目的 探讨关节克痹丸联合依托考昔片治疗膝骨关节炎的临床疗效。方法 选取唐山市人民医院在2023年2月—2025年1月收治的92例膝骨关节炎患者。92例患者按随机数字表法分为对照组和治疗组，每组46例。对照组口服依托考昔片，1次/d，1片/次。治疗组在对照组基础上口服关节克痹丸，2次/d，8丸/次。两组完成3个月治疗。比较两组的治疗效果、晨僵时间、疼痛程度、关节功能、生活质量和血清指标。结果 对照组总有效率为82.61%，治疗组总有效率为95.65%，组间比较差异显著（P＜0.05）。治疗后，两组的晨僵时间、数字疼痛强度量表（NRS）评分、Lequesne指数评分降低（P＜0.05）；治疗组的晨僵时间、NRS评分、Lequesne指数评分低于对照组（P＜0.05）。两组治疗后SF-36评分均升高（P＜0.05），且治疗组SF-36评分比对照组高（P＜0.05）。两组治疗后的血清趋化因子配体2（CCL2）、高迁移率族蛋白B1（HMGB1）、组织蛋白酶D（CATD）水平显著降低（P＜0.05）；治疗组治疗后的血清CCL2、HMGB1、CATD水平低于对照组（P＜0.05）。结论 关节克痹丸联合依托考昔片可提高膝骨关节炎的临床疗效，减轻膝关节晨僵和疼痛程度，改善膝关节功能，提高生活质量，降低炎症反应。

Objective To explore the clinical efficacy of Guanjie Kebi Pills combined with Etoricoxib Tablets in treatment of knee osteoarthritis.Methods 92 Patients with knee osteoarthritis admitted to Tangshan People's Hospital from February 2023 to January 2025 were selected, and were divided into control group and treatment group using random number table method, with 46 cases in each group. The control group took oral Etoricoxib Tablets, once daily, 1 tablets/time. The treatment group were orally administered with Guanjie Kebi Pills on the basis of the control group, twice daily, 8 pills per time. Two groups completed 3 months of treatment. The treatment efficacy, morning stiffness time, pain level, joint function, quality of life, and serum indicators between two groups of patients were compared.Results The total effective rate of the control group was 82.61%, while the total effective rate of the treatment group was 95.65%, with significant differences between the groups (P < 0.05). After treatment, the morning stiffness time, NRS scores, and Lequesne index scores of both groups were decreased (P < 0.05), and the morning stiffness time, NRS scores, and Lequesne index scores of the treatment group were lower than those of the control group (P < 0.05). After treatment, the SF-36 scores of both groups were decreased (P < 0.05), and the SF-36 scores of the treatment group was higher than those in the control group (P < 0.05). The serum levels of chemokine ligand 2 (CCL2), high mobility group protein B1 (HMGB1), and cathepsin D (CATD)were significantly decreased after treatment in both groups (P < 0.05), and the levels of CCL2, HMGB1, and CATD in the treatment group were lower than those in the control group after treatment (P < 0.05).Conclusion The combination of Guanjie Kebi Pills and Etoricoxib Tablets can improve the clinical efficacy of knee osteoarthritis, alleviate morning stiffness and pain in the knee joint, improve knee joint function, enhance quality of life, and reduce inflammatory reactions.

R977

河北省卫生健康委科研基金项目（20201524）