Objective To evaluate the efficacy and safety of intra-articular injection of sodium hyaluronate and oral glucosamine and diacerein with only oral glucosamine and diacerein for knee osteoarthritis ( OA). Methods A randomized parallel-controlled clinical trial of twice methords was performed. 80 patients suffering from knee OA were randomized into 2 groups. All patients received glucosamine 3 times daily with total 1500 mg per day and diacerein one time daily with SO mg per day for 12 weeks. Observation group(40 cases)received sodium hyaluronate intra-articular injection 1 time weekly with 2. 5 ml per week for 5 weeks at same time. The Lequesne index of the knee joint, ESR, CRP and X-ray improvement were evaluated in the two groups respectively. Results At the twelfth week,the Lequesne index、in-flammation index in observation group more improved than that in control group( P < 0. 05 ). At the twenty-forth week,the Lequesne index and inflammation index in the observation group were lower than that in control group. X-ray improvement in observation group more improve than that in control group (P < 0.05). The rate of excellent effect were 80% and 52% in the observation and control groups respectively. Conclusion Diacerein combined with hyaluronate and glucosamine sulfafe provides a feasible, safety, excellent efficiency, convenient and curative effect lasting solutions for treatment of osteoarthritis and is worth clinical promotion.%目的 研究双醋瑞因、硫酸氨基葡萄糖联合透明质酸钠治疗膝骨关节炎的临床疗效.方法 将160例骨关节炎患者随机分为2组,治疗组80例给予双醋瑞因50 mg,口服,1次/天,硫酸氨基葡萄糖胶囊500 mg,口服,3次/天,共服药12周；透明质酸钠注射剂2.5ml膝关节腔内注射,每周1次,连续5周为1个疗程.对照组80例仅予双醋瑞因和硫酸氨基葡萄糖口服(剂量、疗程同前)观察治疗前、治疗后12周、24周临床疗效指标、炎性指标和影像学表现改善情况.结果 12周时2组患者在临床疗效指标、炎性指标方面较治疗前比较均显著改善(P均＜0.05)；治疗组改善程度优于对照组(P＜0.05).24周时,治疗组的临床疗效指标、炎性指标等均较治疗前改善(P＜0.05),但改善程度较12周时下降(P＜0.05),但仍优于对照组(P＜0.05),此时影像学表现方面有改善(P＜0.05)；对照组的临床疗效指标、炎性指标和影像学表现等与治疗前比较无明显改善(P＞0.05).治疗过程中,两组患者均未发生严重不良反应.结论 双醋瑞因和硫酸氨基葡萄糖联合透明质酸钠治疗膝骨关节炎是可行、安全、优效、便捷、疗效持久的方案,值得临床推广.
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