目的 探讨筋骨痛消丸联合氟比洛芬治疗增生性膝骨关节炎的临床疗效及药理作用。方法 选择2019年4月—2021年4月在河南省洛阳正骨医院诊治的202例增生性膝骨关节炎患者，根据就诊顺序分为对照组和治疗组，每组各101例。对照组口服氟比洛芬缓释片，0.2 g/次，1次/d；治疗组在对照组基础上口服筋骨痛消丸，6 g/次，2次/d。两组均治疗4周。观察两组临床疗效，比较治疗前后两组临床症状改善时间，WOMAC评分、生存质量评分（QOL-BREF）、视觉模拟评分（VAS）和膝关节评分（ISOA）及炎症介质高迁移率族B1蛋白（HMGB1）、白细胞介素-1α（IL-1α）、成纤维细胞生长因子-2（FGF-2）、组织金属蛋白抑制因子-1（TIMP-1）和血管内皮细胞生长因子（VEGF）水平。结果 经治疗，治疗组总有效率显著高于对照组（98.02%vs 87.13%，P<0.05）。经治疗，治疗组临床症状改善时间上明显早于对照组（P<0.05）。经治疗，两组患者WOMAC评分、VAS评分和ISOA评分明显下降，而QOL-BREF评分明显升高（P<0.05），且治疗组患者这些评分项目明显好于对照组（P<0.05）。经治疗，两组患者血清HMGB1、IL-1α、VEGF水平均明显降低，而FGF-2和TIMP-1水平明显升高（P<0.05），且治疗组患者炎症介质水平明显好于对照组（P<0.05）。结论 筋骨痛消丸联合氟比洛芬缓释片治疗增生性膝骨关节炎可有效改善患者临床症状，促进患者生活质量和关节功能改善，有利于改善机体细胞因子的改善。

Objective To investigate the clinical efficacy and pharmacological action of Jingutongxiao Pills combined with flurbiprofen in treatment of proliferative knee osteoarthritis. Methods Patients (202 cases) with proliferative knee osteoarthritis in Luoyang Orthopedic-Traumatological Hospital of Henan Province from April 2019 to April 2021 were divided into control (101 cases) and treatment (101 cases) groups. Patients in the control group were po administered with Flurbiprofen Sustained Release Tablets, 0.2 g/time, once daily. Patients in the treatment group were po administered with Jingu Tongxiao Pills, 6 g/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the scores of WOMAC, QOL-BREF, VAS, and ISOA, and the levels of inflammatory mediators HMGB1, IL-1α, VEGF, FGF-2, and TIMP-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (98.02% vs 87.13%, P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P< 0.05). After treatment, the WOMAC score, VAS score and ISOA score in two groups were significantly decreased, while the QOL-BREF score was significantly increased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of serum HMGB1, IL-1α, and VEGF were significantly decreased, while the levels of FGF-2 and TIMP-1 were significantly increased in two groups (P < 0.05), and the level of inflammatory mediators in the treatment group was significantly better than that in the control group (P< 0.05). Conclusion Jingu Tongxiao Pills combined with and flurbiprofen in treatment of proliferative knee osteoarthritis can effectively improve the clinical symptoms, the quality of life and joint function, and the cytokines.

R977

河南省卫生健康委项目（20-21ZY1059）