目的 探讨罗浮山风湿膏药联合美洛昔康片治疗骨关节炎的临床疗效。方法 回顾性分析2020年2月—2022年2月在武汉市中医医院进行治疗的102例骨关节炎患者临床资料，依据用药差别将所有患者分为对照组和治疗组，每组各51例。对照组口服美洛昔康片，7.5 mg/次，1次/d；治疗组在对照组基础上外敷罗浮山风湿膏药，每次贴敷24 h。两组经4周治疗进行效果比较。观察两组患者的临床疗效，比较两组治疗前后相关评分、疼痛相关介质和血清学指标的变化情况。结果 治疗后，治疗组患者总有效率是98.04%，显著高于对照组的82.35%（P<0.05）。治疗后，两组患者奎森功能演算指数（Lequesne）评分、麦克马斯特（WOMAC）评分、视觉模拟（VAS）评分均较治疗前显著降低，但关节炎生活质量问卷（AIMS2-SF）评分显著升高（P<0.05）；治疗后，相关评分以治疗组改善更为明显（P<0.05）。治疗后，两组血清P物质（SP）、前列腺素E₂（PGE₂）、5-羟色胺（5-HT）疼痛相关介质水平均显著降低（P<0.05），并以治疗组下降的更明显（P<0.05）。治疗后，两组血清YKL-40、促血管生成素Ⅰ、肿瘤坏死因子诱导蛋白6（TSG-6）、Wnt-3α、白细胞介素-17（IL-17）水平均较治疗前显著降低，而碱性成纤维细胞生长因子2（FGF-2）显著升高（P<0.05），并以治疗组改善更明显（P<0.05）。结论 罗浮山风湿膏药联合美洛昔康治疗骨关节炎临床效果显著，可有效改善关节功能，降低疼痛，调节血清因子水平，值得临床推广应用。

Objective To investigate the clinical efficacy of Luofushan Rheumatic Plaster combined with meloxicam in treatment of osteoarthritis. Methods The clinical data of 102 patients with osteoarthritis treated in Wuhan Hospital of Traditional Chinese Medicine from February 2020 to February 2022 were retrospectively analyzed. All patients were divided into control group and treatment group according to medication difference, with 51 cases in each group. Patients in the control group were po administered with Meloxicam Tablets, 7.5 mg/time, once daily. Patients in the treatment group were given Luofushan Rheumatic Plaster on the basis of the control group, applied for 24 h each time. The results were compared between the two groups after 4 weeks of treatment. The clinical efficacy of the two groups were observed, and the changes of correlation scores, pain related mediators, and serological indicators were compared between the two groups before and after treatment. Results After treatment, the total effective rate of treatment group was 98.04%, significantly higher than that of control group 82.35% (P < 0.05). After treatment, Lequesne score, WOMAC score, and visual analog scale (VAS) score in two groups were significantly decreased compared with before treatment, but arthritis quality of life questionnaire (AIMS2-SF) score was significantly increased (P < 0.05). After treatment, the correlation score of the treatment group improved more significantly (P < 0.05). After treatment, the levels of serum substance P (SP), prostaglandin E₂ (PGE₂), and 5-hydroxytryptamine (5-HT) pain related mediators in two groups were significantly decreased (P < 0.05), and the decrease was more obvious in the treatment group (P< 0.05). After treatment, the serum levels of YKL-40, angiogenic hormone Ⅰ, tumor necrosis factor-induced protein 6 (TSG-6), WNT-3α and interleukin 17 (IL-17) in two groups were significantly decreased compared with before treatment, while basic fibroblast growth factor 2 (FGF-2) was significantly increased (P < 0.05). The improvement was more obvious in the treatment group (P < 0.05). Conclusion Luofushan Rheumatic Plaster combined with meloxicam has significant clinical effect in treatment of osteoarthritis, and can effectively improve joint function, reduce pain, and adjust the level of serum factors, which is worthy of clinical application.

R977

湖北省卫生健康委员会科研项目（WJ2021M022）