目的 探討羅浮山風(fēng)濕膏藥聯(lián)合美洛昔康片治療骨關(guān)節(jié)炎的臨床療效。方法 回顧性分析2020年2月—2022年2月在武漢市中醫(yī)醫(yī)院進(jìn)行治療的102例骨關(guān)節(jié)炎患者臨床資料，依據(jù)用藥差別將所有患者分為對照組和治療組，每組各51例。對照組口服美洛昔康片，7.5 mg/次，1次/d；治療組在對照組基礎(chǔ)上外敷羅浮山風(fēng)濕膏藥，每次貼敷24 h。兩組經(jīng)4周治療進(jìn)行效果比較。觀察兩組患者的臨床療效，比較兩組治療前后相關(guān)評分、疼痛相關(guān)介質(zhì)和血清學(xué)指標(biāo)的變化情況。結(jié)果 治療后，治療組患者總有效率是98.04%，顯著高于對照組的82.35%（P<0.05）。治療后，兩組患者奎森功能演算指數(shù)（Lequesne）評分、麥克馬斯特（WOMAC）評分、視覺模擬（VAS）評分均較治療前顯著降低，但關(guān)節(jié)炎生活質(zhì)量問卷（AIMS2-SF）評分顯著升高（P<0.05）；治療后，相關(guān)評分以治療組改善更為明顯（P<0.05）。治療后，兩組血清P物質(zhì)（SP）、前列腺素E₂（PGE₂）、5-羥色胺（5-HT）疼痛相關(guān)介質(zhì)水平均顯著降低（P<0.05），并以治療組下降的更明顯（P<0.05）。治療后，兩組血清YKL-40、促血管生成素Ⅰ、腫瘤壞死因子誘導(dǎo)蛋白6（TSG-6）、Wnt-3α、白細(xì)胞介素-17（IL-17）水平均較治療前顯著降低，而堿性成纖維細(xì)胞生長因子2（FGF-2）顯著升高（P<0.05），并以治療組改善更明顯（P<0.05）。結(jié)論 羅浮山風(fēng)濕膏藥聯(lián)合美洛昔康治療骨關(guān)節(jié)炎臨床效果顯著，可有效改善關(guān)節(jié)功能，降低疼痛，調(diào)節(jié)血清因子水平，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy of Luofushan Rheumatic Plaster combined with meloxicam in treatment of osteoarthritis. Methods The clinical data of 102 patients with osteoarthritis treated in Wuhan Hospital of Traditional Chinese Medicine from February 2020 to February 2022 were retrospectively analyzed. All patients were divided into control group and treatment group according to medication difference, with 51 cases in each group. Patients in the control group were po administered with Meloxicam Tablets, 7.5 mg/time, once daily. Patients in the treatment group were given Luofushan Rheumatic Plaster on the basis of the control group, applied for 24 h each time. The results were compared between the two groups after 4 weeks of treatment. The clinical efficacy of the two groups were observed, and the changes of correlation scores, pain related mediators, and serological indicators were compared between the two groups before and after treatment. Results After treatment, the total effective rate of treatment group was 98.04%, significantly higher than that of control group 82.35% (P < 0.05). After treatment, Lequesne score, WOMAC score, and visual analog scale (VAS) score in two groups were significantly decreased compared with before treatment, but arthritis quality of life questionnaire (AIMS2-SF) score was significantly increased (P < 0.05). After treatment, the correlation score of the treatment group improved more significantly (P < 0.05). After treatment, the levels of serum substance P (SP), prostaglandin E₂ (PGE₂), and 5-hydroxytryptamine (5-HT) pain related mediators in two groups were significantly decreased (P < 0.05), and the decrease was more obvious in the treatment group (P< 0.05). After treatment, the serum levels of YKL-40, angiogenic hormone Ⅰ, tumor necrosis factor-induced protein 6 (TSG-6), WNT-3α and interleukin 17 (IL-17) in two groups were significantly decreased compared with before treatment, while basic fibroblast growth factor 2 (FGF-2) was significantly increased (P < 0.05). The improvement was more obvious in the treatment group (P < 0.05). Conclusion Luofushan Rheumatic Plaster combined with meloxicam has significant clinical effect in treatment of osteoarthritis, and can effectively improve joint function, reduce pain, and adjust the level of serum factors, which is worthy of clinical application.

R977

湖北省衛(wèi)生健康委員會科研項目（WJ2021M022）