Thie N M, Prasad N G, Major P W
Orofacial Pain Clinic, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
J Rheumatol. 2001 Jun;28(6):1347-55.
To compare the treatment potential of glucosamine sulfate (GS) and ibuprofen in patients diagnosed with temporomandibular joint (TMJ) osteoarthritis (OA).
Forty women and 5 men received either GS (500 mg tid) or ibuprofen (400 mg tid) for 90 days in a randomized double blind study.
TMJ pain with function, pain-free, and voluntary maximum mouth opening, Brief Pain Inventory (BPI) questionnaire and masticatory muscle tenderness were performed after a one week washout and at Day 90. Acetaminophen (500 mg) dispensed for breakthrough pain was counted every 30 days to Day 120.
In total, 176 adults were interviewed, 45 (26%) qualified, 39 (87%) completed the study (21 GS, 18 ibuprofen). Four discontinued due to stomach upset (3 ibuprofen, one GS), one due to dizziness (GS), one due to inadequate pain control (ibuprofen). Within-group analysis revealed significant improvement compared to baseline of all variables in both treatment groups but no change in acetaminophen used. Fifteen GS (71%) and 11 ibuprofen (61%) improved, with positive clinical response taken as a 20% decrease in primary outcome (TMJ pain with function). The number of patients with positive clinical response was not statistically different between groups (p = 0.73). Between-group comparison revealed that patients taking GS had a significantly greater decrease in TMJ pain with function, effect of pain, and acetaminophen used between Day 90 and 120 compared with patients taking ibuprofen.
GS and ibuprofen reduce pain levels in patients with TMJ degenerative joint disease. In the subgroup that met the initial efficacy criteria, GS had a significantly greater influence in reducing pain produced during function and effect of pain with daily activities. GS has a carryover effect.
比较硫酸氨基葡萄糖（GS）和布洛芬对颞下颌关节（TMJ）骨关节炎（OA）患者的治疗潜力。
在一项随机双盲研究中，40名女性和5名男性接受了90天的GS（500毫克，每日三次）或布洛芬（400毫克，每日三次）治疗。
在为期一周的洗脱期后以及第90天时，对TMJ功能疼痛、无痛及自主最大张口度进行评估，填写简明疼痛量表（BPI）问卷并检查咀嚼肌压痛情况。在第120天前，每30天统计一次用于缓解突破性疼痛的对乙酰氨基酚（500毫克）的用量。
总共采访了176名成年人，45人（26%）符合条件，39人（87%）完成了研究（21人使用GS，18人使用布洛芬）。4人因胃部不适停药（3人使用布洛芬，1人使用GS），1人因头晕（使用GS）停药，1人因疼痛控制不佳（使用布洛芬）停药。组内分析显示，两个治疗组的所有变量与基线相比均有显著改善，但对乙酰氨基酚的用量没有变化。15名使用GS的患者（71%）和11名使用布洛芬的患者（61%）病情改善，将主要结局（TMJ功能疼痛）降低20%作为临床阳性反应。两组间临床阳性反应患者数量无统计学差异（p = 0.73）。组间比较显示，与使用布洛芬的患者相比，使用GS的患者在第90天至120天期间，TMJ功能疼痛、疼痛影响及对乙酰氨基酚用量的降低幅度显著更大。
GS和布洛芬可降低TMJ退行性关节病患者的疼痛水平。在符合初始疗效标准的亚组中，GS对减轻功能活动时产生的疼痛及日常活动中的疼痛影响有显著更大的作用。GS有持续效应。
