目的 探討復方玄駒膠囊聯(lián)合雙醋瑞因治療膝骨性關(guān)節(jié)炎的臨床療效。方法 選取2019年5月—2021年4月在揚州大學醫(yī)學院附屬沭陽醫(yī)院就診的200例膝骨性關(guān)節(jié)炎患者作為研究對象，按照治療方法將患者分為對照組和觀察組，各100例。對照組口服雙醋瑞因膠囊，50 mg/次，2次/d。觀察組在對照組基礎(chǔ)上口服復方玄駒膠囊，3粒/次，3次/d。患者連續(xù)治療4周。觀察兩組的臨床療效，比較兩組治療前后的西安大略和麥馬斯特大學骨關(guān)節(jié)炎指數(shù)（WOMAC）、膝關(guān)節(jié)的活動度評分（ROM）、膝關(guān)節(jié)功能評分（Lysholm）以及血清人類軟骨寡聚蛋白（COMP）、基質(zhì)金屬蛋白酶-3（MMP-3）、白細胞介素-17（IL-17）水平。結(jié)果 治療后，觀察組的總有效率為91.00%，明顯高于對照組的80.00%，差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的疼痛、僵硬、日常生活評分、WOMAC總分顯著降低（P<0.05）；治療后，觀察組的疼痛、僵硬、日常生活評分、WOMAC總分顯著低于對照組，差異有統(tǒng)計學意義（P<0.05）。治療后，兩組ROM評分、Lysholm評分均顯著升高（P<0.05），且觀察組ROM評分、Lysholm評分顯著高于對照組（P<0.05）。治療后，兩組的COMP、MMP-3、IL-17水平均顯著降低（P<0.05）；且觀察組COMP、MMP-3和IL-17水平顯著低于對照組，差異有統(tǒng)計學意義（P<0.05）。結(jié)論 復方玄駒膠囊聯(lián)合雙醋瑞因治療膝骨性關(guān)節(jié)炎的療效確切，可改善膝關(guān)節(jié)功能和活動度，控制病情，可能與調(diào)節(jié)炎癥因子有關(guān)，安全性良好。

Objective To investigate the clinical efficacy of Compound Xuanju Capsules combined with diacerein in treatment of knee osteoarthritis. Methods A total of 200 patients with knee osteoarthritis admitted to Shuyang Hospital Affiliated to Medical College of Yangzhou University from May 2019 to April 2021 were selected as the research subjects. According to the treatment methods, the patients were divided into control group and observation group, with 100 patients in each group. Patients in the control group were po administered with Diacerein Capsules, 50 mg/time, twice daily. Patients in the observation group were po administered with Compound Xuanju Capsules on the basis of control, three capsules/time, three times daily. Patients were treated for four weeks. The clinical efficacy of two groups was observed. WOMAC scores, ROM scores, Lysholm scores, and the levels of COMP, MMP-3, and IL-17 before and after treatment were compared between two groups. Results After treatment, the total effective rate of the observation group was 91.00%, significantly higher than 80.00% of the control group, and the difference was statistically significant (P < 0.05). After treatment, pain, stiffness, daily living score, and WOMAC total score were significantly decreased in both groups (P < 0.05). After treatment, the pain, stiffness, daily life score, and WOMAC total score in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). After treatment, ROM score and Lysholm score in two groups were significantly increased (P < 0.05), and ROM score and Lysholm score in observation group were significantly higher than those in control group (P < 0.05). After treatment, the levels of COMP, MMP-3, and IL-17 in two groups were significantly decreased (P < 0.05). The levels of COMP, MMP-3 and IL-17 in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). Conclusion Compound Xuanju Capsules combined with diacerein has definite efficacy in treatment of knee osteoarthritis, which can improve the function and activity of knee joint and control the condition. It may be related to the regulation of inflammatory factors and has good safety.

R982