目的 探討玄七健骨片聯(lián)合鹽酸氨基葡萄糖膠囊治療膝骨關(guān)節(jié)炎（筋脈瘀滯證）的臨床療效。方法 納入2022年6月—2024年6月新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院收治的160例膝骨關(guān)節(jié)炎（筋脈瘀滯證）患者，根據(jù)隨機數(shù)字表法分為對照組和治療組，每組各80例。對照組口服硫酸氨基葡萄糖膠囊，2粒/次，3次/d。治療組在對照組的基礎(chǔ)上口服玄七健骨片，4片/次，3次/d，兩組均治療8周。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)癥候積分、Lysholm評分、WOMAC評分及GQOL-74評分，滑膜厚度和關(guān)節(jié)軟骨厚度，軟骨代謝指標(biāo)骨鈣素（BGP）、骨保護素（OPG）和抗酒石酸酸性磷酸酶-5b（TRACP-5b）水平，炎癥因子前列腺素E₂（PGE₂）、白細胞介素-17（IL-17）和腫瘤壞死因子-α（TNF-α）水平，氧化應(yīng)激指標(biāo)超氧化物歧化酶（SOD）、丙二醛（MDA）和谷胱甘肽過氧化物酶（GSH-Px）水平。結(jié)果 治療后，治療組總有效率顯著高于對照組（92.50% vs 80.00%，P＜0.022）。治療后，兩組中醫(yī)證候積分和WOMAC評分顯著降低，而Lysholm和GQOL-74評分均顯著升高（P＜0.05），且治療后治療組評分改善更明顯（P＜0.05）。治療后，兩組滑膜厚度顯著降低，而關(guān)節(jié)軟骨厚度均顯著升高（P＜0.05），且與對照組比，治療組滑膜厚度降低程度更顯著，而關(guān)節(jié)軟骨厚度升高程度更顯著（P＜0.05）。治療后，兩組BGP、OPG、SOD和GSH-Px水平顯著升高（P＜0.05），而TRACP-5b、PGE2、IL-17、TNF-α和MDA水平顯著降低（P＜0.05），且與對照組相比，治療組這些指標(biāo)水平改善程度更顯著（P＜0.05）。結(jié)論 玄七健骨片聯(lián)合鹽酸氨基葡萄糖膠囊治療膝骨關(guān)節(jié)炎（筋脈瘀滯證）的臨床療效顯著，能顯著改善膝骨關(guān)節(jié)炎患者的臨床癥狀并提高生活質(zhì)量，主要與改善機體軟骨代謝、降低炎癥狀態(tài)及氧化應(yīng)激水平有關(guān)。

Objective To investigate the clinical efficacy of Xuanqi Jiangu Tablets combined with glucosamine in treatment of Knee osteoarthritis (syndrome of stasis in muscles and veins). Methods Patients (160 cases) with knee osteoarthritis (syndrome of stasis in muscles and veins) in the First Affiliated Hospital of Xinxiang Medical University from June 2022 to June 2024 were divided into control and treatment group according to random number table method, and each group had 80 cases. Patients in the control group were po administered with Glucosamine Sulfate Capsules, 2 grains/time, three times 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. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, and the scores of TCM syndrome, Lysholm, WOMAC and GQOL-74, the synovial and articular cartilage thickness, the levels of BGP, OPG, TRACP-5b, PGE2, IL-17, TNF-α, SOD, GSH-Px and MDA in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (92.50% vs 80.00%, P < 0.05). After treatment, the TCM symptom and WOMAC scores in two groups were significantly reduced, while the Lysholm and GQOL-74 scores were significantly increased (P < 0.05), and the scores in the treatment group were improved more significantly (P < 0.05). After treatment, the synovial thickness was significantly decreased in two groups, while the articular cartilage thickness was significantly increased (P < 0.05). Compared with the control group, the synovial thickness was decreased more significantly in the treatment group, and the articular cartilage thickness was increased more significantly (P < 0.05). After treatment, the levels of BGP, OPG, SOD and GSH-Px were significantly increased in two groups (P < 0.05), while the levels of TRACP-5b, PGE2, IL-17, TNF-α and MDA were significantly decreased (P < 0.05). Compared with the control group, the levels of these indicators in the treatment group were improved more significantly (P < 0.05). Conclusion Xuanqi Jiangu Tablets combined with glucosamine in treatment of knee osteoarthritis (syndrome of stasis in muscles and veins) have significant clinical efficacy, which can significantly improve the clinical symptoms of patients with knee osteoarthritis and improve the quality of life, mainly related to improving cartilage metabolism and reducing inflammation. and oxidative stress levels.

R982

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（LHGJ20240491）；新鄉(xiāng)醫(yī)學(xué)院組織工程與再生臨床醫(yī)學(xué)中心開放課題項目（2022YFYKFKT06）