李慧　曾明珠　張瑜

[摘要] 目的 探討補(bǔ)腎強(qiáng)筋膠囊對早中期膝骨性關(guān)節(jié)炎（KOA）患者滑液中白細(xì)胞介素-1β（IL-1β）、腫瘤壞死因子-α（TNF-α）、前列腺素E2（PGE2）及血清PGE2的影響。 方法 選取2018年1月～2018年8月廣東省第二中醫(yī)院收治的KOA患者103例。根據(jù)隨機(jī)數(shù)字表法將患者分為對照組（n = 51）與研究組（n = 52），對照組給予氨基葡萄糖膠囊聯(lián)合玻璃酸鈉關(guān)節(jié)腔內(nèi)注射治療，研究組在對照組基礎(chǔ)上聯(lián)合補(bǔ)腎強(qiáng)筋膠囊治療。比較兩組治療后臨床效果，治療前后滑液中IL-1β、TNF-α、PGE2、血清PGE2水平及膝關(guān)節(jié)功能恢復(fù)情況，記錄兩組患者治療期間不良反應(yīng)發(fā)生情況。 結(jié)果 研究組患者治療后臨床總有效率高于對照組患者（P < 0.05）。兩組患者治療后滑液中IL-1β、TNF-α、PGE2均低于治療前，且研究組IL-1β、TNF-α低于對照組（P < 0.05），兩組治療后滑液中PGE2水平比較，差異無統(tǒng)計(jì)學(xué)意義（P > 0.05）。兩組患者治療后血清PGE2水平均降低，且研究組低于對照組（P < 0.05）。兩組患者治療后關(guān)節(jié)功能、關(guān)節(jié)疼痛、肌力、活動度、屈曲畸形、關(guān)節(jié)活動度評分均升高，且研究組高于對照組（P < 0.05）。兩組患者治療過程中均未出現(xiàn)不良反應(yīng)現(xiàn)象。 結(jié)論 補(bǔ)腎強(qiáng)筋膠囊治療早中期KOA患者，效果顯著，可有效改善滑液中IL-1β、TNF-α水平，及血清PGE2水平，且不增加不良反應(yīng)發(fā)生率。

[關(guān)鍵詞] 補(bǔ)腎強(qiáng)筋膠囊;早中期膝骨性關(guān)節(jié)炎滑液;白介素-1β;腫瘤壞死因子-α;前列腺素E2

[中圖分類號] R684.3 ? ? ? ? ?[文獻(xiàn)標(biāo)識碼] A ? ? ? ? ?[文章編號] 1673-7210（2019）05（c）-0119-05

[Abstract] Objective To investigate the effects of Bushen Qiangjin Capsules on interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， prostaglandin E2 （PGE2） in synovial fluid and serum PGE2 of patients with knee osteoarthritis （KOA） in the early and middle stages. Methods From January 2018 to August 2018， 103 patients with KOA in Guangdong Second Hospital of Traditional Chinese Medicine were selected as the research subjects. The patients were divided into control group （n = 51） and research group （n = 52） according to random number table method. The control group was treated with Glucosamine Capsules combined with Sodium Hyaluronate Intra-Articular Injection. The research group was treated with Bushen Qiangjin Capsules on the basis of the control group. The clinical efficacy was compared between the two groups after treatment. The levels of IL-1β， TNF-α， PGE2 in synovial fluid， serum PGE2 and the recovery of knee joint function were compared between the two groups before and after treatment. The occurrence of adverse reactions during treatment were recorded in the two groups. Results The total effective rate of the study group was significantly higher than the control group （P < 0.05）. After treatment， the levels of IL-1β， TNF-α and PGE2 in synovial fluid of the two groups were lower than those before treatment， and that in the study group was lower than those in the control group （P < 0.05）. No significant difference in the levels of PGE2 in synovial fluid between the two groups after treatment （P > 0.05）. The serum PGE2 level of the two groups decreased after treatment， and the study group was lower than that of the control group （P < 0.05）. After treatment， the scores of joint function， joint pain， muscle strength， range of motion， flexion deformity and range of motion of the two groups were all increased， and those in the study group were higher than that of the control group （P < 0.05）. No adverse reactions was observed in the two groups during the treatment. Conclusion Bushen Qiangjin Capsules is effective in the treatment of KOA patients in the early and middle stages. It can effectively improve the levels of IL-1β， TNF-α in synovial fluid and serum PGE2 in synovial fluid without increasing the incidence of adverse reactions. It has certain clinical value.