目的 探討尪痹膠囊聯(lián)合玻璃酸鈉治療踝關節(jié)創(chuàng)傷性關節(jié)炎的臨床療效。方法 選擇2021年10月—2022年4月海南省中醫(yī)院收治的90例踝關節(jié)創(chuàng)傷性關節(jié)炎患者，按照數(shù)字隨機法分為對照組和治療組，每組各45例。對照組關節(jié)囊內(nèi)注射玻璃酸鈉注射液，20 mg/次，1次/周。在對照組的基礎上，治療組口服尪痹膠囊，5粒/次，3次/d。兩組治療12周。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀緩解時間，視覺模擬評分法（VAS）和Mcguire踝關節(jié)功能評分，血清腫瘤壞死因子-α（TNF-α）、干擾素誘生蛋白-10（IP-10）、白細胞介素-1β（IL-1β）和白細胞介素-6（IL-6）水平，及不良反應。結(jié)果 治療后，治療組患者臨床有效率為97.78%，明顯高于對照組有效率（82.22%，P＜0.05）。治療后，治療組癥狀緩解時間均早于對照組（P＜0.05）。治療后，兩組VAS評分明顯低于治療前，而Mcguire踝關節(jié)功能評分明顯高于治療前（P＜0.05），且治療組評分明顯好于對照組（P＜0.05）。治療后，兩組患者血清炎性因子IL-1β、IL-6、IP-10、TNF-α水平較治療前明顯降低（P＜0.05），且治療組明顯均低于對照組（P＜0.05）。治療后，治療組不良反應總發(fā)生率為8.89%，明顯低于對照組（15.56%，P＜0.05）。結(jié)論 尪痹膠囊聯(lián)合玻璃酸鈉注射液治療踝關節(jié)創(chuàng)傷性關節(jié)炎效果確切，能有效緩解踝關節(jié)功能，有效減弱關節(jié)炎性反應，促進疼痛狀態(tài)好轉(zhuǎn)，且安全可靠。

Objective To investigate the effect of Wangbi Capsules combined with intra-articular injection of sodium hyaluronate in treatment of traumatic arthritis of ankle joint. Methods Patients (90 cases) with traumatic arthritis of ankle joint in Hainan Traditional Chinese Medicine Hospital from October 2021 to April 2022 were divided into control and treatment group by the random number table method, and each group had 45 cases. Patients in the control group was intra-articular injection administered with Sodium Hyaluronate Injection, 20 mg/time, once weekly. Patients in the treatment group were po administered with Wangbi Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluation was evaluated, and the symptom relief time, the scores of VAS and McGuire ankle function, the levels of serum factor IL-1β, IL-6, IP-10 and TNF-α, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 97.78%, which was significantly higher than that of the control group (82.22%, P < 0.05). After treatment, the time of symptom relief in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the VAS score in two groups was significantly lower than that before treatment, while the Mcguire ankle function score was significantly higher than that before treatment (P < 0.05), and the scores of the treatment group were significantly better than that of the control group (P < 0.05). After treatment, the levels of serum inflammatory factors IL-1β, IL-6, IP-10, and TNF-α in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the total incidence of adverse reactions in the treatment group was 8.89%, which was significantly lower than that in the control group (15.56%, P < 0.05). Conclusion Wangbi Capsules combined with intra-articular injection of sodium hyaluronate have definite therapeutic effect in treatment of traumatic arthritis of ankle joint, can effectively relieve the ankle function, effectively weaken the joint inflammatory reaction, and promote the improvement of pain state, and which is safe and reliable.

R977

海南省臨床醫(yī)學中心建設項目（21A200188）