目的 觀察玄七健骨片聯(lián)合美洛昔康治療膝骨關(guān)節(jié)炎的臨床療效。方法 選取2023年6月—2024年6月復(fù)旦大學(xué)附屬中山醫(yī)院青浦分院骨科收治的82例膝骨關(guān)節(jié)炎癥患者，按照隨機(jī)數(shù)字法分為對(duì)照組和治療組，每組41例。對(duì)照組患者給予口服美洛昔康片，7.5 mg/次，1次/d。治療組在對(duì)照組的基礎(chǔ)上給予口服玄七健骨片，4片/次，3次/d。兩組患者連續(xù)治療28天。觀察兩組臨床療效，比較兩組中醫(yī)癥狀評(píng)分、西安大略和麥克馬斯特大學(xué)骨關(guān)節(jié)炎指數(shù)（WOMAC）評(píng)分、視覺(jué)模擬疼痛量表（VAS）評(píng)分、簡(jiǎn)單健康狀況調(diào)查表（SF-36）評(píng)分、血清成纖維細(xì)胞生長(zhǎng)因子-2（FGF-2）、血軟骨寡聚基質(zhì)蛋白（CTX-Ⅱ）、轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）、基質(zhì)金屬蛋白酶-9（MMP-9）水平。結(jié)果 治療后，治療組總有效率是95.12%，顯著高于對(duì)照組的80.48%（P＜0.05）。治療后，兩組患者膝關(guān)節(jié)行走痛評(píng)分、膝關(guān)節(jié)腫脹評(píng)分、倦怠乏力評(píng)分、腰膝酸軟評(píng)分均顯著降低（P＜0.05）；治療后，治療組膝關(guān)節(jié)行走痛評(píng)分、膝關(guān)節(jié)腫脹評(píng)分、倦怠乏力評(píng)分、腰膝酸軟評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組WOMAC評(píng)分、VAS評(píng)分均較同組治療前顯著降低，而SF-36評(píng)分升高（P＜0.05）；治療后，治療組WOMAC評(píng)分、VAS評(píng)分低于對(duì)照組，而SF-36評(píng)分高于對(duì)照組（P＜0.05）。治療后，兩組FGF-2、TGF-β1水平均升高，而CTX-Ⅱ、MMP-9水平顯著降低（P＜0.05）；且治療后，與對(duì)照組對(duì)比，治療組FGF-2、TGF-β1水平均更高，CTX-Ⅱ、MMP-9水平均更低（P＜0.05）。結(jié)論 玄七健骨片聯(lián)合美洛昔康治療膝骨關(guān)節(jié)炎具有良好的臨床療效，能夠有效減輕疼痛和改善關(guān)節(jié)功能，較好地調(diào)節(jié)了血清細(xì)胞因子水平。

Objective To observe the clinical efficacy of Xuanqi Jiangu Tablets combined with meloxicam in treatment of knee osteoarthritis. Methods A total of 82 patients with knee osteoarthritis admitted to the Department of Orthopedics of Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from June 2023 to June 2024 were selected and divided into control group and treatment group according to random number method, with 41 cases in each group. Patients in control group were po administered with Meloxicam Tablets, 7.5 mg/time, once daily. Patients in the treatment group were po administered with Xuanqi Jiangu Tablets on the basis of the control group, 4 tablets/time, three times daily. The two groups of patients were treated continuously for 28 d. The clinical efficacy of two groups was observed. The TCM symptom scores, WOMAC scores, VAS scores, SF-36 scores, serum FGF-2, CTX-I, TGF-β1, and MMP-9 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.12%, significantly higher than that of the control group (80.48%, P < 0.05). After treatment, the scores of knee walking pain, knee swelling, fatigue and weakness, and lumbar and knee soreness and weakness in both groups were significantly decreased (P < 0.05). After treatment, knee joint walking pain score, knee joint swelling score, fatigue and weakness score, waist and knee soreness score in treatment group were lower than those in control group (P < 0.05). After treatment, the WOMAC scores and VAS scores of both groups were significantly lower than those before treatment in same group, but SF-36 score increased (P < 0.05). After treatment, the WOMAC score and VAS score of treatment group were lower than those of control group, but SF-36 score was higher than that of control group (P < 0.05). After treatment, the levels of FGF-2 and TGF-β1 in both groups increased, but the levels of CTX-II and MMP-9 significantly decreased (P < 0.05). After treatment, compared with control group, the levels of FGF-2 and TGF-β1 in treatment group were both higher. Moreover, the levels of CTX-II and MMP-9 in treatment group were both lower (P < 0.05). Conclusion Xuanqi Jiangu Tablets combined with meloxicam has a good clinical effect in treatment of knee osteoarthritis, can effectively relieve pain and improve joint function, and better regulate the levels of serum cytokines.

R982

上海市青浦區(qū)衛(wèi)生健康委員會(huì)面上項(xiàng)目（QWJ2024-06）；蚌醫(yī)自然科學(xué)重點(diǎn)項(xiàng)目（2023byzd199）