目的 探讨复方玄驹胶囊联合双醋瑞因治疗膝骨性关节炎的临床疗效。方法 选取2019年5月—2021年4月在扬州大学医学院附属沭阳医院就诊的200例膝骨性关节炎患者作为研究对象，按照治疗方法将患者分为对照组和观察组，各100例。对照组口服双醋瑞因胶囊，50 mg/次，2次/d。观察组在对照组基础上口服复方玄驹胶囊，3粒/次，3次/d。患者连续治疗4周。观察两组的临床疗效，比较两组治疗前后的西安大略和麦马斯特大学骨关节炎指数（WOMAC）、膝关节的活动度评分（ROM）、膝关节功能评分（Lysholm）以及血清人类软骨寡聚蛋白（COMP）、基质金属蛋白酶-3（MMP-3）、白细胞介素-17（IL-17）水平。结果 治疗后，观察组的总有效率为91.00%，明显高于对照组的80.00%，差异有统计学意义（P<0.05）。治疗后，两组的疼痛、僵硬、日常生活评分、WOMAC总分显著降低（P<0.05）；治疗后，观察组的疼痛、僵硬、日常生活评分、WOMAC总分显著低于对照组，差异有统计学意义（P<0.05）。治疗后，两组ROM评分、Lysholm评分均显著升高（P<0.05），且观察组ROM评分、Lysholm评分显著高于对照组（P<0.05）。治疗后，两组的COMP、MMP-3、IL-17水平均显著降低（P<0.05）；且观察组COMP、MMP-3和IL-17水平显著低于对照组，差异有统计学意义（P<0.05）。结论 复方玄驹胶囊联合双醋瑞因治疗膝骨性关节炎的疗效确切，可改善膝关节功能和活动度，控制病情，可能与调节炎症因子有关，安全性良好。

Objective To investigate the clinical efficacy of Compound Xuanju Capsules combined with diacerein in treatment of knee osteoarthritis. Methods A total of 200 patients with knee osteoarthritis admitted to Shuyang Hospital Affiliated to Medical College of Yangzhou University from May 2019 to April 2021 were selected as the research subjects. According to the treatment methods, the patients were divided into control group and observation group, with 100 patients in each group. Patients in the control group were po administered with Diacerein Capsules, 50 mg/time, twice daily. Patients in the observation group were po administered with Compound Xuanju Capsules on the basis of control, three capsules/time, three times daily. Patients were treated for four weeks. The clinical efficacy of two groups was observed. WOMAC scores, ROM scores, Lysholm scores, and the levels of COMP, MMP-3, and IL-17 before and after treatment were compared between two groups. Results After treatment, the total effective rate of the observation group was 91.00%, significantly higher than 80.00% of the control group, and the difference was statistically significant (P < 0.05). After treatment, pain, stiffness, daily living score, and WOMAC total score were significantly decreased in both groups (P < 0.05). After treatment, the pain, stiffness, daily life score, and WOMAC total score in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). After treatment, ROM score and Lysholm score in two groups were significantly increased (P < 0.05), and ROM score and Lysholm score in observation group were significantly higher than those in control group (P < 0.05). After treatment, the levels of COMP, MMP-3, and IL-17 in two groups were significantly decreased (P < 0.05). The levels of COMP, MMP-3 and IL-17 in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). Conclusion Compound Xuanju Capsules combined with diacerein has definite efficacy in treatment of knee osteoarthritis, which can improve the function and activity of knee joint and control the condition. It may be related to the regulation of inflammatory factors and has good safety.

R982