目的 探討蠲痹抗生丸聯合美洛昔康治療膝骨關節(jié)炎的臨床療效。方法 選擇2019年3月—2021年3月平煤神馬醫(yī)療集團總醫(yī)院接診的78例骨關節(jié)炎患者，隨機分為對照組和治療組，每組各39例。對照組口服美洛昔康片，1片/次，1次/d。在對照組基礎上，治療組口服蠲痹抗生丸，2丸/次，2次d。兩組患者治療7周為1個療程。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀緩解時間，視覺模擬評分法（VAS）和西大略湖和麥克馬斯特骨性關節(jié)炎指數（WOMAC）評分，血清因子白細胞介素-1（IL-1）、白細胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）和轉移生長因子-β（TGF-β）水平，及不良反應情況。結果 治療后，對照組總有效率為76.92%，顯著低于治療組的97.44%（P＜0.05）。治療后，治療組關節(jié)腫脹、關節(jié)活動受限、關節(jié)晨僵、關節(jié)疼痛緩解時間明顯早于對照組（P＜0.05）。治療后，兩組患者VAS評分、WOMAC評分比治療前均明顯下降（P＜0.05），且治療組評分均顯著低于對照組（P＜0.05）。治療后，兩組患者血清因子IL-1、IL-6、TNF-α水平均明顯降低，而TGF-β明顯升高（P＜0.05），且治療組各血清因子水平明顯好于對照組（P＜0.05）。治療組患者不良反應發(fā)生率為7.69%，明顯低于對照組的15.38%（P＜0.05）。結論 蠲痹抗生丸聯合美洛昔康治療膝骨關節(jié)炎，癥狀改善明顯，局部炎癥反應明顯降低，且藥物安全有效。

Objective To explore the clinical study of Juanbi Kangsheng Pills combined with meloxicam in treatment of knee osteoarthritis. Methods Patients (78 cases) with knee osteoarthritis in General Hospital of Pingmei Shenma Group from March 2019 to March 2021 were randomly divided into control and treatment group, and each group had 39 cases. Patients in the control group were po administered with Meloxicam Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Juanbi Kangsheng Pills on the basis of the control group, 2 pills/time, twice daily. Patients in two groups were treated for 7 weeks as a course of treatment. After treatment, the clinical evaluation was evaluated, the relief time of symptom, VAS scores and WOMAC scores, levels of serum factors IL-1, IL-6, TNF-α, and TGF-β, adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the control group was 76.92%, which was significantly lower than that of the treatment group (97.44%) (P < 0.05). After treatment, the relief time of joint swelling, limitation of joint movement, morning stiffness and joint pain in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the VAS scores, and WOMAC scores in two groups were significantly lower than those before treatment (P < 0.05), and the scores of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the serum levels of IL-1, IL-6, and TNF- α were significantly decreased, while TGF-β were significantly increased in two groups (P < 0.05), and these indexes in the treatment group was significantly better than the control group (P < 0.05). The incidence of adverse reactions in the treatment group was 7.69%, which was significantly lower than 15.38% in the control group (P < 0.05). Conclusion In the treatment of knee osteoarthritis with Juanbi Kangsheng Pills combined with meloxicam, the symptoms were obviously improved, the local inflammatory reaction was significantly reduced, and the combination was safe and effective.

R982

河南省科技攻關項目(172102310656)