机构地区:[1]重庆央都生物研究院,重庆408000 [2]重庆医科大学附属永川医院,重庆402160 [3]重庆市涪陵中心医院,重庆408000 [4]重庆医科大学附属第一医院,重庆400016 [5]重庆市江津区中心医院,重庆402260
出 处:《中国药业》2019年第24期45-48,共4页China Pharmaceuticals
基 金:2016年重庆市卫生计生委医学科研项目[2016MSXM163]
摘 要:目的探讨骨友灵搽剂治疗膝关节炎(KOA)的临床疗效和对膝关节液中炎性细胞因子的影响。方法该研究联合4家医院进行,研究设计为多中心、随机、对照方式,将符合纳入标准的KOA患者240例,按随机数字表法分为观察组(骨友灵搽剂治疗)和对照组(口服双氯芬酸钠治疗),各120例。疗程均为2个月。结果观察组总有效率为84.17%,明显高于对照组的70.83%(χ^2=6.117,P<0.05);治疗1个月和2个月后,两组西安大略和麦克马斯特大学骨关节炎调查量表(WOMAC)评分及日本骨科协会(JOA)评分均明显改善(P<0.05),治疗2个月后改善更明显(P<0.05),且观察组患者改善情况均明显优于对照组(P<0.05);治疗1个月和2个月后,两组患者的关节液中肿瘤坏死因子-α(TNF-α)和前列腺素E2(PGE2)水平均明显下降(P<0.05),治疗2个月后下降更明显(P<0.05),且观察组患者下降更明显(P<0.05);两组均未发生药物相关的严重不良事件,对照组共发生12例(10.00%)恶心等轻度胃肠道不适,观察组共发生8例(6.67%)局部皮肤斑丘疹,经对症干预后好转,两组不良反应发生率相当(χ^2=0.873,P=0.35>0.05)。结论骨友灵搽剂能有效缓解KOA患者的临床症状,抑制关节腔内炎性细胞因子的渗出,促进软骨合成修复,有效缓解关节疼痛,改善关节活动功能。Objective To investigate the clinical efficacy of Guyouling Liniment in the treatment of knee osteoarthritis and its effect on inflammatory cytokines in knee synovial fluid.Methods A multi-center,randomized,controlled design was used to study 240 patients with knee osteoarthritis who met the inclusion criteria in four hospitals.All the patients were divided into the observation group(Guyouling Liniment)and the control group(Diclofenac Sodium Sustained-Release Tablets)according to the random number table method,120 cases in each group.The course of treatment was two months.Results The total effective rate of the observation group was84.17%,which was significantly higher than 70.83%of the control group(χ^2=6.117,P<0.05).After one and two months of treatment,the Western Ontario and McMaster Universities Arthritis Index(WOMAC)score and Japanese Orthopaedic Association(JOA)score in the two groups were significantly improved(P<0.05),the improvement in the two groups was more significant after two months of treatment(P<0.05),and the improvement in the observation group was significantly better than that in the control group(P<0.05).After one and two months of treatment,the levels of tumor necrosis factor-α(TNF-α)and prostaglandin E2(PGE2)in the joint fluid of the two groups were significantly decreased(P<0.05),the decrease in the two groups was more significant after two months of treatment(P<0.05),and the decrease in the observation group was more significant(P<0.05).No serious adverse drug-related events occurred in the two groups.In the control group,there were 12 patients(10.00%)with mild gastrointestinal discomfort such as nausea.In the observation group,there were 8 patients(6.67%)with local skin spot papules,which improved after the intervention.The incidence of adverse reactions in the two groups was similar(χ^2=0.873,P=0.35>0.05).Conclusion Guyouling Liniment can effectively relieve the clinical symptoms of patients with knee osteoarthritis,inhibit the exudation of inflammatory cytokines in the articular ca
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