目的 探討虎力散片聯(lián)合塞來昔布膠囊治療膝骨關(guān)節(jié)炎的臨床療效。方法 選取2019年4月—2021年12月來廈門大學(xué)附屬第一醫(yī)院康復(fù)醫(yī)學(xué)科診療的170例膝骨關(guān)節(jié)炎患者，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各85例。對(duì)照組口服塞來昔布膠囊，0.2g/次，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服虎力散片，0.3g/次，2次/d。兩組用藥42d。觀察兩組的臨床療效，比較兩組臨床癥狀改善時(shí)間、兩組疼痛視覺模擬評(píng)分（VAS）、骨關(guān)節(jié)炎指數(shù)評(píng)分（WOMAC）、白細(xì)胞介素-1β（IL-1β）、血管內(nèi)皮生長因子（VEGF）、轉(zhuǎn)化生長因子-β1（TGF-β1）、腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，治療組總有效率是98.82%，顯著高于對(duì)照組的85.88%（P＜0.05）。治療后，治療組出現(xiàn)膝關(guān)節(jié)疼痛、膝關(guān)節(jié)僵硬、膝關(guān)節(jié)腫脹、膝關(guān)節(jié)發(fā)冷等癥狀改善時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組VAS評(píng)分、WOMAC評(píng)分均較治療前顯著降低（P＜0.05）；且治療后治療組VAS評(píng)分和WOMAC評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組患者IL-1β、VEGF、TNF-α水平均較治療前顯著降低，TGF-β1水平顯著升高（P＜0.05）；治療后，治療組血清因子水平改善優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 虎力散片聯(lián)合塞來昔布膠囊治療膝骨關(guān)節(jié)炎的效果確切，可有效緩解膝關(guān)節(jié)疼痛及改善關(guān)節(jié)功能，并能減輕機(jī)體炎性反應(yīng)，值得推廣應(yīng)用。

Objective To investigate the therapeutic effect of Hulisan Tablets combined with celecoxib in treatment of knee osteoarthritis. Methods A total of 170 patients with knee osteoarthritis admitted to the Department of Rehabilitation Medicine of the First Affiliated Hospital of Xiamen University from April 2019 to December 2021 were selected and divided into control group and treatment group according to random number table method, with 85 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 Hulisan Tablets, 0.3 g/time, twice daily. Both groups were treated for 42 d. The clinical efficacy of the two groups was observed, and the improvement time of clinical symptoms, pain visual analogue score (VAS), osteoarthritis index score (WOMAC), interleukin-1β (IL-1β), vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β1), tumor necrosis factor (TNF-α) levels were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 98.82%, which was significantly higher than that of the control group 85.88% (P<0.05). After treatment, the improvement time of knee pain, knee stiffness, knee swelling and knee chills in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, VAS score and WOMAC score were significantly decreased in both groups compared with before treatment (P<0.05). After treatment, VAS score and WOMAC score in the treatment group were lower than those in the control group (P<0.05). After treatment, the levels of IL-1β, VEGF and TNF-α were significantly decreased in both groups compared with before treatment, while the level of TGF-β1 was significantly increased (P<0.05). After treatment, the improvement of serum factor level in treatment group was better than that in control group (P<0.05). Conclusion Hulisan Tablets combined with celecoxib have definite therapeutic effects in treatment of knee osteoarthritis, and can effectively relieve knee pain and improve joint function, and reduce the inflammatory reaction of the body, which is worthy of popularization and application.

R977