汉防己甲素联合利塞膦酸钠治疗膝关节骨性关节炎的疗效  

Therapeutic effect of tetrandrine combined with risedronate sodium on knee osteoarthritis

作　　者：吉明 陈建 JIMing;CHEN Jian(Department of Orthopedics,Jinzhou Medical University Graduate Training Base(Affiliated Three Gorges Hsopital,Chongqing University),Chongqing 404000,CHINA)

机构地区：[1]锦州医科大学研究生培养基地(重庆大学附属三峡医院)骨科,重庆404000

出　　处：《江苏医药》2025年第3期225-228,233,共5页Jiangsu Medical Journal

基　　金：重庆市万州区科卫联合重点项目(wzstc-kw2021006);重庆市教育委员会科学技术项目(KJZD-K202300107)。

摘　　要：目的探讨汉防己甲素联合利塞膦酸钠治疗膝关节骨性关节炎(KOA)的疗效及对膝关节液中基质细胞衍生因子-1(SDF-1)/CXC趋化因子受体4(CXCR4)信号通路的影响。方法200例KOA患者分为两组,每组100例。对照组予美洛昔康片7.5mg口服,每日1次。研究组在对照组基础上加用汉防己甲素片20mg口服,每日3次;利塞膦酸钠片35mg口服,每周1次。两组疗程均为3个月。治疗后比较两组临床疗效、骨性关节炎严重程度指数(ISOA)评分、Lysholm评分、麦吉尔疼痛问卷表(MPQ)评分以及膝关节液中SDF-1、CXCR4 mRNA表达和MMP-3、MMP-9水平。结果研究组治疗总有效率高于对照组(92.0%vs.76.0%)(P<0.01)。治疗后,两组ISOA评分、MPQ评分、膝关节液中SDF-1和CXCR4 mRNA表达以及MMP-3、MMP-9水平均低于治疗前,Lysholm评分高于治疗前(P<0.05),且研究组较对照组变化更明显(P<0.05)。结论加用汉防己甲素联合利塞膦酸钠治疗KOA可更有效地促进患者膝关节功能恢复,缓解疼痛,这可能与其调控SDF-1/CXCR4信号通路和降低炎症反应有关。Objective To investigate the therapeutic effect of tetrandrine combined with risedronate sodium on knee osteoarthritis(KOA)and its influence on the signal pathway of stromal cell-derived factor-1(SDF-1)/CXC chemokine receptor 4(CXCR4)in knee joint fluid.Methods A total of 200 KOA patients were divided into two groups with 100 cases each.Group C was given 7.5mg of meloxicam tablets orally once a day.Group A was additionally given tetrandrine tablets 20mg orally three times a day and risedronate sodium tablets 35 mg orally once a week.The course of treatment was 3 months in both groups.The therapeutic effect,index of severity for osteoarthritis(ISOA)score,Lysholm score,McGill pain questionnaire(MPQ)score and the mRNA expressions of SDF-1 and CXCR4 and levels of MMP-3 and MMP-9 in knee joint fluid were compared between the two groups after treatment.Results The total effective rate of group A was higher than that of group C(92.0%vs.76.0%)(P<0.01).After treatment,the ISOA score,MPQ score,mRNA expressions of SDF-1 and CXCR4 and levels of MMP-3 and MMP-9 in knee joint fluid were lower,while the Lysholm score was higher than those before treatment in both groups(P<0.05),which changed more obviously in group A than those in group C(P<0.05).Conclusion Additionally using tetrandrine combined with risedronate sodium is more effective in treating KOA patients,which can effectively promote the recovery of knee joint function and relieve pain.The mechanism for that may be related to regulating SDF-1/CXCR4 signaling pathway and reducing inflammatory responses.

关 键 词：膝关节骨性关节炎 汉防己甲素 利塞膦酸钠 基质细胞衍生因子-1 CXC趋化因子受体4 

分 类 号：R684[医药卫生—骨科学]