目的 探討通絡(luò)祛痛膏聯(lián)合依托考昔治療膝骨關(guān)節(jié)炎的臨床療效。方法 選取2019年8月—2022年7月東營市東營區(qū)人民醫(yī)院收治的122例膝骨關(guān)節(jié)炎患者，按隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各61例。對照組口服依托考昔片，60 mg/次，1次/d。治療組在對照組治療基礎(chǔ)上使用通絡(luò)祛痛膏，根據(jù)患者痛處面積大小選用1～2貼外貼于患膝，1次/d，每次貼敷時(shí)間＜12 h。兩組療程均為8周。觀察兩組的臨床療效，比較治療前后兩組膝關(guān)節(jié)晨僵時(shí)間、疼痛視覺模擬量表（VAS）評分、腫脹評分和活動(dòng)度，病情嚴(yán)重程度評分、膝骨性關(guān)節(jié)炎生存質(zhì)量量表（QOL-KOA）總分、紅細(xì)胞沉降率（ESR）及血清血小板反應(yīng)蛋白-1（TSP-1）、Toll樣受體4（TLR4）、C反應(yīng)蛋白（CRP）、高遷移率族蛋白B1（HMGB1）水平。結(jié)果 治療后，治療組總有效率是95.08%，顯著高于對照組的83.61%（P＜0.05）。治療后，兩組膝關(guān)節(jié)晨僵時(shí)間均顯著縮短，疼痛VAS評分和腫脹評分均顯著降低，主、被動(dòng)活動(dòng)度均顯著增加（P＜0.05）；治療后，這些指標(biāo)均以治療組改善更明顯（P＜0.05）。治療后，兩組患者病情嚴(yán)重程度評分、QOL-KOA總分均顯著降低（P＜0.05），且以治療組下降更顯著（P＜0.05）。治療后，兩組ESR和血清TSP-1、TLR4、CRP、HMGB1水平較治療前均顯著下降（P＜0.05）；且治療后，治療組ESR和血清TSP-1、TLR4、CRP、HMGB1水平均顯著低于對照組（P＜0.05）。結(jié)論 通絡(luò)祛痛膏聯(lián)合依托考昔治療膝骨關(guān)節(jié)炎有確切療效，在改善患者膝關(guān)節(jié)癥狀、減輕病情及提高生活質(zhì)量方面均可獲得滿意效果，并可進(jìn)一步抑制機(jī)體炎癥反應(yīng)，且安全性較高。

Objective To investigate the clinical efficacy of Tongluo Qutong Ointment combined with etoricoxib in treatment of knee osteoarthritis. Methods A total of 122 patients with knee osteoarthritis admitted to Dongying District People’s Hospital of Dongying City from August 2019 to July 2022 were selected and divided into control group and treatment group according to random number table method, with 61 cases in each group. Patients in the control group were po administered with Etoricoxib Tablets, 60 mg/time, once daily. Patients in the treatment group were administered with Tongluo Qutong Ointment on the basis of the control group. According to the pain area of the patient, one to two external patches were applied to the affected knee, once daily, and the time of each patch was less than 12 h. The treatment course of both groups was 8 weeks. The clinical efficacy of the two groups were observed, and the time of morning stiffness of knee joint, VAS score, swelling score and range of motion, severity score, QOL-KOA score, erythrocyte settlement rate (ESR), TSP-1, TLR4, CRP, and HMGB1 were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 95.08%, which was significantly higher than that of the control group (83.61%, P < 0.05). After treatment, morning stiffness time of knee joint was significantly shortened, pain VAS score and swelling score were significantly decreased, and active and passive activity were significantly increased in both groups (P < 0.05). After treatment, these indexes were improved more significantly in the treatment group (P < 0.05). After treatment, the score of disease severity and the total score of QOL-KOA in 2 groups were significantly decreased (P < 0.05), and the decrease was more significant in the treatment group (P < 0.05). After treatment, the levels of ESR, serum TSP-1, TLR4, CRP and HMGB1 in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of ESR, serum TSP-1, TLR4, CRP and HMGB1 in treatment group were significantly lower than those in control group (P < 0.05). Conclusion Tongluo Qutong Ointment combined with etoricoxib has a definite curative effect in treatment of knee osteoarthritis. Satisfactory effects can be obtained in improving knee joint symptoms, relieving disease and improving quality of life, and can further inhibit the body’s inflammatory response, and it is safe higher.

R977

東營市衛(wèi)生和計(jì)劃生育委員會(huì)基金項(xiàng)目（2017HW252）