上面就是解答了为什么氨基葡萄糖也止痛的问题。
科学家与骗子沒办法成群体！
药，食物，用品都必须用监管來确保质量与诚信。保健品与食品在美国沒如药品一样被监管。而加拿大食品
也己被监管，其食品与保健品都有牌。满地可出的每个粽都有其卫生局发的产品牌照号，其意义是生产商被登记，质量成份合标准。若出错，别想再做这一生意及坐牢房。加拿大对产品监管非常严格！中国也不久会出现产品牌照，

现在有不少国产的保健品其实添加了其它的药物，比如镇疼药，那对身体不一定有好处。一定要看到国家药监局查询是不是正品，找到一些反面文章（比如说有人报道那个有负面问题）来参考一下。现在国内保健食品，和食品冒充药物的情况非常普遍。

我想氨基葡萄糖也根本不会有那么药到病除的镇痛作用，切不可迷信暂时的疗效！！！

但是这项研究发现，反过来也是可以的：自认一个非常有效的止痛药不会减轻他们的痛苦的患者会报告说，该止痛药没有效。

用于这项研究的大脑成像技术也支持这一发现，该技术显示大脑可以同意的人的意识。

为了检验“安慰剂效应”，牛津大学大脑功能性磁共振成像中心的艾琳.翠茜（Irene Tracey）招集一个由英国和德国的研究人员组成的团队进行了一些实验。

他们首先招募了22位为科学目的愿意忍受一点痛苦的志愿者。

他们给志愿者静脉滴注，并把志愿者置于一个功能性磁共振大脑扫瞄仪来监测他们大脑的活动。然后，他们用实验室的加热设备引起志愿者下肢疼痛。

当他们要求志愿者在1至100范围评价自己的疼痛，平均而言，他们定级为66。

作为这项研究的第一部份，科学家们在没有告诉志愿者的的情况下，开始给志愿者的静脉滴注注入了强大的，速效合成止痛药瑞芬太尼。

志愿者报告疼痛的感觉略少了，疼痛等级约为55。

这项研究下一部份，给志愿者注入瑞芬太尼，并告诉他们被给予了止痛药。尽管志愿者以同样的方式获得的与第一个实验相同的止痛药，他们报告的疼痛等级则下跌至39。

最后，再以同样的方式给予志愿者止痛药，但告诉他们没有得到任何药物，甚至可能会经历更多的疼痛。

志愿者报告，他们的疼痛程度提高到64。几乎和第一次使用加热设一样糟糕，-即使给予志愿者同一剂量的该药物。

大脑扫瞄显示，这些志愿者的痛苦网络志愿者的疼痛报告是匹配的。当志愿者认为给他们用了止痛药，大脑中的痛苦网络活动就减低了，当志愿者期望和报告疼痛时，活动增大。

这一结果发表在科学转化医学杂志上。

研究人员说，他们的实验表明安慰剂效应的影响力，并说，医生应意识到病人的期望力量。

“医生不应低估病人的消极期望对治疗结果的重大影响 ，”翠茜在声明中说。

“例如，有慢性疼痛的人常常会看很多医生和尝试了许多对他们没有效果的药物。他们带着这样一种负面经验来诊所:不指望得到任何能解除他们病痛的药物。医生几乎第一时间就应把患者的这种负面消极的期望去掉，否则任何药物都不会对他们有效果。”

翠茜说，也有为临床试验的设计经验。这类研究往往进行试验药物与安慰剂的比对，看看是否有任何一个超出了安慰剂药效。这项研究表明，志愿者的期望可能会扭曲结果。

“我们应该控制人们的期望，对任何临床试验结果的影响。最起码我们应该确保我们尽量减少任何消极的期望，以确保我们不会掩盖试验药物的真实疗效，”她说。

Clinical studiesThere have been multiple clinical trials of glucosamine as a medical therapy for osteoarthritis, but results have been conflicting. The evidence both for and against glucosamine’s efficacy has led to debate among physicians about whether to recommend glucosamine treatment to their patients.[44]

Multiple clinical trials in the 1980s and 1990s, all sponsored by the European patent-holder, Rottapharm, demonstrated a benefit for glucosamine. However, these studies were of poor quality due to shortcomings in their methods, including small size, short duration, poor analysis of drop-outs, and unclear procedures for blinding.[45][46] Rottapharm then sponsored two large (at least 100 patients per group), three-year-long, placebo-controlled clinical trials of the Rottapharm brand of glucosamine sulfate. These studies both demonstrated a clear benefit for glucosamine treatment.[47][48] There was not only an improvement in symptoms but also an improvement in joint space narrowing on radiographs. This suggested that glucosamine, unlike pain relievers such as NSAIDs, can actually help prevent the destruction of cartilage that is the hallmark of osteoarthritis. On the other hand, several subsequent studies, independent of Rottapharm, but smaller and shorter, did not detect any benefit of glucosamine.[49][50]

Due to these controversial results, some reviews and meta-analyses have evaluated the efficacy of glucosamine. Richie et al. performed a meta-analysis of randomized clinical trials in 2003 and found efficacy for glucosamine on VAS and WOMAC pain, Lequesne index and VAS mobility and good tolerability.[51]

Recently, a review by Bruyere et al. about glucosamine and chondroitin sulfate for the treatment of knee and hip osteoarthritis concludes that both products act as valuable symptomatic therapies for osteoarthritis disease with some potential structure-modifying effects.[52]

This situation led the National Institutes of Health in the U.S.A. to fund a large, multicenter clinical trial (the GAIT trial) studying reported pain in osteoarthritis of the knee, comparing groups treated with chondroitin sulfate, glucosamine, and the combination, as well as both placebo and celecoxib.[53] The results of this 6-month trial found that patients taking glucosamine HCl, chondroitin sulfate, or a combination of the two had no statistically significant improvement in their symptoms compared to patients taking a placebo.[15] The group of patients who took celecoxib did have a statistically significant improvement in their symptoms. These results suggest that glucosamine and chondroitin did not effectively relieve pain in the overall group of osteoarthritis patients, but it should be interpreted with caution because most patients presented only mild pain (thus a narrow margin to appraise pain improvement) and because of an unusual response to placebo in the trial (60%). However, exploratory analysis of a subgroup of patients suggested that the supplements taken together (glucosamine and chondroitin sulfate) may be significantly more effective than placebo (79.2% versus 54%; p = 0.002) and a 10% higher than the positive control, in patients with pain classified as moderate to severe (see testing hypotheses suggested by the data).

In an accompanying editorial, Dr. Marc Hochberg also noted that “It is disappointing that the GAIT investigators did not use glucosamine sulfate … since the results would then have provided important information that might have explained in part the heterogeneity in the studies reviewed by Towheed and colleagues”[54][55] But this concern is not shared by pharmacologists at the PDR who state, “The counter anion of the glucosamine salt (i.e. chloride or sulfate) is unlikely to play any role in the action or pharmacokinetics of glucosamine”.[18] Thus the question of glucosamine’s efficacy will not be resolved without further updates or trials.

In this respect, a 6-month double-blind, multicenter trial has been recently performed to assess the efficacy of glucosamine sulfate 1500 mg once daily compared to placebo and acetaminophen in patients with osteoarthritis of the knee (GUIDE study). The results showed that glucosamine sulfate improved the Lequesne algofunctional index significantly compared to placebo and the positive control. Secondary analyses, including the OARSI responder indices, were also significantly favorable for glucosamine sulfate.[17]

A subsequent meta-analysis of randomized controlled trials, including the NIH trial by Clegg, concluded that hydrochloride is not effective and that there was too much heterogeneity among trials of glucosamine sulfate to draw a conclusion.[56] In response to these conclusions, Dr. J-Y Reginster in an accompanying editorial suggests that the authors failed to apply the principles of a sound systematic review to the meta-analysis, but instead put together different efficacy outcomes and trial designs by mixing 4-week studies with 3-year trials, intramuscular/intraarticular administrations with oral ones, and low-quality small studies reported in the early 1980s with high-quality studies reported in 2007.[57]

However, currently OARSI (OsteoArthritis Research Society International) is recommending glucosamine as the second most effective treatment[citation needed] for moderate cases of osteoarthritis. Likewise, recent European League Against Rheumatism practice guidelines for knee osteoarthritis grants to glucosamine sulfate the highest level of evidence, 1A, and strength of the recommendation, A.[57]

A 2009 small study has concluded that glucosamine reduces cartilage turnover in osteoarthritis patients in response to physical training.[58]

A report by the UK’s Arthritis Research Campaign concluded that:

Despite some mixed results, the majority of trials that have evaluated the effectiveness of glucosamine sulphate demonstrated significant clinical benefits when compared to placebo or NSAIDs. Evidence from trials on glucosamine hydrochloride is scarce and much less convincing. The medication, in both sulphate and hydrochloride preparations, appears to be safe with only mild and infrequent adverse effects.[24]

English to Chinese translation
临床studiesThere已作为药物治疗骨性关节炎的葡萄糖胺多个临床试验，但结果是矛盾的。支持和反对的氨基葡萄糖的功效的证据，导致医生之间的辩论是否建议氨基葡萄糖治疗病人。[44]

20世纪80年代和90年代中，所有的欧洲专利持有人，Rottapharm，赞助多的临床试验证明了氨基葡萄糖的利益。然而，这些研究都是由于质量低劣在它们的方法，包括小规模，持续时间短，辍学贫困分析的缺点，并致盲不明的程序。[45] [46] Rottapharm然后赞助了两个大（至少100每组例），三年之久，安慰剂对照的氨基葡萄糖硫酸盐Rottapharm品牌临床试验。这些研究都表现出了氨基葡萄糖治疗有明显益处。[47] [48]这不仅是改善症状，而且是在X光片上关节间隙狭窄的改善。这表明，氨基葡萄糖，不像如NSAIDs的止痛药，实际上可以帮助防止软骨破坏，这是骨关节炎的标志。另一方面，若干后续研究，独立的Rottapharm，但体积更小，短，没有发现任何葡萄糖好处。[49] [50]

由于这些争议的结果，一些评论和meta分析评估了葡萄糖胺的疗效。里奇等人。在2003年进行的随机临床试验的荟萃分析，发现对VAS和WOMAC疼痛，Lequesne指数以及VAS的流动性和良好的耐受性葡萄糖胺的疗效。[51]

近日，一项由Bruyere等审查。关于氨基葡萄糖和膝盖和髋关节骨性关节炎治疗硫酸软骨素的结论是，这两种产品的宝贵疾病治疗骨关节炎症状与一些潜在的结构修饰效果的行为。[52]

这种情况导致国家卫生研究院在美国资助的大型，多中心临床试验（步态试验）研究报告在膝关节骨性关节炎疼痛，比较，硫酸软骨素，氨基葡萄糖，治疗组和组合，以及两安慰剂和塞来昔布。[53]这6个月的试验结果发现，患者服用氨基葡萄糖盐酸，硫酸软骨素，或者是两者的结合并没有统计学显着改善其症状的病人相比，服用安慰剂。[15]谁的病人做了celecoxib组在统计学上有明显改善症状。这些结果表明，氨基葡萄糖和软骨素没有有效地缓解骨性关节炎患者总体组的疼痛，但应谨慎解释，因为大多数病人只有轻微的疼痛，提交（从而以微弱优势，评估疼痛的改善），因为一个不寻常的反应在审判（60％）安慰剂。然而，探索的患者群分析结果表明，补充合计（氨基葡萄糖和软骨素硫酸盐）可能明显比安慰剂更有效（79.2％比54％; p值= 0.002）和10％，比阳性对照，在疼痛病人的分类为中度至重度（见测试的数据表明，假设）。

在随后的社论中，马克Hochberg博士还指出，“这是令人失望的步态研究人员并没有使用氨基葡萄糖硫酸盐…因为结果将不得不提供了重要信息，有可能部分解释审查的异质性研究Towheed和同事们“[54] [55]但这种担心是没有谁在人民民主共和国国家，药理共享他说：”葡萄糖盐（即氯化物或硫酸盐）计数器负离子是不可能的行动中发挥任何作用或药代动力学葡萄糖胺“。[18]因此，葡萄糖胺的疗效问题就不会得到解决，不再更新或审判。

在这方面，6个月的双盲，多中心临床试验已于日前完成，以评估疗效氨基葡萄糖硫酸盐相比，1500毫克，每天一次，并与安慰剂的膝盖（指导学习）骨关节炎患者对乙酰氨基酚。结果表明，氨基葡萄糖硫酸盐提高Lequesne algofunctional指数显着高于安慰剂组和阳性对照。二次分析，包括OARSI急救员指数也显着有利的氨基葡萄糖硫酸盐。[17]

随后元的随机对照试验，其中包括由美国国立卫生研究院克莱格试验分析，得出结论认为没有效果，盐酸，有硫酸氨基葡萄糖试验中过多异质性得出一个结论。[56]针对这些结论，博士。在一篇社论中浴火重生的Reginster建议，提交未申请一套完善的系统回顾了荟萃分析的原则，而是放在一起3年的试验，肌肉注射不同的评价结果和混合4周的研究，试验设计/关节主管部门与口服的，低质量的小型研究与高质量的研究报告报道20世纪80年代初在2007年。[57]

然而，目前OARSI（骨关节炎研究会国际）是葡萄糖的第二个建议最有效的治疗[引文需要]为中度骨性关节炎的病例。同样，最近欧洲抗风湿联盟膝关节骨性关节炎的做法给予指引，氨基葡萄糖硫酸盐的证据，第1A最高水平，该建议的，答：[57]实力

2009年的小规模研究的结论是，氨基葡萄糖降低响应体能训练软骨骨关节炎患者的营业额。[58]

一个由英国关节炎研究运动的报告的结论是：

尽管取得了一些不同的结果，该评估了氨基葡萄糖硫酸盐多数显示了明显的成效试验相比，安慰剂或NSAIDs临床益处。从氨基葡萄糖盐酸盐试验的证据缺乏，更令人信服。该药物，硫酸和盐酸中的准备，似乎只有轻微和罕见不良反应的安全。[24]

Listen
Read phoneticallyDictionary – View detailed dictionary