补肾活血法联合氨基葡萄糖片对膝骨关节炎患者血清IL-6、IL-18、VEGF及关节液SOD、MDA表达的影响
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摘要
目的:观察补肾活血法联合氨基葡萄糖片治疗膝骨关节炎的临床疗效及其对血清白细胞介素-6(interleukin-6,IL-6)、白细胞介素-18 (interleukin-18,IL-18)、血管内皮生长因子(vascular endothelial growth factor,VEGF)及关节液超氧化物歧化酶(superoxide Dismutase,SOD)、丙二醛(malondialdehyde,MDA)的影响。方法:收治膝骨关节炎患者140例,随机分为观察组与对照组,每组各70例。对照组采用氨基葡萄糖片口服,观察组在对照组基础上联合服用补肾活血中药方,治疗3个月后对比两组患者的临床疗效及治疗前后Lequesne指数、血清IL-6、IL-18、VEGF变化及关节液SOD活性和MDA含量。结果:观察组临床有效率为92. 9%,显著高于对照组的78. 6%,差异具有统计学意义(P <0. 05);两组治疗前Lequesne指数评分无显著差异,治疗后两组评分均降低,且观察组低于对照组,差异具有统计学意义(P <0. 05);治疗前两组患者血清IL-6、IL-18、VEGF水平无显著差异,治疗后两组各指标水平均低于治疗前,且观察组三者水平均低于对照组,差异具有统计学意义(P <0. 05);治疗前两组患者关节液SOD活性、MDA含量无显著差异,治疗后观察组SOD活性显著高于对照组,MDA含量显著低于对照组,差异具有统计学意义(P <0. 05)。结论:补肾活血法联合氨基葡萄糖片可以显著提高膝骨关节炎的疗效,改善患者症状,降低Lequesne指数评分,其机制可能是与降低血清IL-6、IL-18、VEGF水平及关节液MDA含量,提高关节液SOD活性有关。
Objective:To observe the curative effect of Bushen Huoxue Method combined with Glucosamine Tablet in the treatment of knee osteoarthritis and serum IL-6 and IL-18,vascular endothelial growth factor( VEGF),and changes of superoxide dismutase( SOD) and malondialdehyde( MDA) in synovial fluid.Methods:140 patients were divided into two groups.One group was treated only with glucosamine tablets as control group.The other group was treated with glucosamine tablets and Kidney-tonifying and Blood-Activating Chinese herbs as observation group,with 70 cases in each group.For 3 months,the curative effect of the two groups,Lequesne,serum IL-6,IL-18,VEGF levels and SOD,MDA in synovial fluid before and after treatment were measured.Results:The effective rate of observation group was higher than that of control group.There was no significant difference between the two groups in the Lequesne index before treatment,the Lequesne index scores of the two groups were lowered after treatment,the score of the observation group was lower than that of the control group,the difference was statistically significant( P < 0.05).There was no significant difference between the two groups in serum IL-6,IL-18 and VEGF levels before treatment,the average level was lower than that before treatment,and the levels of the observation group were lower than those of the control group,the differences were statistically significant( P < 0.05).There were no significant differences between the two groups in the levels of SOD and MDA in the joint fluid before treatment,SOD level in the observation group was significant raised after treatment.Compared with the control group,MDA level of observation group was significantly lower than that of the control group,and the difference was statistically significant( P < 0.05).Conclusion:The combination of Bushen Huoxue Method and Glucosamine Tablet can significantly improve the curative effect of knee osteoarthritis,improve the symptoms of patients and reduce the Lequesne index.The mechanism may be through the reduction of serum IL-6,IL-18,VEGF and synovial fluid MDA levels and increasing SOD levels in synovial fluid.
Objective:To observe the curative effect of Bushen Huoxue Method combined with Glucosamine Tablet in the treatment of knee osteoarthritis and serum IL-6 and IL-18,vascular endothelial growth factor( VEGF),and changes of superoxide dismutase( SOD) and malondialdehyde( MDA) in synovial fluid.Methods:140 patients were divided into two groups.One group was treated only with glucosamine tablets as control group.The other group was treated with glucosamine tablets and Kidney-tonifying and Blood-Activating Chinese herbs as observation group,with 70 cases in each group.For 3 months,the curative effect of the two groups,Lequesne,serum IL-6,IL-18,VEGF levels and SOD,MDA in synovial fluid before and after treatment were measured.Results:The effective rate of observation group was higher than that of control group.There was no significant difference between the two groups in the Lequesne index before treatment,the Lequesne index scores of the two groups were lowered after treatment,the score of the observation group was lower than that of the control group,the difference was statistically significant( P < 0.05).There was no significant difference between the two groups in serum IL-6,IL-18 and VEGF levels before treatment,the average level was lower than that before treatment,and the levels of the observation group were lower than those of the control group,the differences were statistically significant( P < 0.05).There were no significant differences between the two groups in the levels of SOD and MDA in the joint fluid before treatment,SOD level in the observation group was significant raised after treatment.Compared with the control group,MDA level of observation group was significantly lower than that of the control group,and the difference was statistically significant( P < 0.05).Conclusion:The combination of Bushen Huoxue Method and Glucosamine Tablet can significantly improve the curative effect of knee osteoarthritis,improve the symptoms of patients and reduce the Lequesne index.The mechanism may be through the reduction of serum IL-6,IL-18,VEGF and synovial fluid MDA levels and increasing SOD levels in synovial fluid.
引文
[1]孙振新,杨矛,朱玲玲,等.中医药治疗膝骨关节炎研究进展[J].辽宁中医药大学学报,2017,19(1):111-114.
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[4]Bennell KL,Hunter DJ,Paterson KL.Platelet-rich plasma for the management of hip and knee osteoarthritis[J].Curr Rheumatol Rep,2017,19(5):24.
[5]周广明,甘务琼,林慧敏.依托考昔联合盐酸氨基葡萄糖治疗膝关节骨性关节炎的疗效分析[J].解放军预防医学杂志,2018,36(3):368-371.
[6]王旭松,宋庆军.盐酸氨基葡萄糖联合股四头肌离心训练治疗膝关节骨性关节炎的疗效观察[J].四川医学,2017,38(1):52-54.
[7]周卫国,胡彦兴,卓彩琴,等.补肾活血逐痹方治疗膝骨关节炎疗效观察[J].山西中医,2018,34(7):19-21.
[8]王大力.腹部推拿配合中药熏蒸疗法治疗膝关节骨性关节炎合并关节腔积液的临床观察[J].中华中医药杂志,2017,32(9):4324-4326.
[9]徐卫东,吴岳篙,张春才.骨关节炎的诊断与治疗[M].上海:第二军医大学出版社,2004:140-141.
[10]付焘,于长禾,张洋,等.膝骨关节炎临床研究中结局评价指标的应用现况[J].中国医药导报,2018,15(29):21-24,28.
[11]Parsons C,Clynes M,Syddall H,et al.How well do radiographic,clinical and self-reported diagnoses of knee osteoarthritis agree?findings from the hertfordshire cohort study[J].Springerplus,2015,4(1):1-5.
[12]Mills K,Hübscher M,O’Leary H,et al.Current concepts in joint pain in knee osteoarthritis[J].Schmerz,2018,32(4):1-7.
[13]Tian K,Cheng H,Zhang J,et al.Intra-articular injection of methylprednisolone for reducing pain in knee osteoarthritis:A systematic review and meta-analysis[J].Medicine,2018,97(15):e0240.
[14]符维广,许立新.晚期骨关节炎患者血清和关节液中基质金属蛋白酶-13和肿瘤坏死因子-α水平的变化及其意义[J].中国骨与关节杂志,2017,6(4):279-282.
[15]芦丹,汪亚群,孙迪.独活寄生汤对膝骨性关节炎患者关节液炎症因子、疗效及膝关节功能状况的影响分析[J].中华中医药学刊,2017,35(4):1050-1052.
[16]靳发万,吴群,瞿群威,等.不同浓度臭氧关节腔注射对膝骨性关节炎患者IL-1和IL-6的影响[J].湖北中医药大学学报,2017,19(1):30-33.
[17]Sato H,Muraoka S,Kusunoki N,et al.Resistin upregulates chemokine production by fibroblast-like synoviocytes from patients with rheumatoid arthritis[J].Arthritis Research&Therapy,2017,19(1):263.
[18]吴迎春,吕刚,依力潘,等.淫羊藿总黄酮联合硫酸氨基葡萄糖对膝骨关节炎疗效临床研究[J].中国骨质疏松杂志,2017,23(9):1195-1198.
[19]赵明宇,鲍铁周,赵启,等.基于平乐正骨“筋滞骨错”理论推拿治疗膝关节骨性关节炎疗效评价[J].中华中医药杂志,2017,32(3):1372-1374.
[20]梁桂洪,梁祖建,林勇凯,等.补肾活血中药对比塞来昔布治疗膝骨性关节炎疗效与安全性的Meta分析[J].中国药房,2016,17(27):3810-3814.
[2]张听雨,白玉龙.膝骨关节炎及其康复治疗[J].上海医药,2017,38(1):19-24.
[3]Cooper C,Rannou F,Richette P,et al.Use of intra-articular hyaluronic acid in the management of knee osteoarthritis in clinical practice.[J].Arthritis Care&Research,2017,69(9):1287-1296.
[4]Bennell KL,Hunter DJ,Paterson KL.Platelet-rich plasma for the management of hip and knee osteoarthritis[J].Curr Rheumatol Rep,2017,19(5):24.
[5]周广明,甘务琼,林慧敏.依托考昔联合盐酸氨基葡萄糖治疗膝关节骨性关节炎的疗效分析[J].解放军预防医学杂志,2018,36(3):368-371.
[6]王旭松,宋庆军.盐酸氨基葡萄糖联合股四头肌离心训练治疗膝关节骨性关节炎的疗效观察[J].四川医学,2017,38(1):52-54.
[7]周卫国,胡彦兴,卓彩琴,等.补肾活血逐痹方治疗膝骨关节炎疗效观察[J].山西中医,2018,34(7):19-21.
[8]王大力.腹部推拿配合中药熏蒸疗法治疗膝关节骨性关节炎合并关节腔积液的临床观察[J].中华中医药杂志,2017,32(9):4324-4326.
[9]徐卫东,吴岳篙,张春才.骨关节炎的诊断与治疗[M].上海:第二军医大学出版社,2004:140-141.
[10]付焘,于长禾,张洋,等.膝骨关节炎临床研究中结局评价指标的应用现况[J].中国医药导报,2018,15(29):21-24,28.
[11]Parsons C,Clynes M,Syddall H,et al.How well do radiographic,clinical and self-reported diagnoses of knee osteoarthritis agree?findings from the hertfordshire cohort study[J].Springerplus,2015,4(1):1-5.
[12]Mills K,Hübscher M,O’Leary H,et al.Current concepts in joint pain in knee osteoarthritis[J].Schmerz,2018,32(4):1-7.
[13]Tian K,Cheng H,Zhang J,et al.Intra-articular injection of methylprednisolone for reducing pain in knee osteoarthritis:A systematic review and meta-analysis[J].Medicine,2018,97(15):e0240.
[14]符维广,许立新.晚期骨关节炎患者血清和关节液中基质金属蛋白酶-13和肿瘤坏死因子-α水平的变化及其意义[J].中国骨与关节杂志,2017,6(4):279-282.
[15]芦丹,汪亚群,孙迪.独活寄生汤对膝骨性关节炎患者关节液炎症因子、疗效及膝关节功能状况的影响分析[J].中华中医药学刊,2017,35(4):1050-1052.
[16]靳发万,吴群,瞿群威,等.不同浓度臭氧关节腔注射对膝骨性关节炎患者IL-1和IL-6的影响[J].湖北中医药大学学报,2017,19(1):30-33.
[17]Sato H,Muraoka S,Kusunoki N,et al.Resistin upregulates chemokine production by fibroblast-like synoviocytes from patients with rheumatoid arthritis[J].Arthritis Research&Therapy,2017,19(1):263.
[18]吴迎春,吕刚,依力潘,等.淫羊藿总黄酮联合硫酸氨基葡萄糖对膝骨关节炎疗效临床研究[J].中国骨质疏松杂志,2017,23(9):1195-1198.
[19]赵明宇,鲍铁周,赵启,等.基于平乐正骨“筋滞骨错”理论推拿治疗膝关节骨性关节炎疗效评价[J].中华中医药杂志,2017,32(3):1372-1374.
[20]梁桂洪,梁祖建,林勇凯,等.补肾活血中药对比塞来昔布治疗膝骨性关节炎疗效与安全性的Meta分析[J].中国药房,2016,17(27):3810-3814.