目的 探讨玄七健骨片联合盐酸氨基葡萄糖胶囊治疗膝骨关节炎（筋脉瘀滞证）的临床疗效。方法 纳入2022年6月—2024年6月新乡医学院第一附属医院收治的160例膝骨关节炎（筋脉瘀滞证）患者，根据随机数字表法分为对照组和治疗组，每组各80例。对照组口服硫酸氨基葡萄糖胶囊，2粒/次，3次/d。治疗组在对照组的基础上口服玄七健骨片，4片/次，3次/d，两组均治疗8周。观察两组患者临床疗效，比较治疗前后两组患者中医症候积分、Lysholm评分、WOMAC评分及GQOL-74评分，滑膜厚度和关节软骨厚度，软骨代谢指标骨钙素（BGP）、骨保护素（OPG）和抗酒石酸酸性磷酸酶-5b（TRACP-5b）水平，炎症因子前列腺素E₂（PGE₂）、白细胞介素-17（IL-17）和肿瘤坏死因子-α（TNF-α）水平，氧化应激指标超氧化物歧化酶（SOD）、丙二醛（MDA）和谷胱甘肽过氧化物酶（GSH-Px）水平。结果 治疗后，治疗组总有效率显著高于对照组（92.50% vs 80.00%，P＜0.022）。治疗后，两组中医证候积分和WOMAC评分显著降低，而Lysholm和GQOL-74评分均显著升高（P＜0.05），且治疗后治疗组评分改善更明显（P＜0.05）。治疗后，两组滑膜厚度显著降低，而关节软骨厚度均显著升高（P＜0.05），且与对照组比，治疗组滑膜厚度降低程度更显著，而关节软骨厚度升高程度更显著（P＜0.05）。治疗后，两组BGP、OPG、SOD和GSH-Px水平显著升高（P＜0.05），而TRACP-5b、PGE2、IL-17、TNF-α和MDA水平显著降低（P＜0.05），且与对照组相比，治疗组这些指标水平改善程度更显著（P＜0.05）。结论 玄七健骨片联合盐酸氨基葡萄糖胶囊治疗膝骨关节炎（筋脉瘀滞证）的临床疗效显著，能显著改善膝骨关节炎患者的临床症状并提高生活质量，主要与改善机体软骨代谢、降低炎症状态及氧化应激水平有关。

Objective To investigate the clinical efficacy of Xuanqi Jiangu Tablets combined with glucosamine in treatment of Knee osteoarthritis (syndrome of stasis in muscles and veins). Methods Patients (160 cases) with knee osteoarthritis (syndrome of stasis in muscles and veins) in the First Affiliated Hospital of Xinxiang Medical University from June 2022 to June 2024 were divided into control and treatment group according to random number table method, and each group had 80 cases. Patients in the control group were po administered with Glucosamine Sulfate Capsules, 2 grains/time, three times daily. Patients in the treatment group were po administered with Xuanqi Jiangu Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, and the scores of TCM syndrome, Lysholm, WOMAC and GQOL-74, the synovial and articular cartilage thickness, the levels of BGP, OPG, TRACP-5b, PGE2, IL-17, TNF-α, SOD, GSH-Px and MDA in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (92.50% vs 80.00%, P < 0.05). After treatment, the TCM symptom and WOMAC scores in two groups were significantly reduced, while the Lysholm and GQOL-74 scores were significantly increased (P < 0.05), and the scores in the treatment group were improved more significantly (P < 0.05). After treatment, the synovial thickness was significantly decreased in two groups, while the articular cartilage thickness was significantly increased (P < 0.05). Compared with the control group, the synovial thickness was decreased more significantly in the treatment group, and the articular cartilage thickness was increased more significantly (P < 0.05). After treatment, the levels of BGP, OPG, SOD and GSH-Px were significantly increased in two groups (P < 0.05), while the levels of TRACP-5b, PGE2, IL-17, TNF-α and MDA were significantly decreased (P < 0.05). Compared with the control group, the levels of these indicators in the treatment group were improved more significantly (P < 0.05). Conclusion Xuanqi Jiangu Tablets combined with glucosamine in treatment of knee osteoarthritis (syndrome of stasis in muscles and veins) have significant clinical efficacy, which can significantly improve the clinical symptoms of patients with knee osteoarthritis and improve the quality of life, mainly related to improving cartilage metabolism and reducing inflammation. and oxidative stress levels.

R982

河南省医学科技攻关计划项目（LHGJ20240491）；新乡医学院组织工程与再生临床医学中心开放课题项目（2022YFYKFKT06）