目的 评估金乌骨通胶囊联合氟比洛芬凝胶贴膏治疗膝骨关节炎的临床疗效。方法 选取2024年1月—2024年12月武汉大学中南医院收治的100例膝骨关节炎患者，经随机数字表法将分为对照组和治疗组，各50例。对照组给予氟比洛芬凝胶贴膏，1贴/次，1次/d。治疗组给予氟比洛芬凝胶贴膏和金乌骨通胶囊，氟比洛芬凝胶贴膏给药方式参照对照组，饭后服用金乌骨通胶囊，3粒/次，3次/d。两组患者均治疗1个月。观察两组治疗效果、症状缓解时间，比较两组骨代谢指标[骨保护素（OPG）和骨钙素（BGP）]、炎症因子[白细胞介素-1α（IL-1α）、白细胞介素-17（IL-17）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）]、Harris评分、关节功能及活动度、运动恐惧程度[坦帕运动恐惧症量表（TSK）]。结果 治疗后，治疗组总有效率是98.00%，显著高于对照组的82.00%（P＜0.05）。治疗过程中，治疗组膝关节疼痛缓解时间、膝关节红肿缓解时间及关节活动受限缓解时间均较对照组更短（P＜0.05）。治疗后，两组患者OPG、BGP水平均升高（P＜0.05）；治疗后治疗组OPG、BGP水平显著高于对照组（P＜0.05）。治疗后，两组IL-1α、IL-17、IL-6、TNF-α水平均较同组治疗前下降（P＜0.05）；治疗后，治疗组IL-1α、IL-17、IL-6、TNF-α水平低于对照组（P＜0.05）。治疗后，两组Harris较前显著升高，膝关节主动及被动活动度均扩大，TSK评分显著降低（P＜0.05）；治疗后，治疗组Harris、膝关节主动及被动活动度高于对照组，TSK评分低于对照组（P＜0.05）。结论 金乌骨通胶囊联合氟比洛芬凝胶贴膏治疗膝骨关节炎患者可显著提升治疗总有效率，下调炎症因子水平同时改善骨代谢指标，促进关节功能与活动度恢复，降低患者运动恐惧现状。

Objective To investigate the therapeutic effect of Jinwu Gutong Capsules combined with flurbiprofen in treatment of knee osteoarthritis. Methods A total of 100 patients with knee osteoarthritis admitted to Zhongnan Hospital of Wuhan University from January 2024 to December 2024 were selected and divided into control group and treatment group by random number table method, with 50 cases in each group. Patients in control group were given Flurbiprofen Cataplasms, 1 patch each time, once daily. Patients in treatment group were given Flurbiprofen Cataplasms and Jinwu Gutong Capsules. The administration method of Flurbiprofen Cataplasms was the same as that of control group. Jinwu Gutong Capsules were taken after meals, 3 capsules each time, 3 times daily. Both groups of patients were treated for one month. The therapeutic effects and symptom relief time of two groups were observed. The bone metabolism indicators (OPG and BGP), inflammatory factors (IL-1α, IL-17, IL-6, and TNF-α), Harris score, joint function and range of motion, and fear degree of movement (TSK) were compared between two groups. Results After treatment, the total effective rate of treatment group was 98.00%, significantly higher than that of control group (82.00%, P < 0.05). During the treatment process, the relief time of knee pain, knee redness and swelling, and joint movement limitation in treatment group was shorter than that in control group (P < 0.05). After treatment, the levels of OPG and BGP in both groups of patients increased (P < 0.05). After treatment, the levels of OPG and BGP in treatment group were significantly higher than those in control group (P < 0.05). After treatment, the levels of IL-1α, IL-17, IL-6, and TNF-α in both groups decreased compared with those before treatment in same group (P < 0.05). After treatment, the levels of IL-1α, IL-17, IL-6, and TNF-α in treatment group were lower than those in control group (P < 0.05). After treatment, the Harris in both groups increased significantly compared with before, the active and passive ranges of motion of the knee joint expanded, and the TSK score decreased significantly (P < 0.05). After treatment, the Harris, active and passive range of motion of the knee joint in treatment group were higher than those in control group, and the TSK score was lower than that in control group (P < 0.05). Conclusion Jinwu Gutong Capsules combined with flurbiprofen in treatment of knee osteoarthritis can significantly increase the total effective rate of treatment, lower the levels of inflammatory factors while improving bone metabolic indicators, promote the recovery of joint function and range of motion, and reduce the current situation of patients’ fear of exercise.

R977

中央高校基本科研业务费专项资金资助（2042022kf1143）