Coaccioli S, Pinoca F, Puxeddu A
Department of Internal Medicine and Rheumatology Unit, Perugia University School of Medicine, Santa Maria General Hospital, Terni, Italy.
Clin Ter. 2006 Jul-Aug;157(4):321-5.
The use of hyaluronic acid (HA) in osteoarthritis (OA) is based on the findings that viscoelasticity of the synovial fluid is entirely due to its HA content and that HA itself may influence the disease by interacting with components of the synovial fluid. The aim of this pilot study was to evaluate the efficacy of HA in OA of the first carpometacarpal joint.
This study was performed on 43 patients with 56 total joints. Five parameters were been relieved: spontaneous pain; provoked pain; joint performances and related pain; algofunctional index of Dreiser; assumption of drugs. The administrations of HA have been performed with 0.5 ml of HA at each injection.
The behaviour of pain shows a significant (p < 0.0005 for all the comparisons) reduction from base time to the end of the study and the Dreiser Index decreased as well. At base time 81.4% of the patients assumed NSAIDs and only 13.8% analgesics. During the following weeks a smaller requirement of NSAIDs (from 81% to 23%) and a greater number of patients without analgesic therapy were observed.
Intra-articular HA seems to be effective in OA of CMC joint. This short term study suggests to observe and to treat these patients during a longer period of time in order to evaluate not only the efficacy but also the clinical safety.
透明质酸（HA）在骨关节炎（OA）中的应用基于以下发现：滑液的粘弹性完全归因于其HA含量，并且HA本身可能通过与滑液成分相互作用来影响疾病。这项初步研究的目的是评估HA在第一掌指关节OA中的疗效。
本研究对43例患者共56个关节进行。评估了五个参数的缓解情况：自发痛；激发痛；关节表现及相关疼痛；德赖泽尔疼痛功能指数；药物服用情况。每次注射HA的剂量为0.5毫升。
疼痛情况显示从基线期到研究结束有显著降低（所有比较中p < 0.0005），德赖泽尔指数也有所下降。在基线期，81.4%的患者服用非甾体抗炎药（NSAIDs），仅13.8%的患者服用镇痛药。在接下来的几周里，观察到NSAIDs的需求量减少（从81%降至23%），且更多患者无需镇痛治疗。
关节内注射HA似乎对第一掌指关节OA有效。这项短期研究表明，为了不仅评估疗效而且评估临床安全性，需要在更长时间内观察和治疗这些患者。
