目的 探讨穿龙骨刺片联合玻璃酸钠注射液治疗早中期膝骨关节炎的临床效果。方法 选择河南省胸科医院2019年6月到2021年6月收治的早中期膝骨关节炎患者160例，将入选的患者按照随机数字表法分为对照组和治疗组，各80例。对照组膝关节腔内注射玻璃酸钠注射液，1支/次，1次/周。治疗组患者在对照组治疗方法的基础上口服穿龙骨刺片，6～8片/次，3次/d。两组连续治疗5周。比较两组的临床疗效、临床症状、血清指标。结果 治疗后，治疗组的总有效率（93.75%）高于对照组（80.00%，P＜0.05）。治疗后，两组视觉模拟评分法（VAS）评分、西大略和麦克马斯特大学骨关节炎指数（WOMAC）评分均下降（P＜0.05），治疗组VAS评分、WOMAC评分低于对照组（P＜0.05）。治疗后，两组血沉（ESR）、Ｃ反应蛋白（CRP）、Ⅰ型胶原羧基端肽β降解产物（β-CTX）、前列腺素E₂（PGE₂）、P物质（SP）、多巴胺（DA）、5-羟色胺（5-HT）水平下降，Ⅰ型前胶原羧基末端肽（PICP）、骨钙素（BGP）水平升高（P＜0.05），治疗组ESR、CRP、β-CTX、PGE₂、SP、DA、5-HT水平低于对照组，PICP、BGP水平高于对照组（P＜0.05）。结论 穿龙骨刺片联合玻璃酸钠注射液治疗早中期膝骨关节炎可有效改善患者的临床症状，调节骨代谢和疼痛介质水平。

Objective To explore the clinical effect of Chuanlong Guci Tablets combine with Sodium Hyaluronate Injection in treatment of knee osteoarthritis in early and middle stage. Methods Patients (160 cases) with knee osteoarthritis in early and middle stage in Henan Provincial Chest Hospital from June 2019 to June 2021 were divided into control (80 cases) and treatment (80 cases) groups according to random number tablet method. Patients in the control group was injected with Sodium Hyaluronate Injection into the knee joint cavity, 1 dose/time, once weekly. Patients in the treatment group were po administered with Chuanlong Guci Tablets on the basis of the control group, 6 — 8/time, three times daily. Patients in two groups were treated for 5 weeks. The clinical efficacies, clinical symptoms, and serum indicators in two groups were compared. Results After treatment, the total effective rate of the treatment group (93.75%) was higher than 80.00% of the control group (P＜0.05). After treatment, VAS score and WOMAC score of two groups were decreased (P＜0.05), and VAS score and WOMAC score of the treatment group were lower than those of the control group (P＜0.05). After treatment, the levels of ESR, CRP, β-CTX, PGE₂, SP, DA, 5-HT, PICP, and BGP in two groups were decreased (P＜0.05), and the levels of ESR, CRP, β-CTX, PGE₂, SP, DA, 5-HT, PICP, and BGP in the treatment group were lower than those in the control group (P＜0.05). Conclusion Chuanlong Guci Tablets combined with Sodium Hyaluronate Injection in treatment of knee osteoarthritis in early and middle stage patients can effectively improve the clinical symptoms, and regulate bone metabolism and pain mediator levels.

R982

河南省医学科技攻关计划联合共建项目（LHGJ2021236）