目的 观察玄七健骨片联合美洛昔康治疗膝骨关节炎的临床疗效。方法 选取2023年6月—2024年6月复旦大学附属中山医院青浦分院骨科收治的82例膝骨关节炎症患者，按照随机数字法分为对照组和治疗组，每组41例。对照组患者给予口服美洛昔康片，7.5 mg/次，1次/d。治疗组在对照组的基础上给予口服玄七健骨片，4片/次，3次/d。两组患者连续治疗28天。观察两组临床疗效，比较两组中医症状评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、视觉模拟疼痛量表（VAS）评分、简单健康状况调查表（SF-36）评分、血清成纤维细胞生长因子-2（FGF-2）、血软骨寡聚基质蛋白（CTX-Ⅱ）、转化生长因子-β1（TGF-β1）、基质金属蛋白酶-9（MMP-9）水平。结果 治疗后，治疗组总有效率是95.12%，显著高于对照组的80.48%（P＜0.05）。治疗后，两组患者膝关节行走痛评分、膝关节肿胀评分、倦怠乏力评分、腰膝酸软评分均显著降低（P＜0.05）；治疗后，治疗组膝关节行走痛评分、膝关节肿胀评分、倦怠乏力评分、腰膝酸软评分低于对照组（P＜0.05）。治疗后，两组WOMAC评分、VAS评分均较同组治疗前显著降低，而SF-36评分升高（P＜0.05）；治疗后，治疗组WOMAC评分、VAS评分低于对照组，而SF-36评分高于对照组（P＜0.05）。治疗后，两组FGF-2、TGF-β1水平均升高，而CTX-Ⅱ、MMP-9水平显著降低（P＜0.05）；且治疗后，与对照组对比，治疗组FGF-2、TGF-β1水平均更高，CTX-Ⅱ、MMP-9水平均更低（P＜0.05）。结论 玄七健骨片联合美洛昔康治疗膝骨关节炎具有良好的临床疗效，能够有效减轻疼痛和改善关节功能，较好地调节了血清细胞因子水平。

Objective To observe the clinical efficacy of Xuanqi Jiangu Tablets combined with meloxicam in treatment of knee osteoarthritis. Methods A total of 82 patients with knee osteoarthritis admitted to the Department of Orthopedics of Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from June 2023 to June 2024 were selected and divided into control group and treatment group according to random number method, with 41 cases in each group. Patients in control group were po administered with Meloxicam Tablets, 7.5 mg/time, once 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. The two groups of patients were treated continuously for 28 d. The clinical efficacy of two groups was observed. The TCM symptom scores, WOMAC scores, VAS scores, SF-36 scores, serum FGF-2, CTX-I, TGF-β1, and MMP-9 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.12%, significantly higher than that of the control group (80.48%, P < 0.05). After treatment, the scores of knee walking pain, knee swelling, fatigue and weakness, and lumbar and knee soreness and weakness in both groups were significantly decreased (P < 0.05). After treatment, knee joint walking pain score, knee joint swelling score, fatigue and weakness score, waist and knee soreness score in treatment group were lower than those in control group (P < 0.05). After treatment, the WOMAC scores and VAS scores of both groups were significantly lower than those before treatment in same group, but SF-36 score increased (P < 0.05). After treatment, the WOMAC score and VAS score of treatment group were lower than those of control group, but SF-36 score was higher than that of control group (P < 0.05). After treatment, the levels of FGF-2 and TGF-β1 in both groups increased, but the levels of CTX-II and MMP-9 significantly decreased (P < 0.05). After treatment, compared with control group, the levels of FGF-2 and TGF-β1 in treatment group were both higher. Moreover, the levels of CTX-II and MMP-9 in treatment group were both lower (P < 0.05). Conclusion Xuanqi Jiangu Tablets combined with meloxicam has a good clinical effect in treatment of knee osteoarthritis, can effectively relieve pain and improve joint function, and better regulate the levels of serum cytokines.

R982

上海市青浦区卫生健康委员会面上项目（QWJ2024-06）；蚌医自然科学重点项目（2023byzd199）