目的 探讨强筋健骨胶囊联合双醋瑞因胶囊治疗膝骨性关节炎的临床疗效。方法 选取2020年3月—2022年4月在江西中医药高等专科学校附属医院就诊的89例膝骨性关节炎患者，依据随机数字表法将所有患者分为对照组（44例）和治疗组（45例）。对照组患者口服双醋瑞因胶囊，1粒/次，2次/d。治疗组在对照组基础上口服强筋健骨胶囊，5粒/次，3次/d。两组患者连续治疗4周。观察两组患者临床疗效，比较两组的晨僵、关节活动度、骨关节炎病情程度以及基质金属蛋白酶-9（MMP-9）、肿瘤坏死因子-α（TNF-α）、转化生长因子-β₁（TGF-β₁）水平。结果 治疗后，治疗组的总有效率95.56%高于对照组的总有效率81.82%（P＜0.05）。治疗后，两组患者的晨僵时间短于治疗前，关节活动度（ROM）评分高于治疗前（P＜0.05）；治疗组的晨僵时间短于对照组，ROM评分高于对照组，差异有统计学意义（P＜0.05）。治疗后，两组的骨关节炎指数（WOMAC）各项评分低于治疗前（P＜0.05），治疗组WOMAC各项评分较对照组明显降低（P＜0.05）。治疗后，两组的血清MMP-9、TNF-α水平低于治疗前，血清TGF-β₁水平高于治疗前（P＜0.05）；治疗后，治疗组的血清MMP-9、TNF-α水平低于对照组，血清TGF-β₁水平高于对照组，差异有统计学意义（P＜0.05）。结论 强筋健骨胶囊联合双醋瑞因胶囊可提高膝骨性关节炎的临床疗效，有效改善临床症状和关节功能，降低炎症反应。

Objective To investigate the clinical effect of Qiangjin Jiangu Capsules combined with Diacerein Capsules in treatment of knee osteoarthritis.Methods Patients (89 cases) with knee osteoarthritis in the Affiliated Hospital of Jiangxi College of Traditional Chinese Medicine from March 2020 to April 2022 were divided into the control group (44 cases) and the treatment group (45 cases) according to the random number table method.Patients in the control group were po administered with Diacerein Capsules,1 grain/time,twice daily.Patients in the treatment group were po administered with Qiangjin Jiangu Capsules on the basis of the control group,5 grains/time,three times daily.Patients in two groups were treated for 4 weeks.After treatment,the clinical efficacies were evaluated,and the morning stiffness,joint activity,degree of osteoarthritis,the levels of MMP-9,TNF-α and TGF-β₁ in two groups were compared.Results After treatment,the total effective rate of the treatment group was 95.56% higher than 81.82% of the control group (P<0.05).After treatment,the morning stiffness time of two groups was lower than that before treatment,and the ROM score of two groups was higher than that before treatment (P<0.05);The morning stiffness time of the treatment group was lower than that of the control group,and the ROM score of the treatment group was higher than that of the control group,the difference was statistically significant (P<0.05).After treatment,the WOMAC scores of two groups were lower than those before treatment (P<0.05),and the WOMAC scores of the treatment group were significantly lower than those of the control group (P<0.05).After treatment,the serum levels of MMP-9 and TNF-α in two groups were lower than those before treatment,and the serum level of TGF-β₁ was higher than that before treatment (P<0.05);After treatment,the serum levels of MMP-9 and TNF-α in the treatment group were lower than those in the control group,and the serum level of TGF-β₁ was higher than that in the control group,the difference was statistically significant (P<0.05).Conclusion Qiangjin Jiangu Capsules combined with Diacerein Capsules can improve the curative effect of knee osteoarthritis,effectively improve clinical symptoms and joint function,and reduce inflammatory reaction.

R977

江西省中医药科研课题(2019B043)