目的 探討復(fù)方骨肽注射液聯(lián)合玻璃酸鈉注射液治療膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床療效。方法 選取2013年6月-2015年6月榆林市第一醫(yī)院收治的膝關(guān)節(jié)骨性關(guān)節(jié)炎患者192例，隨機(jī)分為玻璃酸鈉組、骨肽組和聯(lián)合組，每組各64例。玻璃酸鈉組清除關(guān)節(jié)積液后關(guān)節(jié)腔內(nèi)注射玻璃酸鈉注射液，25 mg/次，1次/周，治療5周；骨肽組靜脈滴注復(fù)方骨肽注射液，4~10 mL加入生理鹽水250 mL中，1次/d，治療20 d。聯(lián)合組采用玻璃酸鈉注射液和復(fù)方骨肽注射液聯(lián)合治療，用法用量、療程同玻璃酸鈉組和骨肽組。觀察3組的臨床療效，比較血清學(xué)指標(biāo)和視覺模擬評分（VAS）情況。結(jié)果 治療后，玻璃酸鈉組、骨肽組和聯(lián)合組總有效率分別為73.44%、75.00%、90.63%，聯(lián)合組總有效率明顯優(yōu)于玻璃酸鈉組和骨肽組，3組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組基質(zhì)金屬蛋白酶-3（MMP-3）、基質(zhì)金屬蛋白酶抑制劑-1（TIMP-1）和腫瘤壞死因子-α（TNF-α）水平均明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且聯(lián)合組這些指標(biāo)下降程度明顯優(yōu)于玻璃酸鈉組和骨肽組，3組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組VAS評分均明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且聯(lián)合組VAS評分下降程度明顯優(yōu)于玻璃酸鈉組和骨肽組，3組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 靜脈滴注復(fù)方骨肽注射液聯(lián)合關(guān)節(jié)腔注射玻璃酸鈉注射液治療膝關(guān)節(jié)骨性關(guān)節(jié)炎具有較好的臨床療效，能改善臨床癥狀，調(diào)節(jié)血清學(xué)指標(biāo)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Compound Ossotide Injection combined with Sodium Hyaluronate Injection in treatment of knee osteoarthritis. Methods Patients (192 cases) with knee osteoarthritis in the First Hospital of Yulin from June 2013 to June 2015 were randomly divided into sodium hyaluronate, ossotide and combined treatment groups, and each group had 64 cases. Patients in the sodium hyaluronate group were intra articular injection administered with Sodium Hyaluronate Injection, 25 mg/time, once weekly, and treated for 5 weeks. Patients in the ossotide group were iv administered with Compound Ossotide Injection, 4-10 mL added into normal saline 250 mL, once daily, treated for 20 d. Patients in the combined treatment group were given Sodium Hyaluronate Injection and Compound Ossotide Injection, usage, dosage and course as above. After treatment, the clinical efficacies were evaluated, and serological indexes and VAS scores in three groups were compared. Results After treatment, the clinical efficacies in the sodium hyaluronate, ossotide and combined treatment groups were 73.44%, 75.00%, and 90.63%, respectively, and the clinical efficacies in the combined treatment group were significantly better than those in the sodium hyaluronate and ossotide groups (P<0.05). After treatment, the levels of MMP-3, TIMP-1, and TNF-α in three groups were significantly decreased, and the differences were statistically significant in the same group (P<0.05). And the observational indexes in the combined treatment group were significantly lower than those in sodium hyaluronate and ossotide groups, with significant difference among three groups (P<0.05). After treatment, the VAS scores in three groups were significantly decreased, and the differences were statistically significant in the same group (P<0.05). And the VAS scores in the combined treatment group were significantly lower than those in sodium hyaluronate and ossotide groups, with significant difference among three groups (P<0.05). Conclusion Compound Ossotide Injection combined with Sodium Hyaluronate Injection has clinical curative effect in treatment of knee osteoarthritis, can improve clinical symptoms, and regulate serological indexes, which has a certain clinical application value.