- 期刊
葡萄糖胺治療骨關節炎的風險與效益
Risk and Benefit of Glucosamine for Osteoarthritis of the Knee
摘要
骨關節炎是相當常見的一種疾病。在美國，至少有兩千萬人為此所苦。老年人口中，骨關節炎也是造成日常行動不便的最主要原因之一。目前骨關節炎疼痛的治療主要還是以非類固醇抗發炎藥物（Non-steroidal anti-inflammatory drugs，簡稱：NSAIDs）為主，不過該類藥物所造成的腸胃不適副作用卻也大幅降低了病人服藥的順從性。近年來，大眾媒體的鼓吹下，在美國屬於補充性食品的葡萄糖胺(glucosamine)，則掀起了另一波治療／保養骨關節的風潮。在早期，許多由藥廠資助的臨床試驗結果顯示：葡萄糖胺是有助於改善骨關節炎病情的，但是越來越的證據顯示：葡萄糖胺的療效仍須再被仔細評估。最近一次由美國國家衛生研究院資助的大規模臨床試驗結果顯示：葡萄糖胺並無法有效地緩解骨關節炎造成的疼痛。本文中，我們將對葡萄糖胺的使用、可能之作用機轉、定位與管理、不良反應通報…等部份，做一系統的回顧。
並列摘要
Osteoarthritis is one of the most common diseases and affects at least 20 million Americans and the disease is more common among women than men. Risk factors include obesity, previous knee surgery, knee injury and occupational lifting. Currently available therapies address the treatment of pain in patients with osteoarthritis and the use of non-steroidal anti-inflammatory drugs (NSAIDs) are the most efficacious and popular approach than any other therapy. However, there are some questions about the safety of NSAIDs, especially in the light of recent reports of cardiovascular risk. Glucosamine, an amino-monosaccharide component of cartilage, has been used to treat osteoarthritis recently. Some reports from industry-sponsored trials have suggested the efficacy of glucosamine for osteoarthritis, but questions have been raised about the scientific quality of these trials. Since glucosamine is relatively safe, the treatment could be useful even if it only shows a low level of efficacy and for that reason glucosamine has become quite popular. However, one recent independent trial sponsored by NIH indicated that glucosamine alone did not result in an overall effective reduction in pain among a group of patients with osteoarthritis. In this article, we review the complexities associated with the testing of this compound and discuss the fact that more research is necessary in order to identify whether glucosamine is an effective treatment for osteoarthritis.