目的 探討仙靈骨葆膠囊聯(lián)合雙醋瑞因治療退行性骨關節(jié)炎的臨床療效。方法 選取2018年1月—2021年2月在桂林市中西醫(yī)結合醫(yī)院骨科門診診療的110例退行性骨關節(jié)炎患者，按照隨機數字表法將所有患者分為對照組和治療組，每組各55例。對照組患者餐后口服雙醋瑞因膠囊，1粒/次，1次/d。治療組在對照組治療基礎上口服仙靈骨葆膠囊，3粒/次，2次/d。兩組均連續(xù)治療6周。觀察兩組的臨床療效和癥狀緩解時間，比較兩組治療前后視覺模擬（VAS）評分、骨關節(jié)炎（Lequesne）指數評分、白細胞介素6-（IL-6）、白細胞介素-1（IL-1）、腫瘤壞死因子-α（TNF-α）、基質金屬蛋白酶-1（MMP-1）的變化情況。結果 治療后，治療組總有效率是98.18%，顯著高于對照組的81.82%（P＜0.05）。經治療，治療組關節(jié)腫脹、關節(jié)疼痛、關節(jié)活動受限、關節(jié)晨僵等癥狀緩解時間均明顯短于對照組（P＜0.05）。治療后，兩組VAS評分、Lequesne指數評分均較同組治療前顯著降低（P＜0.05），且治療后治療組VAS評分、Lequesne指數評分明顯低于對照組（P＜0.05）。治療后，兩組患者IL-6、IL-1、TNF-α、MMP-1水平均較治療前顯著降低（P＜0.05）；且治療后，治療組IL-6、IL-1、TNF-α、MMP-1水平明顯低于對照組（P＜0.05）。治療后，治療組不良反應發(fā)生率是7.27%，明顯低于對照組的16.36%（P＜0.05）。結論 仙靈骨葆膠囊聯(lián)合雙醋瑞因治療退行性骨關節(jié)炎可提高臨床效果，能改善骨關節(jié)功能，更有效地抑制關節(jié)炎性反應，值得借鑒和推廣。

Objective To investigate the efficacy of Xianling Gubao Capsules combined with diacerein in treatment of degenerative osteoarthritis. Methods A total of 110 patients with degenerative osteoarthritis treated in the orthopedics outpatient of Guilin Hospital of Traditional and Western Medicine from January 2018 to February 2021 were selected. According to the random number table method, all patients were divided into control group and treatment group, with 55 cases in each group. Patients in the control group were po administered with Diacerein Capsules, 1 grain/time, once daily. Patients in the treatment group were po administered with Xianling Gubao Capsules on the basis of the control group, 3 grains/time, twice daily. Both groups were treated for 6 weeks. The clinical efficacy and symptom relief time of two groups were observed, and the changes of VAS score, Lequesne index score, IL-6, IL-1, TNF-α, and MMP-1 before and after treatment were compared between two groups. Results After, The total effective rate of treatment group was 98.18%, significantly higher than that of control group 81.82% (P < 0.05). After treatment, the relief time of joint swelling, joint pain, joint mobility limitation, joint stiffness and other symptoms in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, VAS score and Lequesne index score in two groups were significantly lower than those before treatment (P < 0.05), and VAS score and Lequesne index score in treatment group were significantly lower than those in control group (P < 0.05). After treatment, the levels of IL-6, IL-1, TNF-α, and MMP-1 in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of IL-6, IL-1, TNF-α, and MMP-1 in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the incidence of adverse reactions in the treatment group was 7.27%, significantly lower than that in the control group (16.36%) (P < 0.05). Conclusion Xianling Gubao Capsules combined with diacerein can improve clinical effect in treatment of degenerative osteoarthritis, and can improve the function of bone and joint and inhibit the inflammatory reaction of joint effectively, which is worthy of reference and promotion.

R982

廣西壯族自治區(qū)衛(wèi)生和計劃生育委員會自籌經費科研課題(Z20180146)