目的 探討鹿川活絡(luò)膠囊聯(lián)合酮洛芬緩釋片治療膝骨關(guān)節(jié)炎的臨床療效。方法 回顧性分析2020年2月-2021年2月在天津市寶坻區(qū)人民醫(yī)院治療的106例膝骨關(guān)節(jié)炎患者臨床資料，根據(jù)用藥差別分為對照組和治療組，每組各53例。對照組患者口服酮洛芬緩釋片，75 mg/次，2次/d；治療組患者在對照組基礎(chǔ)上口服鹿川活絡(luò)膠囊，1.35 g/次，3次/d。兩組均經(jīng)4周治療進(jìn)行效果比較。觀察兩組的臨床療效，比較兩組治療前后相關(guān)評分、血清學(xué)指標(biāo)、超聲指標(biāo)的變化情況。結(jié)果 經(jīng)治療，治療組患者總有效率是98.11%，顯著高于對照組的81.13%（P<0.05）。經(jīng)治療，兩組患者Lysholms評分顯著升高，但VAS評分、WOMAC評分、ISOA評分及臨床癥狀評分均顯著降低（P<0.05），治療后，治療組相關(guān)評分改善優(yōu)于對照組（P<0.05）。經(jīng)治療，兩組患者髕上囊積液深度、腘窩囊腫范圍、滑膜厚度均顯著降低，但股骨內(nèi)外側(cè)髁軟骨厚度均顯著增加（P<0.05）；治療后，治療組軟骨病變情況及滑膜組織改善優(yōu)于對照組（P<0.05）。經(jīng)治療，兩組血清金屬蛋白酶組織抑制因子1（TIMP-1）顯著升高，但白細(xì)胞介素-1β（IL-1β）、血管內(nèi)皮生長因子（VEGF）、基質(zhì)金屬蛋白酶-9（MMP-9）、白細(xì)胞介素-6（IL-6）均顯著降低（P<0.05）；且治療后，治療組炎癥介質(zhì)水平改善優(yōu)于對照組（P<0.05）。結(jié)論 鹿川活絡(luò)膠囊聯(lián)合酮洛芬緩釋片治療膝骨關(guān)節(jié)炎具有較好的臨床療效，可有效改善患者癥狀和關(guān)節(jié)功能，降低炎癥介質(zhì)水平和滑膜組織損傷，有著良好的臨床應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Luchuan Huoluo Capsules combined with ketoprofen in treatment of knee osteoarthritis. Methods The clinical data of 106 patients with knee osteoarthritis treated in Tianjin Baodi Hospital from February 2020 to February 2021 were retrospectively analyzed. They were divided into control group and treatment group according to medication difference, with 53 cases in each group. Patients in the control group were po administered with Ketoprofen Sustained Release Tablets, 75 mg/time, twice daily. Patients in the treatment group were po administered with Luchuan Huoluo Capsules on the basis of the control group, 1.35 g/time, three times daily. The two groups were compared after 4 weeks of treatment. The clinical efficacy of the two groups were observed, and the changes of related scores, serological indexes and ultrasonic indexes were compared between the two groups before and after treatment. Results After treatment, the total effective rate of treatment group was 98.11%, significantly higher than that of control group 81.13% (P<0.05). After treatment, Lysholms score was significantly increased in two groups, but VAS score, WOMAC score, ISOA score, and clinical symptom score were significantly decreased (P<0.05). After treatment, correlation score improvement in treatment group was better than that in control group (P<0.05). After treatment, the depth of suprapatellar sac fluid, the range of popliteal cyst and synovial thickness were significantly decreased in two groups, but the thickness of medial and lateral femoral condylar cartilage was significantly increased (P<0.05). After treatment, the improvement of cartilage lesion and synovial tissue in the treatment group was better than that in the control group (P<0.05). After treatment, serum tissue inhibitor of metalloproteinase 1 (TIMP-1) was significantly increased, but interleukin-1β (IL-1β), vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), and interleukin-6 (IL-6) were significantly decreased in both groups (P<0.05). After treatment, the level of inflammatory mediators in the treatment group was better than that in the control group (P<0.05). Conclusion Luchuan Huoluo Capsules combined with ketoprofen has good clinical efficacy in treatment of knee osteoarthritis, and can effectively improve the symptoms and joint function of patients, and also can reduce the level of inflammatory mediators and synovial tissue damage, which has good clinical application value.

R977

天津市衛(wèi)生局科技計(jì)劃項(xiàng)目（2011KZ05）