右归丸联合美洛昔康治疗膝骨性关节炎的临床研究

Clinical study on Yougui Pills combined with meloxicam in treatment of knee osteoarthritis

目的探究右归丸联合美洛昔康治疗膝骨性关节炎的临床疗效。方法选取2016年5月—2019年6月新乡医学院附属第一医院收治的膝骨性关节炎患者123例,按自愿原则分为对照组(41例)和治疗组(82例)。对照组口服美洛昔康片,15 mg/次,1次/d。治疗组在对照组基础上口服右归丸,9 g/次,3次/d,两组患者连续治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者骨关节炎指数(WOMAC)评分、Lysholm膝关节评分、静息关节视觉模拟评分(VAS)和膝关节屈曲度,及炎症因子环氧化酶-2(COX-2)、基质金属蛋白酶-3(MMP-3)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平。结果治疗后,对照组和治疗组临床有效率分别为70.73%、87.80%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者WOMAC和VAS评分显著降低,而LKSS评分明显升高,膝关节屈曲度明显增加(P<0.05),且治疗组上述指标明显好于对照组(P<0.05)。治疗后,两组患者炎症因子COX-2、MMP-3、TNF-α、IL-6水平均显著下降(P<0.05),且治疗组明显低于对照组(P<0.05)。结论右归丸联合美洛昔康治疗膝骨性关节炎疗效优于单独应用美洛昔康,可改善膝关节功能,减轻关节炎症,安全有效。

Objective To investigate the clinical value of Yougui Pills combined with meloxicam in treatment of knee osteoarthritis. Methods Patients(123 cases) with knee osteoarthritis in the First Affiliated Hospital of Xinxiang Medical University from May 2016 to June 2019 were divided into control(41 cases) and treatment(82 cases) groups on a voluntary basis. Patients in the control group were po administered with Meloxicam Tablets, 15 mg/time, once daily. Patients in the treatment group were po administered with Yougui Pills on the basis of the control group, 9 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the WOMAC and LKSS scores, joint VAS scores at rest, knee flexion, and the inflammatory factors levels of COX-2, MMP-3, TNF-α and IL-6 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 70.73% and 87.80% respectively, and there were differences between two groups(P < 0.05). After treatment, the WOMAC and VAS scores in two groups were significantly decreased(P < 0.05), the LKSS scores and the knee flexion were significantly increased(P < 0.05), and these indexes in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the inflammatory factors levels of COX-2, MMP-3, TNF-α and IL-6 in two groups were significantly decreased(P < 0.05), and which in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion The effect of Yougui Pills combined with meloxicam is better than that of meloxicam alone in treatment of knee osteoarthritis. The combination can improve knee function and reduce joint inflammation, and it is safe and effective.