目的 探討骨痛靈酊聯(lián)合玻璃酸鈉治療踝關(guān)節(jié)炎的臨床療效。方法 選取2020年6月—2023年5月華北醫(yī)療健康集團(tuán)峰峰總醫(yī)院收治的82例踝關(guān)節(jié)炎患者，按隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各41例。對(duì)照組關(guān)節(jié)腔內(nèi)注射玻璃酸鈉注射液，2 mL/次，1次/周。治療組在對(duì)照組治療基礎(chǔ)上外用骨痛靈酊，10 mL浸于敷帶上，貼敷于患處，30 min/次，1次/d。兩組療程12周。觀察兩組的臨床療效，比較治療前后兩組踝關(guān)節(jié)腫脹評(píng)分、疼痛視覺模擬量表（VAS）評(píng)分、晨僵時(shí)間、Kofoed踝關(guān)節(jié)功能評(píng)分、AOFAS踝與后足功能評(píng)分、36項(xiàng)健康調(diào)查簡(jiǎn)表（SF-36）評(píng)分及血清轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）水平。結(jié)果 治療后，治療組總有效率是95.12%，較對(duì)照組的80.49%顯著提高（P＜0.05）。治療后，兩組腫脹評(píng)分、疼痛VAS評(píng)分均顯著降低，晨僵時(shí)間均顯著縮短（P＜0.05）；治療后，治療組腫脹評(píng)分、疼痛VAS評(píng)分和晨僵時(shí)間改善均優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組Kofoed踝關(guān)節(jié)功能評(píng)分中疼痛、功能、活動(dòng)度評(píng)分及其總分均顯著增加（P＜0.05）；以治療組增加更顯著（P＜0.05）。治療后，兩組AOFAS踝與后足功能評(píng)分、SF-36評(píng)分均顯著增加，而血清TGF-β1水平均顯著降低（P＜0.05）；治療后，治療組AOFAS踝與后足功能評(píng)分、SF-36評(píng)分和血清TGF-β1改善優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 骨痛靈酊聯(lián)合玻璃酸鈉治療踝關(guān)節(jié)炎在療效及安全性方面具有較佳表現(xiàn)，能有效減輕患者臨床癥狀、改善踝關(guān)節(jié)功能及提升生活質(zhì)量，并下調(diào)血清TGF-β1表達(dá)而促進(jìn)病情緩解。

Objective To explore the clinical efficacy of Gutongling Tincture combined with sodium hyaluronate in treatment of ankle arthritis. Methods A total of 82 patients with ankle arthritis admitted to Fengfeng General Hospital of North China Medical and Health Group from June 2020 to May 2023 were selected and divided into control group and treatment group according to random number table method, with 41 cases in each group. Patients in control group were given Sodium Hyaluronate Injection, 2 mL/time, once weekly. Patients in treatment group were given Gutongling Tincture, 10 mL was soaked on the tape and applied to the affected area, 30 min/time, once daily. Both groups were treated for 12 weeks. The clinical efficacy of two groups was observed, and the ankle joint swelling score, pain visual analogue scale (VAS) score, morning stiffness time, Kofoed ankle joint function score, AOFAS ankle and hind foot function score, 36 health survey summary (SF-36) score, and serum transforming growth factor β1 (TGF-β1) before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 95.12%, which was significantly higher than that of the control group (80.49%, P < 0.05). After treatment, swelling score and pain VAS score were significantly decreased, and morning stiffness time was significantly shortened in both groups (P < 0.05). After treatment, swelling score, pain VAS score and morning stiffness time in treatment group were better than those in control group (P < 0.05). After treatment, the scores of pain, function, range of motion and total scores of Kofoed ankle joint function were significantly increased in both groups (P < 0.05). The increase was more significant in treatment group (P < 0.05). After treatment, AOFAS ankle and hind foot function scores and SF-36 scores were significantly increased, but serum TGF-β1 levels were significantly decreased in both groups (P < 0.05). After treatment, AOFAS ankle and hind foot function scores, SF-36 scores and serum TGF-β1 in treatment group were better than those in control group (P < 0.05). Conclusion Gutongling Tincture combined with sodium hyaluronate has better efficacy and safety in treatment of ankle arthritis, and can effectively reduce clinical symptoms, improve ankle joint function and improve life quality, and down-regulate the expression of TGF-β1 in serum to promote remission of disease.

R982

河北省重點(diǎn)研發(fā)計(jì)劃自籌項(xiàng)目（182777245）；邯鄲市科技計(jì)劃項(xiàng)目（21422083376）