosamine sulfate can be a treatment plan for KOA patients.

     

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