氨基葡萄糖应用于治疗椎间盘源性下腰痛的临床研究

发布时间：2018-04-26 01:39

本文选题：氨基葡萄糖 + 椎间盘源性下腰痛　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:本研究通过将氨基葡萄糖联合非甾体类抗炎药及中枢性肌松药联合应用于治疗椎间盘源性下腰痛,并对比单纯应用非甾体类抗炎药和中枢性肌松药的的疗效差异,探讨氨基葡萄糖应用于治疗椎间盘源性下腰痛的有效性、安全性,以便帮助临床医生采用相应疗法改善患者的预后。方法:在征得医院伦理委员会及患者的同意后,我们选取2015年12月一2016年8月期间就诊于莒南县人民医院骨科门诊并确诊为椎间盘源性下腰痛且符合纳入标准的的76名患者,将其随机分为实验组及对照组两组,以上各组患者的年龄、体重、病程等一般资料均无明显统计学差异。实验组我们给予口服盐酸氨基葡萄糖胶囊、非甾体类消炎药依托度酸胶囊及中枢性肌松药盐酸乙哌立松三药联合应用,对照组给予联合应用非甾体类抗炎药依托度酸胶囊及中枢性肌松药盐酸乙哌立松,两组患者治疗疗程均为12周。我们选取治疗前及治疗后12周、16周3个时间点分别从日本骨科协会(JOA)的腰痛疗效评分,相关脊柱节段的骨密度、腰椎活动度和静脉血白细胞介素-6(IL-6)的浓度变化等四个方面进行资料收集,并对各个时间点收集到的结果进行统计学分析评估。同时我们记录2组患者在治疗期间不良反应发生的情况。结果:1、通过对2组患者的研究我们发现实验组患者在治疗开始后的12周、16周时日本骨科协会(JOA)腰痛疗效评分,的骨密度、腰椎活动度和静脉血白细胞介素-6(IL-6)的浓度等方面均有明显变化,差异具有统计学意义(P0.05);2、两组患者在12周、16周时的各项数据进行比较,实验组明显优于对照组,差异明显具有统计学意义(P0.05);3、实验组在16周时的各项结果明显优于同组12周时的,差异具有统计学意义(P0.05);4、两组患者治疗期间不良反应主要为胃肠道反应,未做特殊处理。发生的例数均为4例。结论:1、氨基葡萄糖联合应用于治疗椎间盘源性下腰痛的效果优于单纯应用非甾体类消炎药和中枢性肌松药,且在停药后仍然有效,长期随访效果更好。2、氨基葡萄糖可以降低患者体内的白细胞介素-6浓度。3、同时研究者发现应用氨基葡萄糖并不增加患者的不良反应发生率,安全性良好。4、本研究中实验组患者的骨密度增加明显,但是由于影响骨密度的因素众多,本研究中没能将影响骨密度变化的其他相关因素进行剔除和分析,导致研究结果存在不准确的可能,因此氨基葡萄糖对于骨密度的影响有待观察,需在后续的研究中进一步研究证实。
[Abstract]:Objective: to study the therapeutic effects of glucosamine combined with non-steroidal anti-inflammatory drugs and central muscle relaxants in the treatment of low back pain caused by intervertebral disc origin, and to compare the therapeutic effects of only non-steroidal anti-inflammatory drugs and central muscle relaxants. To explore the efficacy and safety of glucosamine in the treatment of low back pain caused by intervertebral disc, so as to help clinicians to improve the prognosis of patients with low back pain. Methods: after obtaining the consent of the Hospital Ethics Committee and the patients, we selected 76 patients who were admitted to the Orthopaedic Clinic of Junan County people's Hospital from December 1 to August 2016 and were diagnosed as low back pain due to disc origin and met the inclusion criteria. The patients were randomly divided into two groups: experimental group and control group. There was no significant difference in age, weight, course of disease and other general data of the above groups. In the experimental group, we were given oral glucosamine hydrochloride capsule, non-steroidal indomethacin etalic acid capsule and central muscle relaxant ethylperisone hydrochloride. The control group was treated with etallic acid capsule and central muscle relaxant ethiperisone hydrochloride. The course of treatment for both groups was 12 weeks. We selected three time points from Japanese Orthopaedic Association (JOAA) before treatment and 12 weeks to 16 weeks after treatment to evaluate the efficacy of low back pain and bone mineral density of related spine segments. The data were collected from four aspects of lumbar movement and the change of interleukin-6 (IL-6) concentration in venous blood. The results collected at each time point were analyzed and evaluated statistically. We also recorded adverse reactions during treatment in both groups. Results by studying the two groups of patients, we found that the BMD of the patients in the experimental group was evaluated by the Japanese Orthopaedic Association (JOA) low back pain in 12 weeks to 16 weeks after treatment. The activity of lumbar vertebra and the concentration of interleukin-6 (IL-6) in venous blood were obviously changed, and the difference was statistically significant (P 0.05). The experimental group was better than the control group in comparing the data of the two groups at 12 weeks and 16 weeks. The difference was statistically significant (P 0.05). The results of the experimental group at 16 weeks were significantly better than those of the same group at 12 weeks. The difference was statistically significant (P 0.05). The adverse reactions of the two groups during treatment were mainly gastrointestinal reactions without special treatment. All the cases occurred in 4 cases. Conclusion the effect of combined use of glucosamine in the treatment of low back pain caused by intervertebral disc is better than that of non-steroidal anti-inflammatory drugs and central muscle relaxants, and it is still effective after withdrawal of the drugs. Long-term follow-up was better. Glucosamine reduced interleukin-6 levels in patients. The researchers found that glucosamine did not increase the incidence of adverse reactions. The safety was good. 4. The BMD of the patients in the experimental group increased significantly, but because of the many factors affecting BMD, the other related factors affecting BMD were not eliminated and analyzed in this study. The results may be inaccurate, so the effect of glucosamine on bone mineral density remains to be observed, which needs to be confirmed in further studies.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.5

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