滑膜炎颗粒治疗老年膝骨关节炎的临床观察

目的：探讨滑膜炎颗粒治疗老年膝骨关节炎（KOA）的临床疗效及对基质金属蛋白酶（MMP）、焦虑抑郁的影响。方法：124例KOA患者随机分为对照组和观察组各62例，均予玻璃酸钠注射液膝关节腔内注射并口服塞来昔布胶囊，观察组加服滑膜炎颗粒，4周为1个疗程。比较临床疗效、疼痛评分（VAS）、焦虑自评量表（SAS）和抑郁自评量表（SDS），测定血清及关节液中MMP-1、MMP-3和MMP-13活性，记录不良反应。结果：观察组总有效率为82.26%，明显高于对照组的62.90%；治疗后，2组VAS、SAS及SDS评分，血清及关节液中MMP-1、MMP-3和MMP-13活性均显著下降；组间比较，观察组VAS、SAS及SDS评分，血清及关节液中MMP-3和MMP-13活性明显较低（P<0.05）；2组均无明显不良反应发生。结论：滑膜炎颗粒对老年KOA具有良好疗效，可能与其降低MMP活性有关。

Clinical observation of Huamoyan granules in elderly patients with knee osteoarthritis

OBJECTIVE To observe clinical effects of Huamoyan granules in elderly patients with knee osteoarthritis (KOA), and influences on matrix metalloproteinase(MMP), anxiety and depression. METHODS A total of 124 elderly patients with KOA were randomly divided into control group (62 cases) and study group (62 cases). Patients in control group received hyaluronic acid intraarticularly and celecoxib orally. Based on therapy in control group, patients in study group took Huamoyan granules additionally. All patients were treated for 4 weeks. Clinical effects, visual analogue scale (VAS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) were compared, levels of MMP-1, MMP-3 and MMP-13 in serum and joint fluid were determined, and adverse reactions were recorded. RESULTS Study group had a total effective rate of 82.26% higher than 62.90% of control group. After treatment, VAS, SAS, SDS and levels of MMP-1, MMP-3 and MMP-13 in serum and joint fluid were decreased in both groups. Compared with control group, study group had much lower VAS, SAS, SDS, and lower levels of MMP-3 and MMP-13 in serum and joint fluid (P<0.05). No obvious adverse reaction occurred. CONCLUSION Huamoyan granules are effective for elderly patients with KOA, and lowering levels of MMPs may be its mechanism.