目的 探讨无敌丹胶囊联合塞来昔布治疗膝骨关节炎的临床疗效。方法 回顾性分析2020年8月—2021年6月在安钢总医院治疗的126例膝骨关节炎患者临床资料，根据用药的差别将患者分为对照组和治疗组，每组各63例。对照组口服塞来昔布胶囊，0.2 g/次，1次/d；治疗组在对照组基础上口服无敌丹胶囊，0.8 g/次，3次/d。两组均经4周治疗进行效果比较。观察两组的临床疗效，比较两组治疗前后相关评分、疼痛介质水平和血清学指标的变化情况。结果 经治疗，治疗组总有效率是98.41%，显著高于对照组82.54%（P<0.05）。经治疗，两组Lequesne指数、VAS评分、ISOA评分和临床症状评分均显著降低，但GQOLI-74评分显著升高（P<0.05）；治疗后，治疗组相关评分改善优于对照组（P<0.05）。经治疗，两组血清P物质（SP）、前列腺素E₂（PGE₂）、5-羟色胺（5-HT）、多巴胺（DA）均显著降低（P<0.05）；且治疗后，治疗组患者疼痛介质水平低于对照组（P<0.05）。经治疗，两组血清肿瘤坏死因子-α（TNF-α）、碱性成纤维细胞生长因子（β-FGF）、基质金属蛋白酶-3（MMP-3）、白细胞介素-6（IL-6）水平均显著降低，但金属蛋白酶组织抑制因子1（TIMP1）显著升高（P<0.05）；治疗后，治疗组炎症介质水平改善优于对照组（P<0.05）。结论 无敌丹胶囊联合塞来昔布胶囊治疗膝骨关节炎可有效改善患者症状，改善关节功能，抑制炎症介质和疼痛介质的表达，有着良好临床应用价值。

Objective To investigate the clinical efficacy of Wudidan Capsules combined with celecoxib in treatment of knee osteoarthritis. Methods Clinical data of 126 patients with knee osteoarthritis treated in Angang General Hospital from August 2020 to June 2021 were retrospectively analyzed, and the patients were divided into control group and treatment group according to the difference of medication, with 63 cases in each group. Patients in the control group were po administered with Celecoxib Capsules, 0.2 g/time, once daily. Patients in the treatment group were po administered with Wudidan Capsules on the basis of the control group, 0.8 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the levels of related scores, pain mediators and serological indexes before and after treatment were compared.Results After treatment, the total effective rate of the treatment group was 98.41%, which was significantly higher than that of the control group (82.54%, P<0.05). After treatment, Lequesne index, VAS score, ISOA score and clinical symptom score were significantly decreased in both groups, but GQOLI-74 score was significantly increased (P<0.05). After treatment, the improvement of related scores in the treatment group was better than that in the control group (P<0.05). After treatment, the serum substance P (SP), prostaglandin E₂(PGE₂), 5-hydroxytryptamine (5-HT), and dopamine (DA) in two groups were significantly decreased (P<0.05). After treatment, the level of pain mediators in treatment group was lower than that in control group (P<0.05). After treatment, the serum levels of tumor necrosis factor-α (TNF-α), basic fibroblast growth factor (β-FGF), matrix metalloproteinase-3 (MMP-3), and interleukin-6 (IL-6) were significantly decreased in both groups, but the tissue inhibitor of metalloproteinase-1 (TIMP1) was significantly increased (P<0.05). After treatment, the level of inflammatory mediators in the treatment group was improved better than that in the control group (P<0.05). Conclusion Wudidan Capsules combined with celecoxib can effectively improve the symptoms of patients in treatment of knee osteoarthritis, and can improve joint function, inhibit the expression of inflammatory mediators and pain mediators, which has good clinical application value.

R977

河南省医学科技攻关计划（联合共建）项目（LHGJ20191445）