目的 評估金烏骨通膠囊聯(lián)合氟比洛芬凝膠貼膏治療膝骨關(guān)節(jié)炎的臨床療效。方法 選取2024年1月—2024年12月武漢大學(xué)中南醫(yī)院收治的100例膝骨關(guān)節(jié)炎患者，經(jīng)隨機(jī)數(shù)字表法將分為對照組和治療組，各50例。對照組給予氟比洛芬凝膠貼膏，1貼/次，1次/d。治療組給予氟比洛芬凝膠貼膏和金烏骨通膠囊，氟比洛芬凝膠貼膏給藥方式參照對照組，飯后服用金烏骨通膠囊，3粒/次，3次/d。兩組患者均治療1個月。觀察兩組治療效果、癥狀緩解時間，比較兩組骨代謝指標(biāo)[骨保護(hù)素（OPG）和骨鈣素（BGP）]、炎癥因子[白細(xì)胞介素-1α（IL-1α）、白細(xì)胞介素-17（IL-17）、白細(xì)胞介素-6（IL-6）和腫瘤壞死因子-α（TNF-α）]、Harris評分、關(guān)節(jié)功能及活動度、運動恐懼程度[坦帕運動恐懼癥量表（TSK）]。結(jié)果 治療后，治療組總有效率是98.00%，顯著高于對照組的82.00%（P＜0.05）。治療過程中，治療組膝關(guān)節(jié)疼痛緩解時間、膝關(guān)節(jié)紅腫緩解時間及關(guān)節(jié)活動受限緩解時間均較對照組更短（P＜0.05）。治療后，兩組患者OPG、BGP水平均升高（P＜0.05）；治療后治療組OPG、BGP水平顯著高于對照組（P＜0.05）。治療后，兩組IL-1α、IL-17、IL-6、TNF-α水平均較同組治療前下降（P＜0.05）；治療后，治療組IL-1α、IL-17、IL-6、TNF-α水平低于對照組（P＜0.05）。治療后，兩組Harris較前顯著升高，膝關(guān)節(jié)主動及被動活動度均擴(kuò)大，TSK評分顯著降低（P＜0.05）；治療后，治療組Harris、膝關(guān)節(jié)主動及被動活動度高于對照組，TSK評分低于對照組（P＜0.05）。結(jié)論 金烏骨通膠囊聯(lián)合氟比洛芬凝膠貼膏治療膝骨關(guān)節(jié)炎患者可顯著提升治療總有效率，下調(diào)炎癥因子水平同時改善骨代謝指標(biāo)，促進(jìn)關(guān)節(jié)功能與活動度恢復(fù)，降低患者運動恐懼現(xiàn)狀。

Objective To investigate the therapeutic effect of Jinwu Gutong Capsules combined with flurbiprofen in treatment of knee osteoarthritis. Methods A total of 100 patients with knee osteoarthritis admitted to Zhongnan Hospital of Wuhan University from January 2024 to December 2024 were selected and divided into control group and treatment group by random number table method, with 50 cases in each group. Patients in control group were given Flurbiprofen Cataplasms, 1 patch each time, once daily. Patients in treatment group were given Flurbiprofen Cataplasms and Jinwu Gutong Capsules. The administration method of Flurbiprofen Cataplasms was the same as that of control group. Jinwu Gutong Capsules were taken after meals, 3 capsules each time, 3 times daily. Both groups of patients were treated for one month. The therapeutic effects and symptom relief time of two groups were observed. The bone metabolism indicators (OPG and BGP), inflammatory factors (IL-1α, IL-17, IL-6, and TNF-α), Harris score, joint function and range of motion, and fear degree of movement (TSK) were compared between two groups. Results After treatment, the total effective rate of treatment group was 98.00%, significantly higher than that of control group (82.00%, P < 0.05). During the treatment process, the relief time of knee pain, knee redness and swelling, and joint movement limitation in treatment group was shorter than that in control group (P < 0.05). After treatment, the levels of OPG and BGP in both groups of patients increased (P < 0.05). After treatment, the levels of OPG and BGP in treatment group were significantly higher than those in control group (P < 0.05). After treatment, the levels of IL-1α, IL-17, IL-6, and TNF-α in both groups decreased compared with those before treatment in same group (P < 0.05). After treatment, the levels of IL-1α, IL-17, IL-6, and TNF-α in treatment group were lower than those in control group (P < 0.05). After treatment, the Harris in both groups increased significantly compared with before, the active and passive ranges of motion of the knee joint expanded, and the TSK score decreased significantly (P < 0.05). After treatment, the Harris, active and passive range of motion of the knee joint in treatment group were higher than those in control group, and the TSK score was lower than that in control group (P < 0.05). Conclusion Jinwu Gutong Capsules combined with flurbiprofen in treatment of knee osteoarthritis can significantly increase the total effective rate of treatment, lower the levels of inflammatory factors while improving bone metabolic indicators, promote the recovery of joint function and range of motion, and reduce the current situation of patients’ fear of exercise.

R977

中央高?；究蒲袠I(yè)務(wù)費專項資金資助（2042022kf1143）