目的 探讨骨筋丸胶囊联合氨糖美辛肠溶片治疗腰椎骨性关节炎的临床疗效及对血清学因子的影响。方法 选择2018年5月—2019年5月在郑州大学第一附属医院治疗的98例腰椎骨性关节炎患者，根据用药差别将患者分成对照组和治疗组，每组各49例。对照组饭后口服氨糖美辛肠溶片，75 mg/次，2次/d；治疗组在对照组基础上饭后口服骨筋丸胶囊，1.2 g/次，3次/d。两组患者治疗20周。观察两组患者临床疗效，比较治疗前后两组患者ODI评分、VAS评分、临床症状评分、JOA评分和GQOLI-74评分，及血清白细胞介素1β（IL-1β）、前列腺素E₂（PGE₂）、环氧化酶-2（COX-2）、基质金属蛋白酶3（MMP-3）和干扰素-γ（IFN-γ）水平。结果 治疗后，治疗组总有效率显著高于对照组（95.92%比81.63%，P<0.05）。治疗后，两组ODI评分、VAS评分、JOA评分、GQOLI-74评分及临床症状评分均显著改善，且治疗组患者改善最明显（P<0.05）。治疗后，两组血清PGE₂、IL-1β、COX-2、IFN-γ、MMP-3水平均显著降低，且治疗组明显低于对照组（P<0.05）。结论 骨筋丸胶囊联合氨糖美辛肠溶片治疗腰椎骨性关节炎患者不仅能够促进临床症状的改善，还可降低机体炎症因子的表达，促进患者生活质量的好转，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Gujin Pill Capsules combined with glucosamine indometacin in treatment of lumbar osteoarthritis and its effect on serological factors. Methods Patients (98 cases) with lumbar osteoarthritis in the First Affiliated Hospital of Zhengzhou University from May 2018 to May 2019 were divided into control and treatment groups according to the difference of medication, and each group had 49 cases. Patients in the control group were po administered with Glucosamine Indometacin Enteric-coated Tablets after meals, 75 mg/time, twice daily. Patients in the treatment group were po administered with Gujin Pill Capsules on the basis of the control group after meals, 1.2 g/time, three times daily. Patients in two groups were treated for 20 weeks. After treatment, the clinical efficacy was evaluated, and the scores of ODI, VAS, clinical symptoms, JOA, and GQOLI-74, and the serum levels of PGE₂, IL-1β, COX-2, IFN-γ and MMP-3 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (95.92% vs 81.63%, P<0.05). After treatment, the scores of ODI, VAS, clinical symptoms, JOA, and GQOLI-74 were significantly improved in two groups (P<0.05), especially in the treatment group (P<0.05). After treatment, the serum levels of PGE₂, IL-1β, COX-2, IFN-γ, and MMP-3 in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Gujin Pill Capsules combined with glucosamine indometacin in treatment of lumbar osteoarthritis can effectively improve the clinical symptoms, reduce the inflammatory reaction, improve the quality of life, which has a certain clinical application value.

R98

河南省重点研发与推广专项（202102310134）