雷公藤多苷联合硫酸氨基葡萄糖钾及双醋瑞因治疗骨关节炎的疗效观察

Clinical observation of Tripterygium wilfordii polyglycosidium combined with glucosamine potassium sulfate and diacerein in the treatment of osteoarthritis

目的观察雷公藤多苷联合硫酸氨基葡萄糖钾及双醋瑞因治疗急性肿胀期骨关节炎（OA）的临床疗效，探讨治疗OA的有效措施。方法选择64例急性肿胀期膝OA患者，在患者知情同意的情况下均分为对照组（n=32例）和观察组（n=32例），对照组给予硫酸氨基葡萄糖钾联合双醋瑞因治疗，观察组给予雷公藤多苷联合硫酸氨基葡萄糖钾及双醋瑞因治疗，比较2组患者治疗前、后视觉模拟阵痛评分（VAS评分）、关节肿胀度评分、关节压痛度评分、WOMAC骨关节炎指数，并比较2组患者治疗后的临床疗效及治疗过程中不良反应情况。结果治疗后观察组患者VAS评分、WOMAC评分、关节肿胀度评分、关节压痛度评分均优于对照组（P〈0．05），且起效更快；治疗8周后2组患者治愈率和显效率比较，差异均有统计学意义（P〈0．05），观察组临床疗效总体优于对照组。结论选择雷公藤多苷联合硫酸氨基葡萄糖钾及双醋瑞因治疗治疗急性肿胀期OA，可促进恢复，提高临床疗效，起效更快，且不增加不良反应。

Objective To observe the clinical effect of Tripterygium wilfordii polyglycosidium combined with glucosamine potassium sulfate and diacerein in the treatment of acute intumescent osteoarthritis （OA） and to discuss the effective therapeutic measures for OA. Method A total of 64 acute intumescent knee OA patients were enrolled in the control group （n = 32 cases） and observation group （n = 32） randomly. Control group received treatment of glucosamine potassium sulfate combined with diacerein, while observation group received treatment of Tripterygium wilfordii polyglycosidium combined with glucosamine potassium sulfate and diacerein. The visual analog scale assessment of pain on walking for 20 metres（ VAS score） , Western Ontario and McMaster Universities Arthritis Index （WOMAC） , joint swelling score, and joint tenderness score before and after the treatment were compared between the 2 groups. Clinical effect and adverse reactions in the course of treatment were also compared. Result The VAS score, WOMAC score, joint swelling score, and joint tenderness score in observation group were siginificantly better than in control group （ P 〈 0.05 ） after treatment for 2 weeks, 4 weeks, and 8 weeks. The observation group had a faster response to the treatment. After treatment for 8 weeks, observation group had better therapeutic effect compared to control group （P 〈 0.05 ）. Conclusion Tripterygium wilfordii polyglycosidium combined with glucosamine potassium sulfate and diacerein for the treatment of acute intumescent OA can improve the therapeutic effect and promote the recovery of the disease, with faster response to treatment and without augment of the adverse reactions