目的 探討恒古骨傷愈合劑聯(lián)合鹽酸氨基葡萄糖膠囊治療膝骨關(guān)節(jié)炎的臨床療效。方法 選取2020年5月—2022年5月在海南省中醫(yī)院進(jìn)行診治的200例膝骨關(guān)節(jié)炎患者為研究對(duì)象,根據(jù)用藥的差別分為對(duì)照組和治療組,每組各100例。對(duì)照組患者口服鹽酸氨基葡萄糖膠囊,2粒/次,3次/d;治療組在對(duì)照組基礎(chǔ)上口服恒古骨傷愈合劑,25 mL/次,1次/2 d。兩組均連續(xù)治療6周。觀察兩組患者的臨床療效,比較兩組患者相關(guān)量表評(píng)分、臨床癥狀改善時(shí)間、血清炎癥因子水平。結(jié)果 經(jīng)治療,治療組總有效率是99.0%,顯著高于對(duì)照組的86.0%(P<0.05)。經(jīng)治療,兩組西大略和麥克馬斯特大學(xué)骨關(guān)節(jié)炎指數(shù)(WOMAC)評(píng)分、視覺模擬(VAS)評(píng)分、膝關(guān)節(jié)骨性關(guān)節(jié)炎嚴(yán)重性指數(shù)(ISOA)評(píng)分均較治療前顯著降低,而關(guān)節(jié)炎生活質(zhì)量量表(AIMS2-SF)評(píng)分、美國膝關(guān)節(jié)協(xié)會(huì)(AKSS)評(píng)分顯著升高,治療后,治療組WOMAC評(píng)分、VAS評(píng)分、ISOA評(píng)分低于對(duì)照組,而AIMS2-SF評(píng)分、AKSS評(píng)分高于對(duì)照組(P<0.05)。經(jīng)治療,治療組晨僵、腫脹、疼痛、灼熱、屈伸不利改善時(shí)間均顯著短于對(duì)照組(P<0.05)。經(jīng)治療,兩組患者血清白細(xì)胞介素-1β(IL-1β)、白細(xì)胞介素-17(IL-17)、腫瘤壞死因子-α(TNF-α)、基質(zhì)金屬蛋白酶-3(MMP-3)水平均較治療前顯著降低,而轉(zhuǎn)化生長(zhǎng)因子-β(TGF-β)顯著升高(P<0.05);治療后治療組各炎癥因子水平改善優(yōu)于對(duì)照組(P<0.05)。結(jié)論 恒古骨傷愈合劑聯(lián)合鹽酸氨基葡萄糖膠囊治療膝骨關(guān)節(jié)炎具有較好的臨床療效,可提高患者生活質(zhì)量、改善臨床癥狀,也可有效改善關(guān)節(jié)功能,調(diào)節(jié)炎癥細(xì)胞因子水平,具有一定的臨床應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Osteoking combined with glucosamine hydrochloride in treatment of knee osteoarthritis.Methods A total of 200 patients with knee osteoarthritis diagnosed and treated in Hainan Hospital of Traditional Chinese Medicine from May 2020 to May 2022 were selected as the research objects and divided into control group and treatment group according to the difference of medication, with 100 cases in each group. Patients in the control group were po administered with Glucosamine Hydrochloride Capsules, 2 grains/time, three times daily. Patients in the treatment group were po administered with Osteoking on the basis of the control group, 25 mL/time once every two days. Both groups were treated continuously for 6 weeks. The clinical efficacy of the two groups was observed, and the scores of relevant scales, the improvement time of clinical symptoms and the levels of serum inflammatory factors were compared between the two groups.Results After treatment, the total effective rate of the treatment group was 99.0%, significantly higher than that of the control group(86.0%)(P<0.05). After treatment, WOMAC score,visual analog score and ISOA score of Western Ontario University and McMaster University were significantly lower than before treatment, while AIMS2-SF score, and AKSS score of Arthritis Quality of Life Scale were significantly higher. After treatment,WOMAC score, VAS score, and ISOA score in the treatment group were lower than those in the control group, while AIMS2-SF score and AKSS score were higher than those in the control group(P<0.05). After treatment, the improvement time of morning stiffness,swelling, pain, burning and flexion and extension impairment in the treatment group was significantly shorter than that in the control group(P<0.05). After treatment, serum levels of interleukin-1β(IL-1β), interleukin-17(IL-17), tumor necrosis factor-α(TNF-α),and matrix metalloproteinase-3(MMP-3) in two groups were significantly decreased compared with before treatment, but transforming growth factor-β(TGF-β) was significantly increased(P<0.05). After treatment, the improvement of inflammatory mediators in the treatment group was better than that in the control group(P<0.05).Conclusion Osteoking combined with glucosamine hydrochloride has good clinical efficacy in treatment of knee osteoarthritis, and can improve the quality of life of patients, improve clinical symptoms, can also effectively improve joint function, regulate the level of inflammatory cytokine s,which has certain clinical application value.

R977