氨基葡萄糖+软骨素联合治疗骨关节炎的文献分析。

Wojciech Marczyński, Witold Tłustochowicz, Wiesław Tomaszewski, Jerzy Białecki
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引用次数: 1

摘要

关节质量的一个重要组成部分是软骨。因此,保护好这一点是保持各关节状态的先决条件。关节软骨存在的评估是通过站立位置的两个关节的x光片显示的。根据Kellgren和Lawrence分级,软骨损伤可分为1、2和3级。医生面临的挑战是根据循证骨科/创伤学的原则确定OA的原因,而不仅仅是对症治疗,这通常是无效的。为了客观地呈现治疗方法、适应症和实施周期,从生物学角度讲,通过对软骨组织损伤原因的分析和适应症得出的软骨组织的需求是合理的保护方法。在实施关节软骨保护的过程中,生物力学和生物学因素是重要的。生物力学因素包括:肢体轴线障碍、长度差异、支撑四边形、骨盆三角形和肩三角形水平的扭曲,以及由莱昂纳多·达·芬奇(Leonardo da Vinci)所说的Fi数节段比例紊乱引起的平衡障碍。所讨论的疾病有许多生物学因素,它们涉及关节软骨结构状态、基质结构、基质生物物理因素、分子海绵机制、软骨细胞、软骨营养和骨关节炎(OA)的严重程度。受损关节软骨的生物成分状况的改善被认为是基本的,并且涉及到软骨保护对许多软骨基质蛋白的积极影响。这种治疗方法包括使用硫酸软骨素和氨基葡萄糖作为药物,根据关节软骨的退化程度,以适当的剂量和较长的时间一起给药,通常需要几个月到几个月。硫酸软骨素与氨基葡萄糖的结合比单独的每种制剂能激活更多的基质蛋白。硫酸软骨素和氨基葡萄糖的药动学呈阳性,有利于其保护软骨的作用。硫酸软骨素和葡萄糖胺的药物蛋白质组学是由尽可能多的关节软骨基质蛋白激活引起的。蛋白质组学技术的发展创造了全新的治疗可能性,并被用于研究单个分子的作用。一个具有临床意义的事实是,软骨素和氨基葡萄糖都是骨组织和关节软骨的天然内源性成分,因此这两种药物的使用在生物上是相容的,并产生许多软骨保护因素。
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Literature Analysis Regarding the Combination of Substances: Glucosamine + Chondroitin in the Treatment of Osteoarthritis.

An essential component of joint quality is cartilage. Therefore, the protection of this is a prerequisite for maintaining the condition of each joint. The assessment of the presence of articular cartilage is shown by X-ray of both joints in the standing position. Cartilage protection is possible for 1, 2 and 3 degree of cartilage damage according to the Kellgren and Lawrence scale.The challenge for the physician is to identify the cause of OA in accordance with the principles of Evidence Based Orthopedics/Traumatology, and not merely treat symptomatically, which is usually ineffective.In order to objectively present treatment methods, indications and the period of their implementation, it is biologically reasonable to refer to the needs of cartilage tissue resulting from the analysis of the causes of its damage and indications for justified methods of its protection.Biomechanical and biological elements are important in the process of implementing articular cartilage protection.The biomechanical elements are: limb axis disorders, differences in length, distortions at the level of the support quadrilateral, pelvic triangle and shoulder triangle, as well as balance disorders resulting from disturbances in the segmental proportion of the Fi number according to Leonardo da Vinci.There are many biological elements of the discussed disorder and they concern: the state of articular cartilage structure, matrix structure, matrix biophysical elements, molecular sponge mechanism, chondrocytes, cartilage nutrition and the severity of osteoarthritis (OA).The improvement of the conditions of the biological elements of damaged articular cartilage is considered fundamental and concerns the positive impact on numerous cartilage matrix proteins by chondroprotection. This element of treatment consists in the use of chondroitin sulphate and glucosamine as a drug, administered together in the appropriate dose and for a long time depending on the degree of degradation of the articular cartilage, usually from several to several months. The combination of chondroitin sulfate with glucosamine causes the activation of a much larger number of matrix proteins than each of the preparations separately.The pharmacokinetics of chondroitin sulfate and glucosamine are positive and favor their chondroprotective effect.The pharmacoproteomics of chondroitin sulfate and glucosamine administered together result from the activation of as many joint cartilage matrix proteins as possible. The development of proteomic techniques creates completely new therapeutic possibilities and is used to study the action of individual molecules.A clinically significant fact is that both chondroitin and glucosamine are natural, endogenous components of bone tissue and articular cartilage, so the use of both drugs is biologically compatible and results in numerous elements of cartilage protection.

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来源期刊
Ortopedia, traumatologia, rehabilitacja
Ortopedia, traumatologia, rehabilitacja Medicine-Rehabilitation
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26
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