目的 探討無(wú)敵丹膠囊聯(lián)合塞來(lái)昔布治療膝骨關(guān)節(jié)炎的臨床療效。方法 回顧性分析2020年8月—2021年6月在安鋼總醫(yī)院治療的126例膝骨關(guān)節(jié)炎患者臨床資料，根據(jù)用藥的差別將患者分為對(duì)照組和治療組，每組各63例。對(duì)照組口服塞來(lái)昔布膠囊，0.2 g/次，1次/d；治療組在對(duì)照組基礎(chǔ)上口服無(wú)敵丹膠囊，0.8 g/次，3次/d。兩組均經(jīng)4周治療進(jìn)行效果比較。觀察兩組的臨床療效，比較兩組治療前后相關(guān)評(píng)分、疼痛介質(zhì)水平和血清學(xué)指標(biāo)的變化情況。結(jié)果 經(jīng)治療，治療組總有效率是98.41%，顯著高于對(duì)照組82.54%（P<0.05）。經(jīng)治療，兩組Lequesne指數(shù)、VAS評(píng)分、ISOA評(píng)分和臨床癥狀評(píng)分均顯著降低，但GQOLI-74評(píng)分顯著升高（P<0.05）；治療后，治療組相關(guān)評(píng)分改善優(yōu)于對(duì)照組（P<0.05）。經(jīng)治療，兩組血清P物質(zhì)（SP）、前列腺素E₂（PGE₂）、5-羥色胺（5-HT）、多巴胺（DA）均顯著降低（P<0.05）；且治療后，治療組患者疼痛介質(zhì)水平低于對(duì)照組（P<0.05）。經(jīng)治療，兩組血清腫瘤壞死因子-α（TNF-α）、堿性成纖維細(xì)胞生長(zhǎng)因子（β-FGF）、基質(zhì)金屬蛋白酶-3（MMP-3）、白細(xì)胞介素-6（IL-6）水平均顯著降低，但金屬蛋白酶組織抑制因子1（TIMP1）顯著升高（P<0.05）；治療后，治療組炎癥介質(zhì)水平改善優(yōu)于對(duì)照組（P<0.05）。結(jié)論 無(wú)敵丹膠囊聯(lián)合塞來(lái)昔布膠囊治療膝骨關(guān)節(jié)炎可有效改善患者癥狀，改善關(guān)節(jié)功能，抑制炎癥介質(zhì)和疼痛介質(zhì)的表達(dá)，有著良好臨床應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Wudidan Capsules combined with celecoxib in treatment of knee osteoarthritis. Methods Clinical data of 126 patients with knee osteoarthritis treated in Angang General Hospital from August 2020 to June 2021 were retrospectively analyzed, and the patients were divided into control group and treatment group according to the difference of medication, with 63 cases in each group. Patients in the control group were po administered with Celecoxib Capsules, 0.2 g/time, once daily. Patients in the treatment group were po administered with Wudidan Capsules on the basis of the control group, 0.8 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the levels of related scores, pain mediators and serological indexes before and after treatment were compared.Results After treatment, the total effective rate of the treatment group was 98.41%, which was significantly higher than that of the control group (82.54%, P<0.05). After treatment, Lequesne index, VAS score, ISOA score and clinical symptom score were significantly decreased in both groups, but GQOLI-74 score was significantly increased (P<0.05). After treatment, the improvement of related scores in the treatment group was better than that in the control group (P<0.05). After treatment, the serum substance P (SP), prostaglandin E₂(PGE₂), 5-hydroxytryptamine (5-HT), and dopamine (DA) in two groups were significantly decreased (P<0.05). After treatment, the level of pain mediators in treatment group was lower than that in control group (P<0.05). After treatment, the serum levels of tumor necrosis factor-α (TNF-α), basic fibroblast growth factor (β-FGF), matrix metalloproteinase-3 (MMP-3), and interleukin-6 (IL-6) were significantly decreased in both groups, but the tissue inhibitor of metalloproteinase-1 (TIMP1) was significantly increased (P<0.05). After treatment, the level of inflammatory mediators in the treatment group was improved better than that in the control group (P<0.05). Conclusion Wudidan Capsules combined with celecoxib can effectively improve the symptoms of patients in treatment of knee osteoarthritis, and can improve joint function, inhibit the expression of inflammatory mediators and pain mediators, which has good clinical application value.

R977

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃（聯(lián)合共建）項(xiàng)目（LHGJ20191445）