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[摘要]
目的 探讨金乌骨通胶囊联合依托考昔治疗膝骨关节炎的临床效果。方法 选取2017年1月—2018年10月北京市隆福医院收治的96例膝骨关节炎患者,随机分为对照组和治疗组,每组各48例。对照组口服依托考昔片,60 mg/次,1次/d。治疗组在对照组基础上口服金乌骨通胶囊,3粒/次,3次/d,饭后服用。两组均连续治疗3个月。比较两组临床疗效,观察两组治疗前后关节疼痛视觉模拟评分法(VAS)评分、晨僵时间、病情积分、Lequesne指数评分、血流变学参数、肿瘤坏死因子(TNF)-α、白介素(IL)-6、基质金属蛋白酶(MMP)-9水平和关节炎影响测量量表2-短卷(AIMS2-SF)评分变化情况。结果 治疗后,对照组和治疗组的总有效率分别是77.1%、91.7%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组关节疼痛VAS评分、病情积分较治疗前均显著降低,晨僵时间均显著缩短,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组关节疼痛VAS评分、病情积分显著低于对照组,晨僵时间短于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组膝关节休息痛评分、运动痛评分、压痛评分、肿胀评分、晨僵评分、行走能力评分及总分均显著低于治疗前,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组这些Lequesne指数评分显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组红细胞变形指数和刚性指数(RDI和RRI)、TNF-α、IL-6、MMP-9较治疗前均显著减小,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组RDI、RRI值、TNF-α、IL-6、MMP-9低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组躯体评分、症状评分、影响评分、社会评分、工作评分及总分均显著上升,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组AIMS2-SF评分均显著高于对照组,两组比较差异具有统计学意义(P<0.05)。结论 金乌骨通胶囊联合依托考昔治疗膝骨关节炎具有较好的临床疗效,可明显减轻患者疼痛等症状,改善膝关节功能及微循环,减轻机体炎症损伤,提高生活质量,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the clinical effect of Jinwu Gutong Capsules combined with etoricoxib in treatment of knee osteoarthritis. Methods Patients (96 cases) with knee osteoarthritis in Longfu Hospital of Beijing from January 2017 to October 2018 were randomly divided into control (48 cases) and treatment (48 cases) groups. Patients in the control group were po administered with Etoricoxib Tablets, 60 mg/time, once daily. Patients in the treatment group were po administered with Jinwu Gutong Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and VAS scores, morning stiffness time, severity scores, Lequesne indexes, hemorheological parameters, TNF-α, IL-6, MMP-9, and AIMS2-SF scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 77.1% and 91.7%, respectively, and there were differences between two groups (P < 0.05). After treatment, VAS scores and severity scores in two groups were significantly decreased, and morning stiffness times were significantly shortened, and there were differences in the same group (P < 0.05). After treatment, VAS scores and severity scores in the treatment group were lower than those in the control group, and morning stiffness time in the control group was shorter than that in the control group, and there were differences between two groups (P < 0.05). After treatment, knee rest pain score, movement pain score, tenderness score, swelling score, morning stiffness score, walking ability score and total score in two groups were significantly decreased, and there were differences in the same group (P < 0.05). After treatment, Lequesne indexes in the treatment group were lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, RDI, RRI, TNF-α, IL-6, and MMP-9 in two groups were significantly decreased, and there were differences in the same group (P < 0.05). After treatment, RDI, RRI, TNF-α, IL-6, and MMP-9 were lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, somatic score, symptom score, influence score, social score, work score and total score were significantly significantly increased in two groups, and there were differences in the same group (P < 0.05). After treatment, AIMS2-SF scores in the treatment group were higher than those in the control group, and there were differences between two groups (P < 0.05). Conclusion Jinwu Gutong Capsules combined with etoricoxib has significant effect in treatment of knee osteoarthritis, and can significantly reduce pain and other symptoms of patients, and also can improve knee joint function and microcirculation, reduce inflammation and injury in the body, and improve the life quality, which has a certain clinical application value.
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