中文摘要
隨著老年人囗的成長，關節炎病症的持續惡化會嚴重影響病人的生活起居，並增加社會的經濟負擔。對年長者而言，關節炎是限制行動的第一號原因，並且可能是造成殘疾的主因。在英國，大於60歲的年長者中，估計有超過80 % 的人可以在X光檢查發現有膝、髖、脊椎或手的關節炎變化；其中更有20 %的人會持續疼痛並造成關節活動的障礙。
止痛劑和非類固醇的消炎劑是常被用來治療關節炎的藥物，但這兩類藥物並不能逆轉關節炎的病變，而且長期使用可能增加併發副作用的危險性。這幾年，繼續有一些臨床實驗顯示，葡萄胺酸(glucosamine)可以有效改善關節炎的症狀；然而，也有一些作者持保留意見，並對於那些臨床研究的實驗設計與資料分析提出質疑。為了能客觀評估葡萄胺酸治療膝關節炎的效果，我們必須進一步瞭解膝關節在治療前和治療後的關節活動與受力變化。本研究將利用步態分析(gait analysis)、坐到站的動作分析(sit-to-stand)、肌力測試來進一步評估退化性膝關節患者在服用葡萄胺酸前後的關節活動與肌力變化。藉由膝關節的生物力學分析，這些資料將可客觀評估葡萄胺酸治療膝關節炎的效果並做為臨床治療的依據。

ABSTRACT

Osteoarthritis (OA) encompass a large and heterogeneous number of disorders affecting joints and bones which culminate in joint failure. In general OA can be defined as degenerative disease characterized by biomechanical and architectural deteriorations of the articular cartilage, with focal destructions of the cartilage that cause reactions of the subchondral bone, fibroplastic changes in synovium, and ultimately painful joint instability and failure.
After the age of 60 years, more than 80% of the people have radiological signs of OA in the knee, hip, spine and hand, and 20% of them suffer from pain and movement limitations. Actually, OA is the most common and important joint disease, and the leading cause of disability in the elderly. The suffering and disability caused by OA severely deteriorates the quality of life of the affected patients and represents one of the heaviest social and economic burden of our society.
The main objectives of treating OA are to relieve pain, improve joint function and prevent disability. Conservative treatments include patient education, physical therapy and pharmacologic treatment. In more advanced OA or patients who failed conservative treatments, surgery with osteotomy or arthroplasty may be the remaining choice. Currently used pharmacologic treatments, including acetaminophen and nonsteroidal anti-inflammatory drugs, do not slow or reverse the degenerative process in osteoarthritis. Glucosamine, a chondro-protective substance, has recently received a great deal of attention from the public as a potential treatment of osteoarthritis, prompting healthcare professionals to investigate its clinical usefulness and potential for adverse effects. Improvement in the symptoms of osteoarthritis associated with the use of glucosamine has been observed in clinical trials; however, there are other authors questioning quality issues, publication bias, and flaws in design and data analysis of these trials. The purpose of this study is to better define the efficacy of these chondro-protective agents in treating OA. The short term and long term results will be evaluated with pain score, Lequesne index, and knee score of Hospital for Special Surgery (HSS); and most importantly, we propose to objectively evaluate the muscle strength, and joint motion with gait and sit-to-stand analysis. These data will warrant a better understanding of the efficacy of these chondro-protective agents in treating osteoarthritic patients.

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