發(fā)布時間：2018-04-26 01:39

  本文選題：氨基葡萄糖 + 椎間盤源性下腰痛　； 參考：《青島大學》2017年碩士論文

【摘要】：目的:本研究通過將氨基葡萄糖聯(lián)合非甾體類抗炎藥及中樞性肌松藥聯(lián)合應用于治療椎間盤源性下腰痛,并對比單純應用非甾體類抗炎藥和中樞性肌松藥的的療效差異,探討氨基葡萄糖應用于治療椎間盤源性下腰痛的有效性、安全性,以便幫助臨床醫(yī)生采用相應療法改善患者的預后。方法:在征得醫(yī)院倫理委員會及患者的同意后,我們選取2015年12月一2016年8月期間就診于莒南縣人民醫(yī)院骨科門診并確診為椎間盤源性下腰痛且符合納入標準的的76名患者,將其隨機分為實驗組及對照組兩組,以上各組患者的年齡、體重、病程等一般資料均無明顯統(tǒng)計學差異。實驗組我們給予口服鹽酸氨基葡萄糖膠囊、非甾體類消炎藥依托度酸膠囊及中樞性肌松藥鹽酸乙哌立松三藥聯(lián)合應用,對照組給予聯(lián)合應用非甾體類抗炎藥依托度酸膠囊及中樞性肌松藥鹽酸乙哌立松,兩組患者治療療程均為12周。我們選取治療前及治療后12周、16周3個時間點分別從日本骨科協(xié)會(JOA)的腰痛療效評分,相關脊柱節(jié)段的骨密度、腰椎活動度和靜脈血白細胞介素-6(IL-6)的濃度變化等四個方面進行資料收集,并對各個時間點收集到的結果進行統(tǒng)計學分析評估。同時我們記錄2組患者在治療期間不良反應發(fā)生的情況。結果:1、通過對2組患者的研究我們發(fā)現(xiàn)實驗組患者在治療開始后的12周、16周時日本骨科協(xié)會(JOA)腰痛療效評分,的骨密度、腰椎活動度和靜脈血白細胞介素-6(IL-6)的濃度等方面均有明顯變化,差異具有統(tǒng)計學意義(P0.05);2、兩組患者在12周、16周時的各項數(shù)據(jù)進行比較,實驗組明顯優(yōu)于對照組,差異明顯具有統(tǒng)計學意義(P0.05);3、實驗組在16周時的各項結果明顯優(yōu)于同組12周時的,差異具有統(tǒng)計學意義(P0.05);4、兩組患者治療期間不良反應主要為胃腸道反應,未做特殊處理。發(fā)生的例數(shù)均為4例。結論:1、氨基葡萄糖聯(lián)合應用于治療椎間盤源性下腰痛的效果優(yōu)于單純應用非甾體類消炎藥和中樞性肌松藥,且在停藥后仍然有效,長期隨訪效果更好。2、氨基葡萄糖可以降低患者體內的白細胞介素-6濃度。3、同時研究者發(fā)現(xiàn)應用氨基葡萄糖并不增加患者的不良反應發(fā)生率,安全性良好。4、本研究中實驗組患者的骨密度增加明顯,但是由于影響骨密度的因素眾多,本研究中沒能將影響骨密度變化的其他相關因素進行剔除和分析,導致研究結果存在不準確的可能,因此氨基葡萄糖對于骨密度的影響有待觀察,需在后續(xù)的研究中進一步研究證實。
[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.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R681.5

【參考文獻】

相關期刊論文 前10條

1 韋健;周建飛;洪定鋼;;氨基葡萄糖硫酸鹽對兔膝關節(jié)骨關節(jié)炎的保護作用研究[J];現(xiàn)代藥物與臨床;2016年08期

2 曹春風;王群波;盧e，

本文編號：1803934