中文摘要：

目的 探讨双醋瑞因口服与玻璃酸钠关节腔注射联合中药外敷治疗重症膝骨关节炎的疗效及安全性。方法 选取2013年12月—2015年12月诊治的重症膝骨关节炎患者150例,按治疗方法不同分为两组,对照组75例采用双醋瑞因口服、玻璃酸钠关节腔注射治疗,观察组75例采用双醋瑞因口服、玻璃酸钠关节腔注射联合中药外敷治疗,比较两组临床指征、相关评分、治疗效果及不良反应。结果 治疗后两组患者C反应蛋白、白介素-6、肿瘤坏死因子-α、WOMAC关节炎指数评分、OA严重程度指数、视觉模拟评分（VAS）评分、关节压痛度评分均较治疗前降低（P〈0.01）。治疗后观察组的上述指标低于对照组（P〈0.01）。观察组的不良反应发生率低于对照组（P〈0.05）。观察组治疗总有效率高于对照组（P〈0.05）。结论 双醋瑞因口服与玻璃酸钠关节腔注射联合中药外敷治疗重症膝骨关节炎的疗效显著,病症改善明显且抗炎效果好,安全性高。

英文摘要：

Objective To investigate efficacy and safety of oral Diacerein and intra-articular injection with Sodium Hyaluronate combined with traditional Chinese medicine external application in treatment of severe knee osteoarthritis.Methods A total of 150 patients with severe knee osteoarthritis during December 2013 and December 2015 were divided into two groups according to different therapeutic methods. Control group（ n = 75） was treated with oral Diacerein and intra-articular injection with Sodium Hyaluronate,while observation group（ n = 75） was treated with oral Diacerein and intra-articular injection with Sodium Hyaluronate combined with traditional Chinese medicine external. Clinical indications,related scores,therapeutic effects and incidence rates of adverse reaction were compared between two groups. Results After treatment,values of C reactive protein,interleukin-6,tumor necrosis factor-α,WOMAC arthritis index score,osteoarthritis（ OA） severity index,visual analogue scales（ VAS） score and joint tenderness score were decreased compared with those before treatment in two groups（ P〈0. 05）. After treatment,values of the above indexes and incidence rate of adverse reaction in observation group were lower than those in control group（ P〈0. 05）. Total effective rate in observation group was higher than that in control group（ P〈0. 05）. Conclusion Oral Diacerein and intra-articular injection with Sodium Hyaluronate combined with traditional Chinese medicine external application in treatment of severe knee osteoarthritis can achieve good efficacy,obviously improve symptoms with good anti-inflammatory effect and safety.