以實證醫學方法探討葡萄糖胺類製劑治療膝關節炎之效果

Evidence-Based Practice: Review of Clinical Evidence on the Efficacy of Glucosamine in the Treatment of Knee Osteoarthritis

譚著文(Chu-Wen Tan) ； 李妙紋(Miao-Wen Li) ； 洪紹寧(Shao-Ning Hung)

《醫學與健康期刊》 2卷1期附冊 (2013/09) Pp. 31-39

摘要

退化性關節炎是導致成年人關節疼痛最普遍的骨骼肌肉疾病，危險因子包括遺傳、女性、關節創傷後、老年人及肥胖者。退化性關節炎主要症狀為疼痛，典型症狀為活動時疼痛加劇，休息時則緩解。治療退化性關節炎的目標為控制關節疼痛、腫脹，從而改善生活品質，但沒有特定藥物能預防關節持續退化。治療退化性關節炎，藥物方面包括止痛藥、非類固醇止痛消炎藥、關節注射、關節沖洗及手術治療等。在臨床上亦廣泛使用葡萄糖胺及軟骨素來延緩關節退化的不適症狀。最近幾年，不少臨床研究以實證醫學方法審視葡萄糖胺及軟骨素在退化性關節炎的效果。在高品質研究中發現，相關產品在臨床上並無明確證據顯示有療效。研究發現其安全性與安慰劑並無差異。這篇主要目的是總結相關研究證據來評估葡萄糖胺、軟骨素對膝部退化性關節炎患者的臨床效用。

關鍵字

退化性關節炎 ； 關節疼痛 ； 葡萄糖胺 ； 軟骨素 ； 實證醫學

並列摘要

Osteoarthritis (OA) is one of the most prevalent musculoskeletal diseases cause of joint pain and disability in adults. Risk factors include genetics, female sex, past trauma, advancing age, and obesity. The principle symptom associated with OA is pain, which is typically exacerbated by activity and relieved by rest. The goals of management of patients with OA are to control joint pain and swelling, improving the quality of life, but there are no specific pharmacologic therapies that can prevent the progression of OA. The major pharmacologic modalities used in the treatment of OA, including analgesics, nonsteroidal anti inflammatory drugs (NSAIDs), intraarticular injection, joint irrigation and surgical approaches to the treatment of OA. Glucosamine sulfate / hydrochloride and Chondroitin are symptomatic slow-acting drugs for OA widely used in clinic. In recent years, many published clinical studies of glucosamine sulfate/hydrochloride and chondroitin on OA are reviewed within the context of evidence-based medicine. The high quality trials had shown little to no evidence of clinically meaningful benefit. Almost every included trial has found the safety of these compounds to be equal to placebo.m The aim of this review summarizes the evidence to assess the clinical effectiveness of glucosamine sulfate/hydrochloride and chondroitin in patients with knee OA.

並列關鍵字

Osteoarthritis ； Joint pain ； Glucosamine ； Chondroitin ； Evidence-based medicine