目的 研究加味阳和汤对2型糖尿病合并膝骨关节炎患者血清分泌型糖蛋白-3α（Wnt-3α）、破骨细胞相关受体（OSCAR）、破骨细胞生成因子（RNKL）水平及膝关节功能的影响。 方法 将98例2型糖尿病合并膝骨关节炎患者采用随机数字表法分为对照组（塞来昔布+常规降糖治疗）和观察组（塞来昔布+常规降糖治疗+加味阳和汤），每组49例，两组均治疗4周。比较两组临床疗效、中医证候积分、血清Wnt-3α、OSCAR、RNKL、糖脂代谢指标、胰岛素样生长因子（IGF）、转化生长因子-β（TGF-β）、25羟基维生素D₃［25（OH）D₃］、炎症因子水平及疼痛、膝关节功能。 结果 治疗4周后，观察组总有效率高于对照组（P 0.05）。治疗4周后两组关节疼痛、痛处固定、肿胀、关节活动不利、畏风寒、关节喜温喜按评分及血清Wnt-3α、RNKL、空腹血糖（FPG）、糖化血红蛋白（HbA_1c）、甘油三酯（TG）、总胆固醇（TC）、IGF、白细胞介素-1（IL-1）、白细胞介素-6（IL-6）水平、视觉模拟评分（VAS）、西安大略和麦克马斯特大学骨关节炎指数评分（WOMAC）评分低于治疗前，观察组低于对照组（P 0.05）；血清OSCAR、TGF-β、25（OH）D₃水平高于治疗前，观察组高于对照组（P 0.05）。 结论 加味阳和汤联合塞来昔布、常规降糖对2型糖尿病合并膝骨关节炎患者进行治疗，可有效改善其中医证候积分，调节血清Wnt-3α、OSCAR、RNKL、IGF、TGF-β、25（OH）D₃水平，降低机体炎症反应，缓解疼痛，改善机体糖脂代谢及膝关节功能，具有较好的临床疗效。

Objective To investigate the effects of Jiawei Yanghe Decoction on the levels of serum secretory glycoprotein-3α （Wnt-3α）， osteoclast-related receptor （OSCAR）， receptor activator of NF-κB ligand （RANKL）， and the knee joint function in patients with type 2 diabetes mellitus complicated by knee osteoarthritis. Methods A total of 98 patients with type 2 diabetes mellitus complicated by knee osteoarthritis were randomly divided into a control group （celecoxib + conventional hypoglycemic therapy） and an observation group （celecoxib + conventional hypoglycemic therapy + Jiawei Yanghe Decoction） using the random number table method， with 49 cases in each group. Both groups received treatment for 4 weeks. The clinical efficacy， score of traditional Chinese medicine syndrome， levels of serum Wnt-3α， OSCAR， RNKL， glucose and lipid metabolism indexes， insulin-like growth factor （IGF）， transforming growth factor-β （TGF-β）， 25-hydroxyvitamin D₃ ［25（OH）D₃］， inflammatory factors， pain， and knee joint function were compared between the two groups. Results After 4 weeks of treatment， the total effective rate of the observation group was significantly higher than that of the control group （P 0.05）. Moreover， after 4 weeks of treatment， the scores of joint pain， pain fixation， swelling， limited joint activity， aversion to wind and cold， preference for joint warmth and stimulation， as well as the levels of serum Wnt-3α， RNKL， fasting blood glucose （FPG）， glycosylated hemoglobin （HbA_1c）， triglyceride （TG）， total cholesterol （TC）， IGF， interleukin-1 （IL-1）， interleukin-6 （IL-6）， scores of visual analogue scale （VAS）， and Western Ontario and McMaster University Osteoarthritis Index （WOMAC） in both groups were lower compared to those before treatment. Notably， the values in the observation group were significantly lower than those in the control group （P 0.05）. In addition， the levels of serum OSCAR， TGF-β， and 25（OH）D₃ were higher than those before treatment， and the levels in the observation group were significantly higher than those in the control group （P 0.05）. Conclusions Jiawei Yanghe decoction， in combination with celecoxib and routine hypoglycemic therapy， can effectively enhance the traditional Chinese medicine syndrome score of patients with type 2 diabetes mellitus complicated by knee osteoarthritis. It can also regulate the serum levels of Wnt-3α， OSCAR， RNKL， IGF， TGF-β， and 25（OH）D₃， reduce the inflammatory response， alleviate pain， and improve the body's glucose and lipid metabolism as well as knee joint function， demonstrating good clinical efficacy.