目的 探讨复方玄驹胶囊联合洛索洛芬钠治疗骨关节炎的临床效果。方法 选取2019年12月—2020年11月天津中医药大学第一附属医院收治的126例骨关节炎患者，随机分成对照组（63例）和治疗组（63例）。对照组口服洛索洛芬钠片，60 mg/次，3次/d。在对照组基础上，治疗组口服复方玄驹胶囊，1.26 g/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典型临床表现改善情况，西安大略和麦克马斯特大学骨关节炎指数（WOMAC）和关节炎影响测量量表 2-短卷（AIMS2-SF）总分，外周血中性粒细胞与淋巴细胞比值（NLR）和血清甲壳质酶蛋白40（YKL-40）、肿瘤坏死因子-α（TNF-α）、白细胞介素-18（IL-18）、前列腺素E₂（PGE₂）水平。结果 治疗后，治疗组总有效率为95.2%，较对照组的84.1%显著升高（P＜0.05）。治疗后，两组关节疼痛VAS评分及关节肿胀、活动不利评分显著降低（P＜0.05），且治疗组的下降更显著（P＜0.05）。治疗后，两组WOMAC总分均显著低于治疗前，而AIMS2-SF总分均显著高于治疗前（P＜0.05），且治疗组的改善更显著（P＜0.05）。治疗后，两组外周血NLR及血清YKL-40、TNF-α、IL-18、PGE₂水平均显著下降（P＜0.05），且治疗组较对照组降低更显著（P＜0.05）。结论 复方玄驹胶囊联合洛索洛芬钠治疗骨关节炎的疗效确切，可安全有效地减轻患者关节疼痛、肿胀症状，改善关节功能，提高生活质量。

Objective To investigate the clinical effect of Compound Xuanju Capsules combined with loxoprofen sodium in treatment of osteoarthritis.Methods Patients (126 cases) with osteoarthritis in First Teaching Hospital of Tianjin University of TCM from December 2019 to November 2020 were randomly divided into control (63 cases) and treatment (63 cases) group. Patients in the control group were po administered with Loxoprofen Sodium Tablets, 60 mg/time, three times daily. Patients in the treatment group were po administered with Compound Xuanju Capsules on the basis of the control group, 1.26 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the improvement of typical clinical manifestations, the total scores of WOMAC and AIMS2-SF, the levels of NLR of peripheral blood, and serum YKL-40, TNF-α, IL-18 and PGE₂ in two groups before and after treatment were compared.Results After treatment, the total effective rate of the treatment group was 95.2%, which was significantly higher than that of the control group (84.1%) (P < 0.05). After treatment, the VAS scores of joint pain and the scores of joint swelling and adverse activity in two groups were significantly decreased, especially in the treatment group (P < 0.05). After treatment, the total score of WOMAC in two groups was significantly lower than that before treatment, while the total score of AIMS2-SF in two groups was significantly higher than that before treatment (P < 0.05), and the improvement in the treatment group was more significant (P < 0.05). After treatment, the levels of peripheral blood NLR and serum YKL-40, TNF-α, IL-18 and PGE₂ in two groups were significantly decreased, and the levels in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion The curative effect of Compound Xuanju Capsules combined with loxoprofen sodium in treatment of osteoarthritis is definite, can safely and effectively relieve the symptoms of joint pain and swelling, improve joint function and improve the quality of life.

R977

天津市名老中医传承工作室（津卫中[2017]193号）；天津市教委资助项目王平劳模创新工作室（津教工[2016]3号）