ABSTRACT
Objective:To explore the therapeutic effect of sodium hyaluronate combined with glucosamine sulfate in the treatment of knee osteoarthritis.Methods:A total of 90 outpatients and inpatients with knee osteoarthritis who visited the Department of Orthopedics and Traumatology, Daishan County Hospital of Traditional Chinese Medicine from January to June 2020 were selected, and they were divided into sodium hyaluronate group (control group) and sodium hyaluronate combined with glucosamine sulfate group (observation group) by random number table method, with 45 patients in each group. Visual analog scale (VAS) score was used to evaluate the changes of pain in the two groups before treatment, 5 weeks and 6 months after treatment, respectively; at the same time, the total effective rate of 5 weeks and 6 months after treatment was compared between the two groups.Results:Before treatment, there was no significant difference in VAS scores [(7.4 ± 1.5) vs (7.3 ± 1.7) points] between the two groups ( t = 0.24, P = 0.812); at 5 weeks [(5.3 ± 1.1) vs (4.1 ± 1.2) points] and 6 months after treatment [(4.0 ± 0.8) vs (3.2 ± 0.9) points], the VAS scores of the observation group were significantly lower than those of the control group, and the differences were statistically significant ( t = 5.54, 5.32, P < 0.001). Compared with the same group before treatment, VAS scores were lower in the two groups at 5 weeks and 6 months after treatment, and the differences were statistically significant ( P < 0.05). At 5 weeks after treatment, there was no significant difference in the total effective rates [44.4% (20/45) vs 48.9% (22/45)] between the two groups (χ 2 = 0.18, P = 0.672); at 6 months after treatment, the total effective rate of the observation group (91.1%, 41/45) was significantly higher than that of the control group (66.7%, 30/45), and the difference was statistically significant (χ 2 = 8.07, P = 0.004). Conclusion:Sodium hyaluronate combined with glucosamine sulfate can significantly reduce the pain in patients with knee osteoarthritis, the total effective rate is higher, and is better than the effect of sodium hyaluronate alone.
ABSTRACT
Objective:To observe and compare the therapeutic effects of glucosamine sulfate (GS) and diacerein (DCN) on adult Kashin-Beck disease (KBD).Methods:A clinical randomized controlled trial was conducted in the historical severe KBD areas Fanrong Township, Fulu Town, Long'anqiao Town, Lianghe Town, Shaowen Township of Heilongjiang Province, and 240 patients were selected according to the criteria of "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), then divided into GS and DCN groups (gender, age, and KBD condition balanced) via the random number table method, with 120 patients in each group. Followed up once a month to investigate the patient's medication and clinical symptoms, and distributed drugs for the next stage. Fasting blood samples and urine samples were collected before, during, and at the end of treatment (0, 90, and 180 days). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum interleukin (IL)-1β level and urine pyridinol (PYD) level. Visual analog scale (VAS) scores, evaluation of affected joints, self-evaluated efficacy, and evaluation of adverse reactions were carried out through questionnaires. Joint dysfunction scores and medications efficacy determination were performed according to the "Judgment of Kaschin-Beck Disease Treatment Effect" (WS/T 79-2011).Results:Expression of cytokines related to cartilage metabolism: after 180 days of treatment, serum IL-1β levels, urine PYD levels in GS group and urine PYD levels in DCN group were lower than those in the same group at 0 day of treatment ( Z = - 2.332, - 5.420, - 5.204, P < 0.05). VAS scores: after 90 days of treatment, the pain, stiffness scores of patients in GS group and the pain, stiffness, and function scores in DCN group were lower than those in the same group at 0 day of treatment ( Z = - 2.612, - 2.359, - 3.637, - 2.881, - 2.238, P < 0.05); after 180 days of treatment, the pain, stiffness and function scores of patients in GS and DCN groups were significantly lower than those of the same group at 0 day of treatment ( Z = - 6.738, - 9.530, - 7.781, - 5.428, - 3.761, - 3.587, P < 0.01). Evaluation of affected joints: after 90 and 180 days of treatment, except for pain of weather changes in DCN group, the scores of symptomatic joints in the two groups were lower than those at 0 day of treatment ( P < 0.05). Efficacy self-evaluation: after 180 days of treatment, the self-evaluated efficacy ratio of DCN group was higher than that of GS group and the same group after 90 days of treatment (χ 2 = 4.165, 4.022, P < 0.05). Evaluation of adverse reactions: after 90 and 180 days of treatment, the main adverse reactions of patients in GS and DCN groups were gastrointestinal symptoms. Joint dysfunction scores: after 90 days of treatment, the sum of the effective rate and the markedly effective rate of GS group was higher than that of DCN group (χ 2 = 4.993 , P < 0.05); while after the 180 days of treatment, there was no significant difference between the two groups (χ 2 = 0.417 , P > 0.05). Conclusions:Both GS and DCN have a certain therapeutic effect on adult KBD and can improve clinical symptoms. The GS takes effect quickly, and long-term use can protect cartilage from inflammatory factors to a certain extent.
ABSTRACT
Objective:To observe and compare the efficacy and safety of glucosamine sulfate (GS) and chondroitin sulfate (CS) in the treatment of adult Kashin-Beck disease (KBD), so as to provide effective medical evidence for the standardized treatment of adult KBD.Methods:A clinical randomized controlled trial was conducted in Fuyu County and Shangzhi City, KBD historical seriously ill areas in Heilongjiang Province. A total of 247 patients were selected according to the standard of "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010). According to gender, age and KBD condition, they were randomly divided into GS and CS groups, 124 and 123 respectively. Follow up once a month to investigate the medication and clinical symptoms of patients, and distribute drugs for the next stage. Fasting blood and urine samples were collected before, during and at the end of treatment (0, 90 and 180 d). Serum interleukin (IL)-1β content and urine pyridine (PYD) level were measured by enzyme-linked immunosorbent assay (ELISA). The visual analogue scale (VAS) score, affected joints, self-evaluation of curative effect and side effects were evaluated through the questionnaire, joint dysfunction and drug efficacy were evaluated according to the criteria of "Evaluation of Therapeutic Effect of Kashin-Beck Disease" (WS/T 79-2011).Results:Expression of cytokines related to cartilage metabolism: at 180 d of treatment, serum IL-1β contents and urinary PYD levels in GS and CS groups were lower than those at 0 d of treatment ( Z = - 2.461, - 2.160, - 5.075, - 5.471, P < 0.05). VAS score: at 90 and 180 d of treatment, the scores of knee pain, stiffness and function in GS and CS groups were lower than those at 0 d of treatment ( P < 0.05); and at 180 d of treatment, the scores of knee stiffness and function in GS group were lower than those in CS group ( P < 0.05). Evaluation of affected joints: at 90 and 180 d of treatment, the scores of joint pain, swelling and stiffness in GS and CS groups were lower than those at 0 d of treatment ( P < 0.05). Self-evaluation of curative effect: at 180 d of treatment, the self-evaluation of curative of CS group were better than that at 90 d of treatment (χ 2 = 9.376, P < 0.05). Evaluation of side effects: at 90 and 180 d of treatment, the side effects in GS and CS groups were mainly gastrointestinal symptoms. Joint dysfunction score: at 90 d of treatment, the sum of effective rate and markedly effective rate in GS group was higher than that in CS group (χ 2 = 4.042, P < 0.05), but there was no significant difference between the two groups at 180 d of treatment (χ 2 = 0.869, P > 0.05). Conclusion:GS and CS have certain therapeutic effects on adult KBD, which can improve symptoms and reduce serum IL-1β content and urinary PYD level, but GS takes effects quickly, and its effect on improving joint stiffness and function are better than CS.
ABSTRACT
Objective To investigate the effect of knee joint injection of sodium hyaluronate combined with oral administration of diacerein and/or glucosamine sulfate on knee joint of Kaschin-Beck disease.Methods The method of prospective study was used,80 patients with Kaschin-Beck disease admitted to the General Internal Medicine,Guang'an People's Hospital from January 2015 to December 2017 were selected as subjects.They were divided into 4 groups according to the difference of their medication methods,20 cases per group.Group A was treated with intra-articular injection of sodium hyaluronate,Group B was treated with intra-articular injection of sodium hyaluronate + oral diacerein,Group C was treated with intra-articular injection of sodium hyaluronate + oral glucosamine sulfate,Group D was treated with intra-articular injection of sodium hyaluronate + oral diacerein and glucosamine sulfate,and the overall therapeutic effects of the 4 groups were compared.Results The knee joint scores of Group D at 7,14,90,and 180 days after treatment were (6.25 ± 2.01),(4.22 ± 1.15),(2.21 ± 1.01),and (1.15 ± 0.15) scores,respectively,they were significantly lower than those of Group A [(12.11 ± 3.02),(11.91 ± 2.98),(11.85 ± 2.85),(11.05 ± 2.52) scores],Group B [(9.11 ± 2.85),(8.32 ± 2.45),(7.55 ± 2.32),(6.15 ± 2.01) scores] and Group C [(9.12 ± 2.84),(8.23 ± 2.32),(7.43 ± 2.29),(6.11 ± 2.00) scores],the differences were statistically significant (P ＜ 0.05).The total effective rates of the 4 groups were 60％ (12/20),65％ (13/20),70％ (14/20),and 90％ (18/20),respectively,Group D was significantly higher than those of other 3 groups (x2 =18.250,18.250,16.000,P ＜ 0.05).The scores of 20 m walking pain and joint tenderness in Group D after treatment and follow-up period were lower than those of other 3 groups (P ＜ 0.05).Conclusions In the clinical practice of Kaschin-Beck disease,intra-articular injection of sodium hyaluronate combined with oral diacerein and glucosamine sulfate can improve the knee joint function of patients,alleviate pain and enhance the overall therapeutic effect.The combined therapy has great clinical value.
ABSTRACT
Aim: To determine the pharmacokinetics and bioavailability of glucosamine after administration of glucosamine hydrochloride (GH) and glucosamine sulfate (GS). Methods: GH or GS was given ig and iv to rats, respectively. An LC-MS/MS method was developed to measure the concentrations of glucosamine in plasma. DAS 3. 0 was employed to obtain the pharmacokinetical parameters as well as bioavailability. Results: There was no marked difference in T1/2, Vz and absolute availability between GH and GS. However, the relative bioavailability of GH was higher than that of GS. In addition, Tmax of GS was shorter than that of GH. Conclusion: There are some differences between the glucosamine pharmacokinetics of GH and GS.
ABSTRACT
OBJECTIVE: The growth plate consists of organized hyaline cartilage and serves as a scaffold for endochondral ossification, a process that mediates longitudinal bone growth. Based on evidence showing that the oral administration of glucosamine sulfate (GS) and/or chondroitin sulfate (CS) is clinically valuable for the treatment of compromised articular cartilage, the current study evaluated the effects of these molecules on the tibial epiphyseal growth plate in female rats. METHOD: The animals were divided into two control groups, including vehicle treatment for 45 days (GC45) and 60 days (GC60) and six ovariectomized (OVX) groups, including vehicle treatment for 45 days (GV45), GS for 45 days (GE45GS), GS+CS for 45 days (GE45GS+CS), vehicle for 60 days (GV60), GS for 60 days (GE60GS) and GS+CS for 60 days (GE60GS+CS). At the end of treatment, the tibias were dissected, decalcified and processed for paraffin embedding. Morphological and morphometric methods were employed for analyzing the distal tibial growth plates using picrosirius red staining and the samples were processed for histochemical hyaluronan detection. Morphometric analyses were performed using the 6.0ProPlus¯ Image system. RESULTS: Notably, after 60 days of treatment, the number of proliferative chondrocytes increased two-fold, the percentage of remaining cartilage increased ...
Subject(s)
Animals , Female , Rats , Cartilage, Articular/drug effects , Chondroitin Sulfates/pharmacology , Glucosamine/pharmacology , Growth Plate/drug effects , Ovariectomy , Osteogenesis/drug effects , Tibia/drug effects , Analysis of Variance , Cartilage, Articular/growth & development , Drug Therapy, Combination , Hyaluronic Acid/analysis , Immunohistochemistry , Random Allocation , Reproducibility of Results , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: To compare glucosamine sulfate with placebo in the management of osteoarthritis. DESIGN: Therapeutic Controlled Trial-Single Blind. SETTING: Out Patient Department of Quezon City General Hospital. STUDY SUBJECTS: Patients aged 50 years old and above who satisfied the clinical criteria for idiopathic knee osteoarthritis. INTERVENTIONS: Subjects were randomly assigned to receive either Glucosamine sulfate (Viartril-S) 500 mg/cap taken three times a day for four weeks or a piacebo taken three times also for four weeks upon admission to the study. MEASUREMENTS: Thorough history taking was done giving particular attention on the knee pain plus the clinical criteria for idiopathic osteoarthritis of the knee. They were randomly assigned to receive either glucosamine sulfate 500 mg/cap or placebo. They were allowed to use their current analgesic for rescue analgesia and continue any form of alternative therapy currently being practiced. Scheduled follow-ups were done after 2 weeks and after 4 weeks from the start of the study period. Visual Analog Scale (VAS) was used to assess for global pain and Western Ontario McMaster Universities (WOMAC) Osteoarthritis Index to assess for pain, stiffness and physical function during the study period. These were done on the first and second follow-up. Subject clinical progress was recorded on the same checklist or data collection forms based on the two scheduled follow-ups. Adverse events were also noted on each follow-up, though study subjects were instructed to have a check-up any day from the start of treatment for instances of occurrence of adverse reactions. RESULTS: A total of 42 patients were screened for eligibility to the study. Six (14.28 percent) were excluded from the study, 4 (9.5 percent) did not fulfill the inclusion criteria and 2 (4.76 percent) declined to be included. From this, 36 (85.71 percent) subjects were enrolled in the study, 18 (50 percent) were placed in Group A (Glucosamine sulfate) and 18 (50 percent) were placed in Group B (Placebo). The prototype of the study subjects with knee osteoarthritis is belonging to age group 51-60 years (Group A = 72.2 percent; Group B = 83.3 percent). Both groups have 9 (50 percent) females and 9 (50 percent) males. Majority of the study subjects are overweight with a BM1 = 25-29.9 kg/m2, (Group A = 66.7 percent; Group B = 66.7 percent), with blue-collar jobs previously (Group A = 100 percent; Group B = 85.3 percent), presently unemployed or housewives (Group A = 77.8 percent; Group B = 66.7 percent) and reached high school (Group A = 88.9 percent; Group B = 50 percent). Most of the subjects in Group A have less than 1 year history of knee osteoarthritis, while in Group B, most of the subjects have history of knee osteoarthritis for 2 years. For both groups, 18 (100 percent) in Group A and 18 (100 percent) in Group B came for their scheduled follow-ups. A total of 36 participants completed the trial. After 4 weeks of the study period, subjects in Group A had a 40 percent decrease from the baseline on VAS scores in contrast to Group B which only has 17.15 percent decrease from the baseline score. The pain dimension on WOMAC in Group A had a decrease from baseline of 57.8 percent, while in Group B there was a decrease of only 12.41 percent from the baseline score. At 4 weeks after treatment, though not statistically significant, Group A had a greater decrease from its baseline stiffness and physical function scores (51 percent) and (58 percent), respectively than Group B (17.07 percent) and (8.4 percent), respectively. Both modes of treatment were well tolerated, with Group A having 22.2 percent occurrence of adverse effects and Group B having 27.8 percent. Adverse events experienced by the study subjects in Group A are cold, headache, constipation and diarrhea. While in Group B, two experienced colds and 1 developed abdominal pain. All adverse events for both groups occurred on the first day of treatment and lasted for only one day. No management was required for these adverse events because all were spontaneously resolved. CONCLUSION: Despite the greater decrease of scores in VAS and WOMAC in group A, glucosamine sulfate use may not be cost-effective.
Subject(s)
Humans , Male , Female , Aged , Middle Aged , Osteoarthritis, Knee , Glucosamine , Constipation , Analgesics , Pain Management , Knee Joint , Abdominal Pain , Headache , Analgesia , Diarrhea , OverweightABSTRACT
The publish summarized three latest systemic reviews and given details of the landmark trail on glucosamine sulfate introduce the yesterday, today and a good future of disease modifying drug for osteoarthritis (DMOAD) on a view. It will helpful to promote the clinical, the assessment and the developing of DMOAD in China.
ABSTRACT
Objective To study the hygroscopicity of glucosamine sulfate powder.Methods Hygroscopic studies were conducted on glucosamine sulfate powder at 5℃ and 30℃ used gravimetric method,determined the equilibrium moisture content(EMC) and drew the moisture sorption isotherms.The experimental values were regressed using the BET model,calculated the monolayer moisture content.Results At 30℃,when water activity exceeded 0.43,samples agglomerated,browned and lose adsorbed water,EMC declined;At 5℃,the isotherm had typical ob-S shape,the EMC increased with water activity raising.At 30℃ and 5℃,the monolayer moisture content were 4.8633,5.5740g/100g respectively.Conclusion At 5,30℃ the appropriate aw for storage appeared to be below 0.3056,0.2784,respectively.
ABSTRACT
Objective To study the stability of glucosamine sulfate prepared by spray drying. Methods The microcapsules of glucosamine sulfate were produced by spray drying,and the effects of different adjuvants on the indices of the microcapsules,such as the yield,fluidity,glass transition temperature and store stability were compared. Results and conclusion The yield,fluidity,glass transition temperature and stability of glucosamine sulfate could be greatly improved by adding 0.5%,1.0%,2.0%,3.0% and 5.0% cyclodextrin,gelatin and copvidone.