| ObjectivesThrough literature review,it found that the method of invigorating qi and invigorating spleen is effective in the treatment of Knee Osteoarthritis(KOA)with synovitis in the early and middle stages.Through clinical study,evaluating the clinical effect of Sishenjian Decoction on KOA complicated with synovitis.Analyzing its related factors associated inflammation by the method of network pharmacology,scientific evaluating traditional Chinese medicine for early middle potential regulation and control mechanism of KOA complicated with synovitis,providing the basis for clinical treatment and scientific research and exploration of KOA.Methods67 patients with early and mid-stage KOA complicated with synovitis were randomly divided into the experimental group and the control group,with 32 cases in the experimental group and 35 cases in the control group.The experimental group was treated with Sishen Decoction and basic treatment,while the control group was treated with basic treatment only for 2 weeks.WOMAC,VAS scale and Lequesne index were scored before and 2 weeks after treatment.5 mL of venous blood was extracted before and 2 weeks after treatment,and 2mL of serum was extracted.Galectin-3(hereafter referred to as Gal-3)content was detected in a low-temperature environment,and relevant data were statistically analyzed.In the part of network pharmacology,the components of each herb were searched in the pharmacology database of traditional Chinese medicine system and the analysis platform TCMSP,and the target genes related to KOA were searched in Disgenet database and OMIM database with the five herbs contained in Sishenjian decoction as the key words.The effective ingredients of Sishenjian Decoction Compound and the targets obtained in Stitch were summarized and collated,and then imported into Cytoscape 3.5.0 software for network construction,and the target network of effective ingredients of Sishenjian Decoction Compound was obtained.Genes related to KOA and active component targets were searched in DisgeNet database and OMIM database to get the intersection.Genes of the intersection part were imported into Cytoscape 3.5.0 software,and protein interaction network was constructed based on String database.At the same time,genetic body(GO)biological process enrichment analysis and KEGG pathway were conducted on the obtained intersection targets with the help of R language kit Clusterprofiler.so as to further explore the mechanism of Sishenjian Decoction in the treatment of KOA.ResultsAll patients were able to cooperate with treatment and follow-up according to the research requirements,and no cases were eliminated or dropped off.Statistical analysis is as follows:1.Patients in the observation group and the control group were compared by statistical analysis in terms of age,gender,and affected side ratio.The baselines were consistent and comparable(P>0.05).2.VAS score,WOMAC score(pain,stiffness,joint mobility score),Lequesne index,Gal-3 level and other data of the experimental group and the control group before treatment were statistically analyzed,and the baseline was consistent,and the two groups were comparable(P>0.05).3.Compared with the control group,there were significant differences in WOMAC total score,WOMAC joint mobility function,Gal-3 level,WOMAC score before and after treatment,WOMAC joint mobility function score before and after treatment,and Gal-3 level before and after treatment in the experimental group(P<0.05).There were no significant differences between the two groups in VAS score,WOMAC pain and stiffness score,Lequesne index,VAS score before and after treatment,WOMAC pain score before and after treatment,WOMAC stiffness score before and after treatment,and Lequesne index before and after treatment(P>0.05).4.Compared with before treatment,there were significant differences in VAS score,WOMAC score(pain,joint mobility score),Lequesne index and Gal-3 level in experimental groups after treatment(P<0.05).Compared with before treatment,there were significant differences in VAS score,WOMAC score(pain,joint mobility score)and Lequesne index in experimental group(P<0.05),while there were no significant differences in Gal-3 level in control group(P<0.05).5.Network pharmacology analysis found that the representative of the spleen and activing party four gods Fried compound in the treatment of KOA mainly involved in the top 20 pathways for toll-like receptors signaling pathways,fat cytokine signaling pathways,epidermal growth factor receptor(ERbB)signaling pathway,B and T cell receptors signaling pathways,silk crack the original amp-activated protein kinase(MAPK)signaling pathway and so on.At the same time,multiple pathways were connected by common targets rather than separated independently,suggesting that each pathway may play a synergistic role in the treatment of KOA.Among them,TLRs receptor-mediated inflammatory signaling pathways in different pathways play an important role in the occurrence and development of KOA.ConclusionsThe method of invigorating qi and invigorating spleen is an effective method for the treatment of KOA complicated with synovitis in the early and middle stages.The representative formula of Sishen Decoction can significantly improve the joint pain,joint function and range of motion in the patients with KOA complicated with synovitis in the early and middle stages.Gal-3 in the downstream of NF-κB,the classical pathway of inflammation,was significantly decreased after treatment with Sishen Decoction.Comprehensive network pharmacological analysis shows that Sishenjian Decoction has certain anti-inflammatory and analgesic effects and can improve the overall function of patients.It may play a role in the treatment of KOA complicated with synovitis by regulating TLR2/NF-κB inflammatory signaling pathway. |
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