Comparative Studies On The Treatment Of Knee Osteoarthritis With Sodium Hyaluronate And Glucosamine Hydrochloride

Research ObjectiveThe knee osteoarthritis (KOA) is a common clinical disease, especially among old people and women. The main clinical symptoms are pain, swelling in the knees and disorder in their functions. No effective therapeutic methods are available, most therapeutic ways are to reduce the pain, alleviate clinical symptoms and protect the functions of knees. Nonoperation treatment is generally employed in the early stage of the disease, operation is strongly recommended in the late stage. Drugs and physical means are given priority in nonoperation treatment. Although the methods mentioned above are effective to some extent, lacking of lasting effectiveness and possessing serious side effects are the drawbacks of the methods. Thus, a more effective and lasting way to treat the knee osteoarthritis is urgently needed in clinical practice.Sodium Hyaluronate(SH) is used to treat KOA because it can moisture the the knees, Glucosamine Hydrochloride(GH) is also used in KOA treatment because it can repair the knee cartilage. But SH and GH is used separately in KOA treatment, no report on the combination of the two in clinical practice. Therefore, the present study is explore the efficacy of combination of SH and GH and compare the combined efficacy with that of SH and GH respectively in KOA treatment.MethodsSubjects:210 patients who came to Longnan hospital of Daqing during June 2007 to June 2008 because of KOA, among them, outpatient 181, in patient 19; male 101, female 109; aged 40 to 70, average age 60±3.5. Diseases duration 3 months to 15 years. Light 67 cases, medium 92 cases and serious 51 cases. Groups:.The subjects were randomly classified into A, B, C group with their case number..62 patients in group A were to be administered SH; 70 patients in group B were to be administered GH; 78 patients in group C were to be administered SH and GH.Administration method: Patients in group A were to be given SH through intraarticular injection, once a week, 25mg per time, five times for the whole treatment period. Patients in group B were to be given GH through ingestion, three times a day, two tablets per time for 5 weeks. Patients in group C were to be given SH and GH combinalby.Evaluation standards: knees pain was evaluated by simplied McGee pain assessment method. Knees swelling was evaluated by WOMAC osteoarthritis index Knees functions assessment is based on the lingzhixiong's methods.Evaluation on the knee pain and function: Patients get score based on the evaluation standards, the treatment efficacy was compared by calculating the score difference before and after treatment.Curative Effects Assessment: improving index =(Scores before treatment-scores after treatment)/scores before treatment. Significantly effective: improving index≥0.75 Effective: 0.50≤improving index < 0.75 Improved: 0.25≤improving index < 0.50 Not effective: improving index <0.25 or worseningAll the data were to be entered excel to establish a data base, statistical analyses were to be done by SPSS 12.0, measurable data analyses were done by variance analyses; ranked data by rank sum test.ResultsPatients treated by SH alone had higher difference scores for knee pain than that by GH alone(P﹤0.01); Patients treated by combination of SH and GH had much more higher difference scores than those by SH or GH alone(P﹤0.01).Patients in group A had higher difference score than those in group B, patients in group C had much more higher difference score than those in group A or group B(P﹤0.01), which showed that combination of SH and GH is better than either of them. Patients in group A had shorter period of time in knee swelling than those in group B, patients in group C had much more shorter period of time in knee swelling than those A or B group(P﹤0.01). The duration of producing effects for SH alone averaged at 7 days, for GH 8.5 days, for combination of SH and GH 5.5 days. The duration of efficacy lasting in group A was longer than that in group B, it was much longer in group C than that in group A or group B. Knee scoring, swelling alleviating and functions all showed that the combination of SH and GH would produce better effects on the treatment of KOA.ConclusionSH alone through intraarticular injection for the treatment of KOA is effective in improving knees pain, swelling and movement.GH alone is effective in improving knees pain and movement limitation, but for function improvement and lasting efficacy is not as effective as the other two groups. Combination of SH and GH for the treatment of KOA is better than SH or GH alone, combined application of SH and GH is characterized by producing effects early, efficacy lasting longer and effectiveness bettering.The results in the present study demonstrate that combination of SH and GH is better than SH or GH alone.