目的 探討筋骨痛消丸聯(lián)合氟比洛芬治療增生性膝骨關(guān)節(jié)炎的臨床療效及藥理作用。方法 選擇2019年4月—2021年4月在河南省洛陽(yáng)正骨醫(yī)院診治的202例增生性膝骨關(guān)節(jié)炎患者，根據(jù)就診順序分為對(duì)照組和治療組，每組各101例。對(duì)照組口服氟比洛芬緩釋片，0.2 g/次，1次/d；治療組在對(duì)照組基礎(chǔ)上口服筋骨痛消丸，6 g/次，2次/d。兩組均治療4周。觀察兩組臨床療效，比較治療前后兩組臨床癥狀改善時(shí)間，WOMAC評(píng)分、生存質(zhì)量評(píng)分（QOL-BREF）、視覺(jué)模擬評(píng)分（VAS）和膝關(guān)節(jié)評(píng)分（ISOA）及炎癥介質(zhì)高遷移率族B1蛋白（HMGB1）、白細(xì)胞介素-1α（IL-1α）、成纖維細(xì)胞生長(zhǎng)因子-2（FGF-2）、組織金屬蛋白抑制因子-1（TIMP-1）和血管內(nèi)皮細(xì)胞生長(zhǎng)因子（VEGF）水平。結(jié)果 經(jīng)治療，治療組總有效率顯著高于對(duì)照組（98.02%vs 87.13%，P<0.05）。經(jīng)治療，治療組臨床癥狀改善時(shí)間上明顯早于對(duì)照組（P<0.05）。經(jīng)治療，兩組患者WOMAC評(píng)分、VAS評(píng)分和ISOA評(píng)分明顯下降，而QOL-BREF評(píng)分明顯升高（P<0.05），且治療組患者這些評(píng)分項(xiàng)目明顯好于對(duì)照組（P<0.05）。經(jīng)治療，兩組患者血清HMGB1、IL-1α、VEGF水平均明顯降低，而FGF-2和TIMP-1水平明顯升高（P<0.05），且治療組患者炎癥介質(zhì)水平明顯好于對(duì)照組（P<0.05）。結(jié)論 筋骨痛消丸聯(lián)合氟比洛芬緩釋片治療增生性膝骨關(guān)節(jié)炎可有效改善患者臨床癥狀，促進(jìn)患者生活質(zhì)量和關(guān)節(jié)功能改善，有利于改善機(jī)體細(xì)胞因子的改善。

Objective To investigate the clinical efficacy and pharmacological action of Jingutongxiao Pills combined with flurbiprofen in treatment of proliferative knee osteoarthritis. Methods Patients (202 cases) with proliferative knee osteoarthritis in Luoyang Orthopedic-Traumatological Hospital of Henan Province from April 2019 to April 2021 were divided into control (101 cases) and treatment (101 cases) groups. Patients in the control group were po administered with Flurbiprofen Sustained Release Tablets, 0.2 g/time, once daily. Patients in the treatment group were po administered with Jingu Tongxiao Pills, 6 g/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the scores of WOMAC, QOL-BREF, VAS, and ISOA, and the levels of inflammatory mediators HMGB1, IL-1α, VEGF, FGF-2, and TIMP-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (98.02% vs 87.13%, P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P< 0.05). After treatment, the WOMAC score, VAS score and ISOA score in two groups were significantly decreased, while the QOL-BREF score was significantly increased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of serum HMGB1, IL-1α, and VEGF were significantly decreased, while the levels of FGF-2 and TIMP-1 were significantly increased in two groups (P < 0.05), and the level of inflammatory mediators in the treatment group was significantly better than that in the control group (P< 0.05). Conclusion Jingu Tongxiao Pills combined with and flurbiprofen in treatment of proliferative knee osteoarthritis can effectively improve the clinical symptoms, the quality of life and joint function, and the cytokines.

R977

河南省衛(wèi)生健康委項(xiàng)目（20-21ZY1059）