双醋瑞因胶囊结合艾瑞昔布片对膝骨关节炎患者的治疗效果及对COX-2、Wnt-3α、骨代谢水平的影响

Therapeutic effect of Diacerein capsule combined with Imrecoxib tablet on patients with knee osteoarthritis and its effect on COX-2,WNT-3αand bone metabolism

目的探究双醋瑞因胶囊结合艾瑞昔布片对膝骨关节炎患者环氧合酶2(cyclooxygenase-2,COX-2)、血清分泌型糖蛋白3α(serumo sekretorinis glikoproteinas-3α,Wnt-3α)及骨代谢水平的影响。方法选取我院收治的膝骨关节炎患者160例,随机表法分为单药治疗组、联合治疗组各80例,单药治疗组使用艾瑞昔布片治疗,联合治疗组使用双醋瑞因胶囊联合艾瑞昔布片治疗。酶联免疫吸附法检测骨特异度碱性磷酸酶(bone specific alkaline phosphatase,BALP)、抗酒石酸盐酸性磷酸酶异构体5b(tartrate-resistant acid phosphatase-5b,TRACP-5b)、白细胞介素1β(intereukin-1β,IL-1β)、甲壳酯酶蛋白(chitinase 3-like protein,YKL-40)、COX-2水平,散射比浊法检测肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平、放射免疫法检测骨钙素(osteocalcin,OC)、Wnt-3α水平,对比两组治疗有效率。结果治疗后,两组血清BALP、OC水平高于治疗前,血清TRACP-5b、IL-1β、TNF-α及YKL-40、COX-2、Wnt-3α水平低于治疗前,与单药治疗组相比,联合治疗组血清BALP、OC水平升高,血清TRACP-5b、IL-1β、TNF-α及YKL-40、COX-2、Wnt-3α水平降低(P<0.05);治疗后,两组膝关节功能评分、疼痛视觉模拟评分(visual analogue scale,VAS)评分低于治疗前,联合治疗组低于单药治疗组(P<0.05);联合治疗组治疗有效率高于单药治疗组(P<0.05)。结论通过双醋瑞因胶囊联合艾瑞昔布片对膝骨关节炎进行治疗,有效缓解疼痛,有效提高骨代谢水平,减轻机体炎症反应,降低关节软骨损伤,提高膝关节功能。

Objective To investigate the effects of Diacerein capsule combined with Imrecoxib tablet on cyclooxygenase-2(COX-2),serumo sekretorinis glikoproteinase-3α(WNT-3α)and bone metabolism in patients with knee osteoarthritis(KOA).Methods A total of 160 patients with KOA admitted to our hospital were selected and divided into a single drug treatment group(n=80)and a combination treatment group(n=80)according to random number table method.Patients in the single drug treatment group were treated with Imrecoxib tablets,while patients in the combination treatment group were treated with Diacerein capsule combined with Imrecoxib tablets.Bone specific alkaline phosphatase(BALP)and tartrate-resistant acid phosphatase-5B(TRACP-5b),intereukin-1β(IL-1β),chitinase 3-like protein(YKL-40),and COX-2 levels were detected by enzyme-linked immunosorbent assay(ELISA).Tumor necrosis factor-α(TNF-α)levels were detected by turbidiometry,and the levels of osteocalcin(OC)and Wnt-3αwere detected by radioimmunoassay.The therapeutic efficiency of the two groups was compared.Results After treatment,the levels of serum BALP and OC in the two groups were higher than those before treatment,while the levels of serum TRACP-5b,IL-1β,TNF-α,YKL-40,COX-2,and Wnt-3αwere lower than those in the single drug treatment group.Compared with those in single drug treatment group,the serum BALP and OC levels in the combination treatment group increased,while the serum TRACP-5b,IL-1β,TNF-α,YKL-40,COX-2,and Wnt-3αlevels decreased(P<0.05).After treatment,both the knee function score and visual analogue scale(VAS)score of both groups were lower than those before treatment,which were lower in the combination treatment group than in the single treatment treatment group(P<0.05).The therapeutic efficiency of the combination treatment group was higher than that of the single drug treatment group(P<0.05).Conclusion The treatment of KOA by Diacerein capsule combined with Imrecoxib tablets can effectively relieve pain,improve bone metabolism level,reduce inflammation and articular cartilage damage,and improve knee function.