Dic health bulletin glucosamine

Author:

October 18th, 2022

醫藥健康淺談
第一話
前言
各位市民：
隨著大家對健康越來越關注，很多時都會自行或被人介紹購買一些保健藥
物，如維他命、補骨藥、皮膚膏等。另一方面，社區藥房充斥着各種類型的健康
產品，可謂五花八門。為幫助大家做一位精明的消費者及避免誤服不必要甚至有
害的藥物，律敦治及鄧肇堅藥房會定期刊出一般較常接觸的產品，希望各位會喜
歡。
但要事先聲明的是：我們並非要向大家推介任何藥物，而只是提供醫藥健康
資訊。所以，一切還是要視乎各人的需要，大家應先向醫生或藥劑師查詢才使用
這些產品。
律敦治及鄧肇堅醫院藥房
二零零六年九月
氨基葡萄糖(葡萄糖氨) Glucosamine﹝補骨
丸﹞
有很多市民都曾向藥房查問補骨藥的資料及藥效，為使大家對它更認識清楚，
《醫
藥健康淺談》會率先為大家深入淺出地分析此藥物。
這是甚麼？
它是一種存在於軟骨細胞裏面及周圍的天然物質。我們的身體會製造這種氨基糖
並把它運輸至軟骨及其他結締組織。軟骨基質(cartilage matrix)和滑液(synovial
fluid)裏的糖胺多糖(glycosaminoglycans)就是由這種氨基葡萄糖構成的。
它有甚麼用處？
現有證據普遍支持氨基葡萄糖用於骨關節炎，尤其是膝關節炎。氨基葡萄糖常
與軟骨素(chondroitin, 一種由關節軟骨提煉出來的糖胺多糖)同服。
甚麼是骨關節炎？
骨關節炎又叫做退化性關節炎，是由於軟骨出現磨損，厚度變薄而引致的。軟骨
緩和在骨組織之間的磨擦力和壓力，若果它變薄，骨頭與骨頭之間便會直接接觸
並承受關節移動所產生的震動。骨關節炎的徵狀包括疼痛、關節僵硬等，嚴重的
會影響日常活動。
此病一般不會在年青時發生，受影響的關節通常是手及承受大型重量的關節，例
如膝蓋。另外，關節使用量愈大，發生關節炎的機會亦較高。患骨關節炎的高危
因素包括年齡、女性、肥胖、職業性質、創傷、遺傳(有待進一步的證實)等。
健康的關節
肌肉
關節囊
腱
滑液囊
骨骼
軟骨
滑液
有骨關節炎的關節
肌肉
骨刺
滑液囊
腱
骨骼
已磨損的軟骨
軟骨碎片
滑液
圖片摘自 National Institute of Arthritis and Musculoskeletal and Skin Diseases
臨床證據
1) 膝關節炎 (輕微至中等)
人類研究普遍支持葡萄糖氨的應用。市面上有很多同類型的產品，但效用未
必是一致的；它們的安全性及成效有待進一步證實。
2) 骨關節炎
有人類及動物實驗提及葡萄糖胺在多種關節的骨關節炎的好處，但證據不及
膝關節炎多，而且實驗結果並不一致。
最近 National Institutes of Health (NIH)其下的 National Center for
Complementary and Alternative Medicine (NCCAM) 和 National Institute of
Arthritis and Musculoskeletal and Skin Diseases (NIAMS)研究葡萄糖胺與軟骨
素對減低膝關節疼痛的短期成效，試驗為期六個月:
Glucosamine/chondroitin Arthritis Intervention Trial (GAIT)
試驗對象為四十歲或以上, 有膝蓋痛並由 X 光證實患有骨關節炎。
➢
➢
在中等至嚴重疼痛的組別裏，葡萄糖氨與軟骨素組能使 79%的人減輕 20%或
以上的痛楚，而對照組則有 54%的人士達到這個指標。
在輕微疼痛的組別裏，與對照組相比，葡萄糖氨或/與軟骨素組未能顯示明顯
的痛楚舒緩。

劑量
以下的建議劑量只供參考，服用前應先請教醫生或藥劑師, 及參照產品說明書的
建議：
十八歲或以上人士：每日三次，每次 500 毫克(500mg)，為期三至六個月
安全性
➢ 葡萄糖氨可從蝦、蟹或其他甲殼類動物提煉出來，對貝類食物或碘敏感的士
要小心使用。
➢ 副作用：腸胃不適、有睡意、失眠、頭痛、皮膚反應、對陽光敏感、指甲變
硬等
➢ 不建議懷孕或哺乳期間服用
藥物相互作用
➢ 使用胰島素或服用糖尿藥的人士要小心使用
➢ 去水丸，例如 frusemide 可能會增加葡萄糖胺的副作用
骨關節炎患者應與醫療人員商討控制關節疼痛的計劃，包括飲
食、運動、體重管理及適當使用舒緩痛楚的藥物。在考慮服用葡萄糖
氨等保護軟骨的產品時，應先向醫生和藥劑師查詢。
參考：
1) http://www.nlm.nih.gov/medlineplus/
2) National Center for Complementary and Alternative Medicine (NCCAM)
3) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
4) 醫藥人 (Issue 60)
資料提供: 律敦治及鄧肇堅醫院藥房
…

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Dic health bulletin glucosamine

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