目的 探討附桂骨痛膠囊聯(lián)合塞來昔布治療老年膝關(guān)節(jié)骨性關(guān)節(jié)炎的臨床療效。方法 選取許昌市中醫(yī)院在2016年4月-2017年4月收治的老年膝關(guān)節(jié)骨性關(guān)節(jié)炎患者63例，隨機分成對照組（31例）和治療組（32例）。對照組患者口服塞來昔布膠囊，1粒/次，1次/d；治療組在對照組的基礎(chǔ)上口服附桂骨痛膠囊，4粒/次，3次/d。兩組患者均治療4周。評價兩組患者臨床療效，同時比較治療前后兩組患者VAS、Lequesne和ADL評分，白細(xì)胞介素1β（IL-1β）、基質(zhì)金屬蛋白酶-3（MMP-3）和腫瘤壞死因子-α（TNF-α）水平以及不良反應(yīng)發(fā)生情況。結(jié)果 治療后，對照組和治療組總有效率分別為77.42%、96.88%；兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者VAS評分、Lequesne評分均明顯降低，ADL評分明顯升高，同組比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組患者VAS評分、Lequesne評分和ADL評分均明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者IL-1β、MMP-3和TNF-α水平均明顯降低（P<0.05）；且治療組患者各指標(biāo)水平比對照組降低的更明顯（P<0.05）。對照組患者不良反應(yīng)發(fā)生率為25.81%，顯著高于治療組的6.25%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 附桂骨痛膠囊聯(lián)合塞來昔布治療老年膝關(guān)節(jié)骨性關(guān)節(jié)炎療效顯著，安全性較高，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical efficacy of Fugui Gutong Capsules combined with celecoxib in treatment of senile knee osteoarthritis. Methods Patients (63 cases) with knee osteoarthritis in Xuchang Hospital of Traditional Chinese Medicine from April 2016 to April 2017 were randomly divided into control (31 cases) and treatment (32 cases) groups. Patients in the control group were po administered with Celecoxib Capsules, 1 grain/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 VAS, Lequesne, and ADL scores, IL-1β, MMP-3 and TNF-α levels, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in control and treatment groups were 77.42% and 96.88%, respectively, and there was difference between two groups (P<0.05). After treatment, the VAS and Lequesne scores in two groups were significantly decreased, but ADL scores were significantly increased, the difference was statistically significant in the same group (P<0.05). And the VAS, Lequesne and ADL scores in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the IL-1β, MMP-3 and TNF-α levels in two groups were significantly decreased (P<0.05). And these indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the incidence of adverse reaction in the control group was 25.81%, which was significantly higher than 6.25% in the treatment group, and there were differences between two groups (P<0.05). Conclusion Fugui Gutong Capsules combined with celecoxib has remarkable curative effect in treatment of senile knee osteoarthritis with high safety, which has a certain clinical application value.