目的 觀察腰痛寧膠囊聯(lián)合醋酸曲安奈德注射液穴位注射治療腰椎骨性關(guān)節(jié)炎的臨床療效。方法 選取2016年5月-2017年1月銅仁市人民醫(yī)院骨科收治的腰椎骨性關(guān)節(jié)炎患者52例為研究對(duì)象，按照住院日期單復(fù)數(shù)隨機(jī)分為對(duì)照組和治療組，每組各26例。對(duì)照組給予穴位注射治療，醋酸曲安奈德注射液4 mL和2%利多卡因4 mL加入到0.9%氯化鈉注射液12 mL中，取上清10 mL，分別在腎俞、委中、昆侖、太溪、足三里、夾脊穴位處進(jìn)針，3~4 mL/穴位，1次/3 d。治療組在對(duì)照組的基礎(chǔ)上睡前口服腰痛寧膠囊，4~6粒/次，1次/d。兩組患者均連續(xù)治療4周。觀察兩組的臨床療效，比較兩組的VAS評(píng)分、JOA脊柱功能、一氧化氮（NO）和粒細(xì)胞-巨噬細(xì)胞集落刺激因子（GM-CSF）水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為73.1%、88.5%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組VAS評(píng)分顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組VAS評(píng)分明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組JOA脊柱功能評(píng)分均明顯提高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組JOA脊柱功能評(píng)分明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組NO和GM-CSF水平均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 腰痛寧膠囊聯(lián)合醋酸曲安奈德注射液穴位注射治療腰椎骨性關(guān)節(jié)炎具有較好的臨床療效，可改善腰椎關(guān)節(jié)功能，降低患者疼痛程度，調(diào)節(jié)NO和GM-CSF水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of Yaotongning Capsules combined with Triamcinolone Acetonide Acetate Injection in acupoint injection in treatment of lumbar osteoarthritis. Methods Patients (52 cases) with lumbar osteoarthritis in Department of Joint Surgery of Tongren People's Hospital from May 2016 to January 2017 were randomly divided into control and treatment groups, and each group had 26 cases. Patients in the control group were given acupoint injection therapy, Triamcinolone Acetonide Acetate Injection (4 mL) and lidocaine (4 mL, 2%) added into normal saline 12 mL, injected into the acupoints (shenshu, Venezuela, Kunlun, Zusanli, Taixi, and Jiaji), 3-4 mL/acupoint, 1 time every 3 days. Patients in the treatment group were po administered with Yaotongning Capsules before going to bed on the basis of the control group, 4-6 grains/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and VAS scores, JOA spinal function scores, NO, and GM-CSF levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.1% and 88.5%, respectively, and there was difference between two groups (P<0.05). After treatment, the VAS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the VAS score in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the JOA spinal function scores in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the JOA spinal function score in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of NO and GM-CSF in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yaotongning Capsules combined with Triamcinolone Acetonide Acetate Injection in acupoint injection has clinical curative effect in treatment of lumbar osteoarthritis, can improve the function of lumbar joint, reduce the pain degree of patients, and adjust the level of NO and GM-CSF, which has a certain clinical application value.