【摘要】 目的 观察防己黄芪汤加减联合复方倍他米松注射液治疗膝骨关节炎(KOA)的疗效，以及对患者关节功能、生活质量与血清基质金属蛋白酶13(MMP-13)、一氧化氮(NO)水平的影响。方法 选取2019年1月至2022年12月收治的112例KOA患者为研究对象，按照随机数字表法分为对照组和观察组，各56例。对照组予复方倍他米松注射液治疗，观察组在对照组的基础上加用防己黄芪汤加减治疗。2组均治疗12周后统计疗效，比较2组治疗前及治疗4、8、12周后Lysholm评分、日本骨科协会评估治疗分数(JOA)评分、简明生活质量量表(SF-36)评分及血清基质金属蛋白酶13(MMP-13)、一氧化氮(NO)水平变化情况，观察2组治疗期间不良反应发生情况。结果 观察组总有效率89.29%(50/56)，对照组总有效率73.21%(41/56)，观察组总有效率高于对照组(P<0.05)。与本组治疗前比较，2组治疗4、8、12周后Lysholm评分、JOA评分均升高(P<0.05)，且观察组治疗4、8、12周后Lysholm评分、JOA评分水平均高于对照组同期(P<0.05)。与本组治疗前比较，2组治疗4、8、12周后SF-36评分均升高(P<0.05)，且观察组治疗4、8、12周后SF-36评分水平高于对照组同期(P<0.05)。与本组治疗前比较，2组治疗4、8、12周后MMP-13、NO水平均降低(P<0.05)，且观察组治疗4、8、12周后MMP-13、NO水平低于对照组同期(P<0.05)。观察组不良反应总发生率10.71%(6/56)，对照组不良反应发生率14.29%(8/56),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 防己黄芪汤加减联合复发倍他米松注射液治疗KOA疗效确切，可显著提高患者关节功能和生活质量，降低MMP-13和NO水平，改善患者的炎症反应。更多还原

【Abstract】 Objective To evaluate the effects of modified Fangji Huangqi Decoction combined with compound betamethasone injection on joint function,quality of life,and serum levels of matrix metalloproteinase 13 (MMP 13) and nitric oxide (NO) in patients with knee osteoarthritis (KOA). Methods A total of 112 KOA patients treated at our hospital from January 2019 to December 2022 were enrolled and randomly assigned to two groups (n = 56 each) : A control group (compound betamethasone injection) and a combined therapy group (compound betamethasone injection plus modified Fangji Huangqi decoction),the treatments lasted 12 weeks. Efficacy was evaluated. Changes in Lysholm scores, Japanese Orthopaedic Association (JOA) scores,Short Form-36 (SF-36) quality of life scores,and serum MMP-13 and NO levels were compared between the two groups at baseline and at 4,8,and 12 weeks after treatment. The incidence of adverse reactions during the treatment period was monitored and recorded for both groups. Results The overall effective rate was significantly higher in the combined therapy group than in the control group (89. 29%[50/56] vs 73.21%[41/56],P < 0. 05). Lysholm,JOA,and SF 36 scores improved over time in both groups,with significantly greater improvements in the combined therapy group at 4,8,and 12 weeks after treatment (all P < 0. 05). Serum MMP 13 and NO concentrations decreased over time in both groups,and reductions were significantly larger in the combined therapy group (both P<0.05). The incidence of adverse events did not differ significantly between groups (10. 71% vs. 14. 29%; P > 0. 05).Conclusion Combining modified Fangji Huangqi Decoction with compound betamethasone injection significantly improves joint function and quality of life,and reduces serum MMP 13 and NO levels in KOA patients,suggesting enhanced anti inflammatory and disease modifying effects compared with betamethasone alone.更多还原