加味独活寄生合剂促进膝骨关节炎软骨修复疗效及的作用机制的研究.docVIP

加味独活寄生合剂促进膝骨关节炎软骨修复疗效及的作用机制的研究 　　摘要：目的 探?加味独活寄生合剂促进膝骨关节炎（KOA）软骨细胞增殖的临床疗效及其作用机制。方法 采用随机数字表法将60例患者随机分为治疗组和对照组各30例。治疗组予加味独活寄生合剂，每次62.5 mL，每日2次，口服；硫酸氨基葡萄糖胶囊，每次1粒，每日3次，口服。对照组予双醋瑞因胶囊，每次1粒，每日2次，口服；硫酸氨基葡萄糖胶囊，用法用量同治疗组。嘱患者行股四头肌舒缩功能锻炼，注意保暖。连续治疗6周。观察2组治疗前后视觉模拟评分法（VAS）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC），检测患膝关节液白细胞介素-1（IL-1）、一氧化氮（NO）、Wnt5a、β-连环蛋白（β-catenin）、Sox9、胶原蛋白Ⅱ（CollagenⅡ）含量，监测不良反应。结果 与本组治疗前比较，2组治疗后IL-1、NO、Wnt5a、β-catenin含量明显降低（P0.05）。2组均未见明显不良反应。结论 加味独活寄生合剂可降低关节液中炎症因子水平，抑制Wnt信号通路，通过调节通路中Sox9、CollagenⅡ表达促进KOA软骨细胞的增殖分化，有效缓解疼痛并改善关节功能。 　　关键词：加味独活寄生合剂；膝骨关节炎；软骨修复 　　DOI：10.3969/j.issn.1005-5304.2018.01.007 　　中图分类号：R274.94 文献标识码：A 文章编号：1005-5304（2018）01-0028-05 　　Clinic Efficacy and Action Mechanism of Promoting Repairment of Knee Osteoarthritis’s Cartilage Corpuscle via Modified Duhuo Jisheng Mixture 　　ZHANG Yong-hui1， OU Liang1， KUANG Gao-yan1， LU Min2 　　1. Hunan University of Chinese Medicine， Changsha 410007， China； 　　2. The First Affiliated Hospital of Hunan University of Chinese Medicine， Changsha 410007， China 　　Abstract： Objective To discuss the clinic efficacy and its mechanism of action in promoting the cell proliferation of knee osteoarthritis’s cartilage corpuscle via modified Duhuo Jisheng Mixture. Methods Totally 60 cases were divided into treatment group and control group by random number table method， with 30 cases in each group. Treatment group was given modified Duhuo Jisheng Mixture， 62.5 mL each time， twice a day， orally， and sulfoglycan sulfate capsules， 1 capsule a day， three times a day， orally； while control group was given diacerein capsules， 1 pill a day， twice a day， orally， and sulfoglycan sulfate capsules， the same as treatment group. Patients were required to do quadriceps muscle systolic and functional exercise， and keep warm. The treatment lasted for 6 weeks. VAS score and WOMAC of the two group were observed before and after treatment. IL-1， NO， Wnt5a， β-catenin， Sox9， Collagen Ⅱ in knee joint fluid were detected. Adverse reactions were monitore