目的 探討附桂骨痛膠囊聯(lián)合依托考昔治療膝骨關節(jié)炎急性期的安全性與有效性。方法 選取2019年10月—2020年9月在天津市津南醫(yī)院就診的117例膝骨關節(jié)炎急性期患者，按照入院順序分成對照組（58例）和治療組（59例）。對照組口服依托考昔片，60 mg/次，1次/d。治療組患者在對照組用藥基礎上口服附桂骨痛膠囊，4粒/次，3次/d。兩組患者均連續(xù)治療4周。觀察兩組患者的臨床療效，比較兩組治療前后Lequesne指數(shù)評分、血清學指標及不良反應。結果 治療后，治療組總有效率是94.92%，明顯高于對照組的81.03%（P<0.05）。治療后，兩組患者疼痛或不適評分、行走距離評分、每日活動能力評分及Lequesne指數(shù)總評分均顯著下降，與同組治療前相比較均具有顯著性差異（P<0.05）；且治療后治療組疼痛或不適、行走距離、每日活動能力及總評分均要明顯低于對照組（P<0.05）。治療后，兩組患者白細胞介素-23（IL-23）、基質金屬蛋白酶9（MMP-9）及軟骨寡聚基質蛋白（COMP）水平均較治療前顯著下降（P<0.05）；治療后治療組各指標相較于對照組下降的更顯著（P<0.05）。治療過程中，治療組不良反應發(fā)生率是3.39%，明顯低于對照組的13.79%（P<0.05）。結論 附桂骨痛膠囊聯(lián)合依托考昔能顯著提升膝骨關節(jié)炎急性期的臨床治療效果，改善患者的病情程度和關節(jié)功能狀態(tài)，降低血清學指標水平，具有一定的臨床推廣應用價值。

Objective To investigate the safety and effectiveness of Fugui Gutong Capsules combined with etoricoxib in treatment of acute stage of knee osteoarthritis. Methods A total of 117 patients with acute stage of knee osteoarthritis admitted to Tianjin Jinnan Hospital from October 2019 to September 2020 were selected and divided into control group (58 cases) and treatment group (59 cases) according to admission order. Patients in the control group were po administered with Etoricoxib Tablets, 60 mg/time, once daily. Patients in the treatment group were po administered with Fugui Gutong Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the levels of Lequesne index score, serological indexes before and after treatment and adverse reactions were compared between two groups. Results After treatment, the total effective rate of the treatment group was 94.92%, which was significantly higher than that of the control group (81.03%, P<0.05). After treatment, pain or discomfort score, walking distance score, daily activity score and Lequesne index score in two groups were significantly decreased, and there were significant differences compared with before treatment (P<0.05). After treatment, the pain or discomfort, walking distance, daily activity ability and total score in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of interleukin-23 (IL-23), matrix metalloproteinase-9 (MMP-9) and cartilage oligomer matrix protein (COMP) in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, each index in the treatment group decreased more significantly than that in the control group (P<0.05). During the course of treatment, the incidence of ADR in the treatment group was 3.39%, which was significantly lower than that in the control group (13.79%, P<0.05). Conclusion Fugui Gutong Capsules combined with etoricoxib can significantly improve the clinical treatment effect of acute knee osteoarthritis, also can improve the severity of the patient's condition and joint function, and reduce the level of serological indicators, which has a certain clinical application value.

R977

天津市重點實驗室開放基金項目（SY-04-201902-003）