目的 探討壯骨關節(jié)丸聯合依托考昔治療早期膝骨關節(jié)炎的臨床療效。方法 選取2020年5月-2023年5月山西省汾陽醫(yī)院收治84例的膝骨關節(jié)炎患者,依據隨機數字表法分為對照組(42例)和治療組(42例)。對照組口服依托考昔片,初始劑量為30 mg/次,若2周后癥狀無明顯緩解,劑量調整為60 mg/次,1次/d。治療組患者在對照組基礎上口服壯骨關節(jié)丸,6 g/次,2次/d。兩組患者均連續(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視覺模擬評分表(VAS)、Lysholm和SF-36評分,及血清白細胞介素-6(IL-6)、腫瘤壞死因子-α(TNF-α)和高敏C反應蛋白(hs-CRP)水平。結果 治療后,治療組總有效率為95.24%,明顯高于對照組80.95%(P<0.05)。治療后,兩組VAS評分明顯降低,而Lysholm評分明顯升高(P<0.05),且治療組評分均明顯好于對照組(P<0.05)。治療后,兩組血清IL-6、TNF-α及hs-CRP水平均明顯降低(P<0.05),且治療組血清水平降低幅度明顯大于對照組(P<0.05)。治療后,兩組SF-36各項維度評分均明顯升高(P<0.05),且治療組總體健康、軀體疼痛、生命活力、生理功能評分升高幅度大于對照組(P<0.05)。結論 壯骨關節(jié)丸聯合依托考昔治療早期膝骨關節(jié)炎具有較好的治療效果,可減輕患者的膝關節(jié)疼痛程度,改善膝關節(jié)功能、體內的炎癥狀態(tài)以及生活質量。

Objective To explore the clinical efficacy of Zhuanggu Guanjie Pills combined with etoricoxib in treatment of early knee osteoarthritis. Methods Patients (84 cases) with early knee osteoarthritis in Shanxi Province Fenyang Hospital from May 2020 to May 2023 were divided into control (42 cases) and treatment (42 cases) group according to random number table method. Patients in the control group were po administered with Etoricoxib Tablets, the initial dose was 30 mg/time, and if there was no obvious relief after 2 weeks, the dose was adjusted to 60 mg/times, once daily. Patients in the treatment group were po administered with Zhuanggu Guanjie Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, the symptom relief time, the scores VAS, Lysholm and SF-36, and the levels of serum IL-6, TNF-α and hs-CRP in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 95.24%, which was significantly higher than that of the control group (80.95%, P < 0.05). After treatment, the VAS scores in two groups were significantly decreased, while the Lysholm scores were significantly increased (P < 0.05), and the scores in the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the serum levels of IL-6, TNF-α and hs-CRP in two groups were significantly decreased (P < 0.05), and the decrease of serum level in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, SF-36 scores in each dimension of two groups were significantly increased (P < 0.05), and the scores of general health, somatic pain, vital vitality, and physiological function in the treatment group were significantly better than those of the control group (P < 0.05). Conclusion Zhuanggu Guanjie Pills combined with etoricoxib has a good therapeutic effect in the treatment of early knee osteoarthritis, which can reduce knee joint pain, improve knee joint function, inflammatory state and quality of life.

R982

山西省衛(wèi)生健康委科研課題（2019099）