尼美舒利联合双醋瑞因治疗膝骨性关节炎的临床研究

Clinical study on nimesulide combined with diacerein in treatment of knee osteoarthritis

目的探讨尼美舒利联合双醋瑞因治疗膝骨性关节炎的临床疗效。方法选取2015年8月—2016年8月在河南科技大学第一附属医院接受治疗的膝骨性关节炎患者86例,按照治疗方法的差别分为对照组和治疗组,每组各43例。对照组口服双醋瑞因胶囊,1粒/次,2次/d。治疗组在对照组基础上口服尼美舒利胶囊,1粒/次,2次/d。两组患者均治疗4周。观察两组的临床疗效,比较骨关节炎指数(WOMAC)评分、视觉模拟量表(VAS)评分、膝关节评分量表(LKSS)评分、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、环氧合酶-2(COX-2)和基质金属蛋白酶-3(MMP-3)的情况。结果治疗后,对照组和治疗组的总有效率分别为81.40%、97.67%,两组比较差异有统计学意义(P<0.05)。治疗后,两组WOMAC评分和VAS评分均显著降低,而LKSS评分均显著升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组IL-1、IL-6、COX-2和MMP-3水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论尼美舒利联合双醋瑞因治疗膝骨性关节炎具有较好的临床疗效,可改善临床症状,降低炎性反应,具有一定的临床推广应用价值。

Objective To evaluate the clinical effect of nimesulide combined with diacerein in treatment of knee osteoarthritis. Methods Patients （86 cases） with knee osteoarthritis in the First Affiliated Hospital of Henan University of Science ＆ Technology from January 2015 to August 2016 were enrolled in this study. According to the difference treatment plan, patients were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Diacerein Capsules, 1 grain/time, once daily. Patients in the treatment group were po administered with Nimesulide Capsules on the basis of the control group, 1 grain/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and WOMAC score, VAS score, LKSS score, IL-1, IL-6, COX-2, and MMP-3 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.40% and 97.67%, respectively, and there was difference between two groups （P 〈 0.05）. After treatment, WOMAC scores and VAS scores in two groups were significantly decreased, but the LKSS scores in two groups were significantly increased, and the difference was statistically significant in the same group （P 〈 0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, the levels ofIL-1, IL-6, COX-2, and MMP-3 in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups （P 〈 0.05）. Conclusion Nimesulide combined with diacerein has clinical curative effect in treatment of knee osteoarthritis, can improve clinicalsymptoms, and decrease inflammatory response, which has a certain clinical application value.