复方雪莲胶囊联合玻璃酸钠治疗膝骨关节炎的临床研究

Clinical study on Compound Xuelian Capsules combined with sodium hyaluronate in treatment of knee osteoarthritis

目的探讨复方雪莲胶囊联合玻璃酸钠治疗膝骨关节炎的临床疗效。方法选取2016年3月—2019年5月在安钢职工总医院治疗的81例膝骨关节炎患者,随机分成对照组(40例)和治疗组(41例)。对照组患者膝关节腔内注射玻璃酸钠注射液,20 mg/次,1次/周。治疗组患者在对照组的基础上口服复方雪莲胶囊,3粒/次,3次/d。两组连续治疗15周。观察两组患者临床疗效,比较治疗前后两组患者膝骨关节炎炎指数评分(WOMAC)、膝关节炎严重度指数评分(Lequesne)及血清炎性因子白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)、软骨寡聚基质蛋白(COMP)和基质金属蛋白酶13(MMP-13)水平及不良反应情况。结果治疗后,治疗组临床有效率为95.12%,显著高于对照组患者的75.00%(P<0.05)。治疗后,两组患者膝部疼痛、关节僵硬、日常活动、腰膝酸软评分均显著降低(P<0.05);治疗后,治疗组WOMAC评分低于对照组(P<0.05)。治疗后,两组患者Lequesne指数均低于治疗前(P<0.05),且治疗组患者膝关节Lequesne指数均低于对照组患者(P<0.05)。治疗后,两组患者血清IL-6、IL-1β、TNF-α、COMP、MMP-13水平均显著降低(P<0.05);治疗后,治疗组血清炎性因子水平低于对照组(P<0.05)。治疗组药物不良反应总发生率9.76%,低于对照组的20.00%(P<0.05)。结论复方雪莲联合玻璃酸钠治疗膝骨关节炎疗效显著,能有效改善临床膝骨关节疼痛、僵硬等症状,明显改善膝关节活动功能,极大的提高了患者的生活质量。

Objective To investigate the curative effect of Compound Xuelian Capsules combined with sodium hyaluronate in treatment of knee osteoarthritis.Methods Patients(81 cases)with knee osteoarthritis in Angang Staff General Hospital from March 2016 to May 2019 were randomly divided into control(40 cases)and treatment(41 cases)groups.Patients in the control group were administered with intra articular injection of Sodium Hyaluronate Injection,20 mg/time,once weekly.Patients in the treatment group were po administered with Compound Xuelian Capsules on the basis of the control group,3 grains/time,three times daily.Patients in two groups were treated for 15 weeks.After treatment,the clinical efficacy was evaluated,and the WOMAC scores,Lequesne indexes,the levels of serum IL-6,IL-1,TNF-α,COMP and MMP-13,adverse reactions in two groups before and after treatment were compared.Results After treatment,the clinical effective rate of the treatment group was 95.12%,which was significantly higher than 75.00%of the control group(P<0.05).After treatment,knee pain,joint stiffness,daily activities,lumbar and knee acid and soft scores in 2 groups were significantly decreased(P<0.05).After treatment,WOMAC score of treatment group was lower than that of control group(P<0.05).After treatment,the Lequesne index in both groups was lower than that before treatment(P<0.05),and the knee joint Lequesne TNF-α,COMP,and MMP-13 in two groups were significantly decreased(P<0.05).After treatment,the level of serum inflammatory factors in treatment group was lower than that in control group(P<0.05).The total incidence of adverse drug reactions in the treatment group was 9.76%,which was lower than 20.00%in the control group(P<0.05).Conclusion Compound Xuelian Capsules combined with Sodium Hyaluronate Injection in treatment of knee osteoarthritis is remarkable,can effectively improve the clinical symptoms such as pain and stiffness of knee joint,obviously improve the activity function of knee joint,and greatly improve the quality of life of patients.