關節用藥 讓你少痛一點Joints allows you to use less pain point

關節用藥 讓你少痛一點 【施靜茹】搶救關節大作戰，各種舒緩關節疼痛的藥物，堪稱廿世紀有助人類的發明之一，讓老祖先是用四隻手腳走路的人類，還能延續直立行走的生活。 葡萄糖胺 軟骨營養劑 退化性關節炎的治療，多為減輕疼痛，包括口服止痛消炎藥、物理治療，或補充軟骨營養劑，及玻尿酸關節液黏稠補充劑。 「葡萄糖胺（ glucosamine）」在現代醫藥界紅遍半邊天，在台灣衛生署藥物查詢系統中，它的適應症是「緩解退化性關節炎之疼痛」。醫院骨科門診候診區，坐滿行動不便的老人家，希望能找到解關節不適的方法。 台大醫院骨科部主治醫師王至弘說，國外報告指出，葡萄糖胺或可視為軟骨營養劑，但能否減輕或治療退化性關節炎，仍有待更大型的研究證實，不過目前對於60歲以上、經X光檢查關節間隙減少至一定程度的患者，可提供補充葡萄糖胺。 玻尿酸 增加關節液 王至弘說，近年，玻尿酸也被用來做為退化性關節炎的治療，它是用來增加關節液正常的玻尿酸濃度，通常半年一個療程，可打三到五針，但必須是口服藥或補充劑半年以上無效者，才考慮是否注射玻尿酸。 「有人打了玻尿酸覺得症狀改善，也有人覺得症狀還在。」王至弘說，玻尿酸能否增加軟骨細胞活性或代謝，醫界也無法百分之百保證。 類固醇 對軟骨有害 有人在關節炎疼痛的急性期，接受注射類固醇，王至弘認為不妥，因為，「一直在關節腔打類固醇，反而對軟骨有傷害」，但偶爾用在緩解肌腱發炎還可以。 至於其他減緩退化性關節炎疼痛藥物，台北振興醫院骨科主任敖曼冠說，有人使用能短期減輕疼痛和發炎的非類固醇抗炎藥，但其有腸胃不適的副作用，目前漸改以COX-2專一性抑制劑來治療。 2008-09-05 Joints allows you to use less pain point [Shi Jing-Ru - the joint rescue operations, all kinds of joint pain relief drug,堪称the 20th century the invention of the human will to use Si Zhishou feet Laozu first human to walk, but also walked upright continuity of life. Glucose amine nutrition of cartilage Degenerative arthritis treatment, and more to alleviate pain, including oral analgesic anti-inflammatory drugs, physical therapy, or supplementary nutrition of cartilage and synovial fluid sticky Bo Niaosuan supplements. "Glucose amine (glucosamine)" in modern Chinese medicine sector Hongbian half the sky, the Department of Health in Taiwan for drug system, it is the indication "ease the pain of osteoarthritis." Orthopaedic hospital out-patient waiting area, filled the mobility of the elderly, hoping to find a joint solution does not apply the method. National Taiwan University Hospital Department of Orthopaedic Dr. Wang to WONG said that foreign reports that glucose amine or can be regarded as nutrition for cartilage, but can reduce or treatment of degenerative arthritis, has yet to be more large-scale study has confirmed, but at the moment for the 60-year-old Above, the X-ray joint space reduced to a certain degree of patients, may provide additional glucose amine. Bo Niaosuan increase joint fluid Wang to WONG said that in recent years, Bo Niaosuan also be used for the treatment of degenerative arthritis, which is used to increase joint fluid Bo Niaosuan a normal concentration, usually half a course, to play 3-5 needles, but I must be the medication or supplement For more than half a year is invalid, before considering whether injection Bo Niaosuan. "Some people think that played Bo Niaosuan symptoms improve, some people think the symptoms are." Wang said to WONG, Bo Niaosuan cartilage cells can increase the activity or metabolism, the medical community can not guarantee 100 per cent. Steroids harmful to the cartilage Some people in the acute phase of arthritis pain, vaccination of steroids, that is wrong with Wang to WONG, because, "has been a joint chamber of steroids, but on a cartilage injury," but occasionally used in mitigation can also tendon inflammation. As for the other slow degenerative arthritis pain drug, the revitalization of the Taipei Hospital, director of orthopedics Ao Man-said, it was short-term use can reduce pain and inflammation of the non-steroidal anti-inflammatory drugs, but its side effects are gastrointestinal discomfort, gradually replaced by COX -2 Specific inhibitor therapy. 2008-09-05 For more information, see World Journal News ePaper

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