目的 探討元七骨痛酊聯(lián)合塞來昔布膠囊治療膝骨性關節(jié)炎的臨床療效。方法 選擇2021年6月—2022年5月中國人民解放軍聯(lián)勤保障部隊第九二一醫(yī)院收治的82例膝骨性關節(jié)炎患者，將所有患者依照隨機數(shù)字表法分為對照組（41例）和治療組（41例）。對照組口服塞來昔布膠囊，0.2 g/次，1次/d。治療組在對照組治療的基礎上于患處涂擦元七骨痛酊，2～5 mL/次，3次/d。兩組患者連續(xù)治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者步態(tài)特征，視覺模擬評分（VAS）和骨關節(jié)炎指數(shù)（WOMAC）評分，血清腫瘤壞死因子-α（TNF-α）、白細胞介素-1β（IL-1β）、白細胞介素-6（IL-6）、基質金屬蛋白酶-3（MMP-3）、骨鈣素（BGP）、骨特異性堿性磷酸酶（BALP）和抗酒石酸鹽酸性磷酸酶異構體-5b（TRACP-5b）水平。結果 治療后，治療組總有效率明顯比對照組高（95.12%vs 80.49%，P<0.05）。治療后，兩組患者步長、步速均顯著提高（P<0.05），且治療組步長、步速比對照組明顯提高（P<0.05）。治療后，兩組VAS、WOMAC評分均明顯下降（P<0.05），且與對照組相比，治療組下降更明顯（P<0.05）。治療后，治療組血清TNF-α、IL-1β、IL-6、MMP-3和TRACP-5b水平均明顯下降，而血清BALP、BGP水平均明顯升高（P<0.05），且治療組明顯好于對照組（P<0.05）。結論 元七骨痛酊聯(lián)合塞來昔布膠囊治療膝骨性關節(jié)炎具有較好的臨床療效，能夠改善步態(tài)特征，明顯減輕癥狀，抑制炎癥反應，改善骨代謝分子水平。

Objective To investigate the clinical efficacy of Yuanqi Gutong Tincture combined with Celecoxib Capsules in treatment of knee osteoarthritis. Methods Patients (82 cases) with knee osteoarthritis in the 921 Hospital of the People's Liberation Army Joint Logistic Support Force from June 2021 to May 2022 were divided into control group (41 cases) and treatment group (41 cases) according to random number table method.. Patients in the control group were po administered with Celecoxib Capsules, 0.2 g/time, once daily. Patients in the treatment group were administered with Yuanqi Gutong Tincture to the affected area on the basis of the control group, 2-5 mL/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, and the gait features, VAS and WOMAC scores, and the levels of serum TNF-α, IL-1β, IL-6, MMP-3, BALP, BGP, and TRACP-5b in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was significantly higher than that of the control group (95.12% vs 80.49%, P < 0.05). After treatment, the step length and speed in two groups were significantly increased (P < 0.05), and the step length and speed of the treatment group were significantly higher than those of the control group (P < 0.05). After treatment, the scores of VAS and WOMAC in two groups were significantly decreased (P < 0.05), and the score in the treatment group significantly decreased than that in the control group (P < 0.05). After treatment, the levels of serum TNF-α, IL-1β, IL-6, MMP-3, and TRACP-5b were significantly decreased, while the levels of serum BALP and BGP were significantly increased in the treatment group (P < 0.05), and which in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Yuanqi Gutong Tincture combined with Celecoxib Capsules has a good clinical effect in the treatment of knee osteoarthritis, which can improve gait characteristics, significantly relieve symptoms, inhibit inflammatory reaction and improve the molecular level of bone metabolism.

R982

湖南省科技計劃項目（2020JJ3165）