目的 探究右歸丸聯(lián)合美洛昔康治療膝骨性關節(jié)炎的臨床療效。方法 選取2016年5月-2019年6月新鄉(xiāng)醫(yī)學院附屬第一醫(yī)院收治的膝骨性關節(jié)炎患者123例，按自愿原則分為對照組（41例）和治療組（82例）。對照組口服美洛昔康片，15 mg/次，1次/d。治療組在對照組基礎上口服右歸丸，9 g/次，3次/d，兩組患者連續(xù)治療12周。觀察兩組患者臨床療效，同時比較治療前后兩組患者骨關節(jié)炎指數(shù)（WOMAC）評分、Lysholm膝關節(jié)評分、靜息關節(jié)視覺模擬評分（VAS）和膝關節(jié)屈曲度，及炎癥因子環(huán)氧化酶-2（COX-2）、基質金屬蛋白酶-3（MMP-3）、腫瘤壞死因子-α（TNF-α）和白細胞介素-6（IL-6）水平。結果 治療后，對照組和治療組臨床有效率分別為70.73%、87.80%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者WOMAC和VAS評分顯著降低，而LKSS評分明顯升高，膝關節(jié)屈曲度明顯增加（P<0.05），且治療組上述指標明顯好于對照組（P<0.05）。治療后，兩組患者炎癥因子COX-2、MMP-3、TNF-α、IL-6水平均顯著下降（P<0.05），且治療組明顯低于對照組（P<0.05）。結論 右歸丸聯(lián)合美洛昔康治療膝骨性關節(jié)炎療效優(yōu)于單獨應用美洛昔康，可改善膝關節(jié)功能，減輕關節(jié)炎癥，安全有效。

Objective To investigate the clinical value of Yougui Pills combined with meloxicam in treatment of knee osteoarthritis. Methods Patients (123 cases) with knee osteoarthritis in the First Affiliated Hospital of Xinxiang Medical University from May 2016 to June 2019 were divided into control (41 cases) and treatment (82 cases) groups on a voluntary basis. Patients in the control group were po administered with Meloxicam Tablets, 15 mg/time, once daily. Patients in the treatment group were po administered with Yougui Pills on the basis of the control group, 9 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the WOMAC and LKSS scores, joint VAS scores at rest, knee flexion, and the inflammatory factors levels of COX-2, MMP-3, TNF-α and IL-6 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 70.73% and 87.80% respectively, and there were differences between two groups (P<0.05). After treatment, the WOMAC and VAS scores in two groups were significantly decreased (P<0.05), the LKSS scores and the knee flexion were significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the inflammatory factors levels of COX-2, MMP-3, TNF-α and IL-6 in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion The effect of Yougui Pills combined with meloxicam is better than that of meloxicam alone in treatment of knee osteoarthritis. The combination can improve knee function and reduce joint inflammation, and it is safe and effective.

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