骨关节炎:现代治疗的可能性

Y. Filatova, M. Ilyin, I. N. Soloviev
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引用次数: 3

摘要

本文讨论骨关节炎(OA)的治疗方法。近几十年来,关于OA发病机制的观点发生了重大变化。如果在研究开始时,OA被认为是一种与年龄相关的退行性过程,那么现在我们已经了解了这种疾病的一些免疫学和遗传学方面,OA的发病机制已经改变了。目前,专业团体制定了临床指南,定义了OA患者的诊断和治疗方法。在俄罗斯,风湿病学家和骨科创伤学家协会于2021年制定了关节病和关节关节病患者管理的临床指南,但目前尚未就使用营养保健品和膳食补充剂的任何治疗建议达成明确的共识。根据已发表的从天然产品中开发的植物和植物营养保健品的研究,与安慰剂药物相比,其疗效和治疗OA患者的潜力的数据已经得到证实。根据N.E. Lane等人的研究,OA患者经常使用补充剂,以及非处方药与处方药联合使用,并且使用处方药的可能性随着OA病程和严重程度的增加而增加。目前还没有足够的知识和信息说明在治疗患者时额外使用营养药品的可能性。本文讨论了具有抗炎、抗分解代谢和抗增殖作用的生物活性添加剂的组成,可考虑作为非甾体抗炎药、硫酸软骨素、糖胺(硫酸或盐酸)及其联合治疗OA的添加剂。II型胶原肽、姜黄素(姜黄素95%)、黑胡椒提取物(胡椒碱)和乳香提取物在临床研究中已经证明了治疗OA患者的有效性和安全性。一些研究也发现了一些多效性效应。抗炎、神经保护、免疫调节、心脏保护和抗肿瘤等作用对合并症患者将是重要的。
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Osteoarthritis: modern possibilities of therapy
The article discusses the treatment of osteoarthritis (OA). In recent decades, ideas about the pathogenesis of OA have undergone significant changes. If at the dawn of the study OA was presented as a degenerative process associated with age, now that some immunological and genetic aspects of the disease have become known, the idea of the pathogenesis of OA has changed. Currently, there are clinical guidelines developed by professional communities that define approaches to the diagnosis and treatment of patients with OA. In Russia, the Association of Rheumatologists and Orthopedic Traumatologists in 2021 developed clinical guidelines for the management of patients with gonarthrosis and coxarthrosis, but currently no clear consensus has been developed in any of the treatment recommendations regarding the use of nutraceuticals and dietary supplements. While according to published studies of plant and botanical nutraceuticals developed from natural products, promising data on efficacy compared to placebo drugs and their potential for the treatment of patients with OA have been demonstrated. According to a study conducted by N.E. Lane et al., patients with OA regularly use supplements, as well as over-the-counter products in combination with prescription drugs, and the likelihood of using prescription products increases with increasing duration and severity of OA. And currently there is not enough knowledge and information about the possibilities of additional use of nutraceuticals in the treatment of patients. The article discusses the composition of the biologically active additive, which has anti-inflammatory, anti-catabolic and antiproliferative effects and can be considered as an addition to NSAIDs, chondroitin sulfate, glycosamine (sulfate or hydrochloride) and their combinations in OA. Type II collagen peptide, curcumin (curcuminoids 95%), black pepper extract (piperine) and Boswellia pilchata extract in clinical studies have demonstrated efficacy and safety in the treatment of patients with OA. A number of studies have also found a number of pleootropic effects. Effects such as anti-inflammatory, neuroprotective, immunomodulatory, cardioprotective and antitumor effects will be important in patients with comorbidity.
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