目的 探讨壮骨关节丸联合依托考昔治疗早期膝骨关节炎的临床疗效。方法 选取2020年5月-2023年5月山西省汾阳医院收治84例的膝骨关节炎患者,依据随机数字表法分为对照组(42例)和治疗组(42例)。对照组口服依托考昔片,初始剂量为30 mg/次,若2周后症状无明显缓解,剂量调整为60 mg/次,1次/d。治疗组患者在对照组基础上口服壮骨关节丸,6 g/次,2次/d。两组患者均连续治疗4周。观察两组患者临床疗效,比较治疗前后两组患者视觉模拟评分表(VAS)、Lysholm和SF-36评分,及血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和高敏C反应蛋白(hs-CRP)水平。结果 治疗后,治疗组总有效率为95.24%,明显高于对照组80.95%(P<0.05)。治疗后,两组VAS评分明显降低,而Lysholm评分明显升高(P<0.05),且治疗组评分均明显好于对照组(P<0.05)。治疗后,两组血清IL-6、TNF-α及hs-CRP水平均明显降低(P<0.05),且治疗组血清水平降低幅度明显大于对照组(P<0.05)。治疗后,两组SF-36各项维度评分均明显升高(P<0.05),且治疗组总体健康、躯体疼痛、生命活力、生理功能评分升高幅度大于对照组(P<0.05)。结论 壮骨关节丸联合依托考昔治疗早期膝骨关节炎具有较好的治疗效果,可减轻患者的膝关节疼痛程度,改善膝关节功能、体内的炎症状态以及生活质量。

Objective To explore the clinical efficacy of Zhuanggu Guanjie Pills combined with etoricoxib in treatment of early knee osteoarthritis. Methods Patients (84 cases) with early knee osteoarthritis in Shanxi Province Fenyang Hospital from May 2020 to May 2023 were divided into control (42 cases) and treatment (42 cases) group according to random number table method. Patients in the control group were po administered with Etoricoxib Tablets, the initial dose was 30 mg/time, and if there was no obvious relief after 2 weeks, the dose was adjusted to 60 mg/times, once daily. Patients in the treatment group were po administered with Zhuanggu Guanjie Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, the symptom relief time, the scores VAS, Lysholm and SF-36, and the levels of serum IL-6, TNF-α and hs-CRP in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 95.24%, which was significantly higher than that of the control group (80.95%, P < 0.05). After treatment, the VAS scores in two groups were significantly decreased, while the Lysholm scores were significantly increased (P < 0.05), and the scores in the treatment group were significantly better than those of the control group (P < 0.05). After treatment, the serum levels of IL-6, TNF-α and hs-CRP in two groups were significantly decreased (P < 0.05), and the decrease of serum level in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, SF-36 scores in each dimension of two groups were significantly increased (P < 0.05), and the scores of general health, somatic pain, vital vitality, and physiological function in the treatment group were significantly better than those of the control group (P < 0.05). Conclusion Zhuanggu Guanjie Pills combined with etoricoxib has a good therapeutic effect in the treatment of early knee osteoarthritis, which can reduce knee joint pain, improve knee joint function, inflammatory state and quality of life.

R982

山西省卫生健康委科研课题（2019099）