目的 探讨仙灵骨葆胶囊联合双醋瑞因治疗退行性骨关节炎的临床疗效。方法 选取2018年1月—2021年2月在桂林市中西医结合医院骨科门诊诊疗的110例退行性骨关节炎患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各55例。对照组患者餐后口服双醋瑞因胶囊，1粒/次，1次/d。治疗组在对照组治疗基础上口服仙灵骨葆胶囊，3粒/次，2次/d。两组均连续治疗6周。观察两组的临床疗效和症状缓解时间，比较两组治疗前后视觉模拟（VAS）评分、骨关节炎（Lequesne）指数评分、白细胞介素6-（IL-6）、白细胞介素-1（IL-1）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-1（MMP-1）的变化情况。结果 治疗后，治疗组总有效率是98.18%，显著高于对照组的81.82%（P＜0.05）。经治疗，治疗组关节肿胀、关节疼痛、关节活动受限、关节晨僵等症状缓解时间均明显短于对照组（P＜0.05）。治疗后，两组VAS评分、Lequesne指数评分均较同组治疗前显著降低（P＜0.05），且治疗后治疗组VAS评分、Lequesne指数评分明显低于对照组（P＜0.05）。治疗后，两组患者IL-6、IL-1、TNF-α、MMP-1水平均较治疗前显著降低（P＜0.05）；且治疗后，治疗组IL-6、IL-1、TNF-α、MMP-1水平明显低于对照组（P＜0.05）。治疗后，治疗组不良反应发生率是7.27%，明显低于对照组的16.36%（P＜0.05）。结论 仙灵骨葆胶囊联合双醋瑞因治疗退行性骨关节炎可提高临床效果，能改善骨关节功能，更有效地抑制关节炎性反应，值得借鉴和推广。

Objective To investigate the efficacy of Xianling Gubao Capsules combined with diacerein in treatment of degenerative osteoarthritis. Methods A total of 110 patients with degenerative osteoarthritis treated in the orthopedics outpatient of Guilin Hospital of Traditional and Western Medicine from January 2018 to February 2021 were selected. According to the random number table method, all patients were divided into control group and treatment group, with 55 cases in each group. Patients in the control group were po administered with Diacerein Capsules, 1 grain/time, once daily. Patients in the treatment group were po administered with Xianling Gubao Capsules on the basis of the control group, 3 grains/time, twice daily. Both groups were treated for 6 weeks. The clinical efficacy and symptom relief time of two groups were observed, and the changes of VAS score, Lequesne index score, IL-6, IL-1, TNF-α, and MMP-1 before and after treatment were compared between two groups. Results After, The total effective rate of treatment group was 98.18%, significantly higher than that of control group 81.82% (P < 0.05). After treatment, the relief time of joint swelling, joint pain, joint mobility limitation, joint stiffness and other symptoms in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, VAS score and Lequesne index score in two groups were significantly lower than those before treatment (P < 0.05), and VAS score and Lequesne index score in treatment group were significantly lower than those in control group (P < 0.05). After treatment, the levels of IL-6, IL-1, TNF-α, and MMP-1 in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of IL-6, IL-1, TNF-α, and MMP-1 in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the incidence of adverse reactions in the treatment group was 7.27%, significantly lower than that in the control group (16.36%) (P < 0.05). Conclusion Xianling Gubao Capsules combined with diacerein can improve clinical effect in treatment of degenerative osteoarthritis, and can improve the function of bone and joint and inhibit the inflammatory reaction of joint effectively, which is worthy of reference and promotion.

R982

广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180146)