目的 探讨蠲痹抗生丸联合美洛昔康治疗膝骨关节炎的临床疗效。方法 选择2019年3月—2021年3月平煤神马医疗集团总医院接诊的78例骨关节炎患者，随机分为对照组和治疗组，每组各39例。对照组口服美洛昔康片，1片/次，1次/d。在对照组基础上，治疗组口服蠲痹抗生丸，2丸/次，2次d。两组患者治疗7周为1个疗程。观察两组患者临床疗效，比较治疗前后两组患者症状缓解时间，视觉模拟评分法（VAS）和西大略湖和麦克马斯特骨性关节炎指数（WOMAC）评分，血清因子白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和转移生长因子-β（TGF-β）水平，及不良反应情况。结果 治疗后，对照组总有效率为76.92%，显著低于治疗组的97.44%（P＜0.05）。治疗后，治疗组关节肿胀、关节活动受限、关节晨僵、关节疼痛缓解时间明显早于对照组（P＜0.05）。治疗后，两组患者VAS评分、WOMAC评分比治疗前均明显下降（P＜0.05），且治疗组评分均显著低于对照组（P＜0.05）。治疗后，两组患者血清因子IL-1、IL-6、TNF-α水平均明显降低，而TGF-β明显升高（P＜0.05），且治疗组各血清因子水平明显好于对照组（P＜0.05）。治疗组患者不良反应发生率为7.69%，明显低于对照组的15.38%（P＜0.05）。结论 蠲痹抗生丸联合美洛昔康治疗膝骨关节炎，症状改善明显，局部炎症反应明显降低，且药物安全有效。

Objective To explore the clinical study of Juanbi Kangsheng Pills combined with meloxicam in treatment of knee osteoarthritis. Methods Patients (78 cases) with knee osteoarthritis in General Hospital of Pingmei Shenma Group from March 2019 to March 2021 were randomly divided into control and treatment group, and each group had 39 cases. Patients in the control group were po administered with Meloxicam Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Juanbi Kangsheng Pills on the basis of the control group, 2 pills/time, twice daily. Patients in two groups were treated for 7 weeks as a course of treatment. After treatment, the clinical evaluation was evaluated, the relief time of symptom, VAS scores and WOMAC scores, levels of serum factors IL-1, IL-6, TNF-α, and TGF-β, adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the control group was 76.92%, which was significantly lower than that of the treatment group (97.44%) (P < 0.05). After treatment, the relief time of joint swelling, limitation of joint movement, morning stiffness and joint pain in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the VAS scores, and WOMAC scores in two groups were significantly lower than those before treatment (P < 0.05), and the scores of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the serum levels of IL-1, IL-6, and TNF- α were significantly decreased, while TGF-β were significantly increased in two groups (P < 0.05), and these indexes in the treatment group was significantly better than the control group (P < 0.05). The incidence of adverse reactions in the treatment group was 7.69%, which was significantly lower than 15.38% in the control group (P < 0.05). Conclusion In the treatment of knee osteoarthritis with Juanbi Kangsheng Pills combined with meloxicam, the symptoms were obviously improved, the local inflammatory reaction was significantly reduced, and the combination was safe and effective.

R982

河南省科技攻关项目(172102310656)