目的 探讨元七骨痛酊联合塞来昔布胶囊治疗膝骨性关节炎的临床疗效。方法 选择2021年6月—2022年5月中国人民解放军联勤保障部队第九二一医院收治的82例膝骨性关节炎患者，将所有患者依照随机数字表法分为对照组（41例）和治疗组（41例）。对照组口服塞来昔布胶囊，0.2 g/次，1次/d。治疗组在对照组治疗的基础上于患处涂擦元七骨痛酊，2～5 mL/次，3次/d。两组患者连续治疗4周。观察两组患者临床疗效，比较治疗前后两组患者步态特征，视觉模拟评分（VAS）和骨关节炎指数（WOMAC）评分，血清肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、基质金属蛋白酶-3（MMP-3）、骨钙素（BGP）、骨特异性碱性磷酸酶（BALP）和抗酒石酸盐酸性磷酸酶异构体-5b（TRACP-5b）水平。结果 治疗后，治疗组总有效率明显比对照组高（95.12%vs 80.49%，P<0.05）。治疗后，两组患者步长、步速均显著提高（P<0.05），且治疗组步长、步速比对照组明显提高（P<0.05）。治疗后，两组VAS、WOMAC评分均明显下降（P<0.05），且与对照组相比，治疗组下降更明显（P<0.05）。治疗后，治疗组血清TNF-α、IL-1β、IL-6、MMP-3和TRACP-5b水平均明显下降，而血清BALP、BGP水平均明显升高（P<0.05），且治疗组明显好于对照组（P<0.05）。结论 元七骨痛酊联合塞来昔布胶囊治疗膝骨性关节炎具有较好的临床疗效，能够改善步态特征，明显减轻症状，抑制炎症反应，改善骨代谢分子水平。

Objective To investigate the clinical efficacy of Yuanqi Gutong Tincture combined with Celecoxib Capsules in treatment of knee osteoarthritis. Methods Patients (82 cases) with knee osteoarthritis in the 921 Hospital of the People's Liberation Army Joint Logistic Support Force from June 2021 to May 2022 were divided into control group (41 cases) and treatment group (41 cases) according to random number table method.. Patients in the control group were po administered with Celecoxib Capsules, 0.2 g/time, once daily. Patients in the treatment group were administered with Yuanqi Gutong Tincture to the affected area on the basis of the control group, 2-5 mL/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, and the gait features, VAS and WOMAC scores, and the levels of serum TNF-α, IL-1β, IL-6, MMP-3, BALP, BGP, and TRACP-5b in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was significantly higher than that of the control group (95.12% vs 80.49%, P < 0.05). After treatment, the step length and speed in two groups were significantly increased (P < 0.05), and the step length and speed of the treatment group were significantly higher than those of the control group (P < 0.05). After treatment, the scores of VAS and WOMAC in two groups were significantly decreased (P < 0.05), and the score in the treatment group significantly decreased than that in the control group (P < 0.05). After treatment, the levels of serum TNF-α, IL-1β, IL-6, MMP-3, and TRACP-5b were significantly decreased, while the levels of serum BALP and BGP were significantly increased in the treatment group (P < 0.05), and which in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Yuanqi Gutong Tincture combined with Celecoxib Capsules has a good clinical effect in the treatment of knee osteoarthritis, which can improve gait characteristics, significantly relieve symptoms, inhibit inflammatory reaction and improve the molecular level of bone metabolism.

R982

湖南省科技计划项目（2020JJ3165）