| Objective1.Through clinical retrospective research,observe and analyze the curative effect of Professor Huang Feng’s core experience prescription of traditional Chinese medicine in the treatment of early and mid-stage liver and kidney deficiency and dampness stagnation KOA.2.By constructing a KOA animal model,explore the effects of the intervention of the core experience prescription of traditional Chinese medicine on the expression of serum IL-1、IL-6、TNF-α inflammatory factors and the morphological and histopathological changes of the knee joint in rats.Methods1.Clinical StudyBy collecting and recording medical records and follow-up data of KOA patients who met the standard during treatment at the Orthopedic Clinic of Professor Huang Feng of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from June 2020 to January 2021,including gender,age,medication plan,and VAS pain The score,WOMAC bone and joint index score,knee joint X-rays,etc.According to the drug regimen,the patients were divided into treatment group and control group.The VAS score and WOMAC score of the first treatment and four weeks after treatment were used as observation and evaluation indicators to analyze and compare the improvement of patients’ clinical symptoms before and after treatment.2.Experimental StudyBy selecting thirty-two male SD rats about three months old,and after adaptive feeding for a week,they were randomly divided into blank group,model group,traditional Chinese medicine group and western medicine group,with eight rats in each group.Except for the blank group,KOA model rats were constructed by modified Hulth’s method in the other groups.After the models were completed,the traditional Chinese medicine group were given a certain proportion of the lyophilized powder of the core experience prescription of traditional chinese medicine to be used for gavage;the western medicine group were given a certain proportion of glucosamine hydrochloride capsules to be used for gavage;the model group were given the same volume of physiology gavage with saline.After four weeks of intervention,blood was taken from the abdominal aorta after anesthesia.After centrifugation,the upper serum was used to detect the expression levels of IL-1,IL-6 and TNF-α inflammatory factors in ELISA.A specimen of the knee joint at the operation side was used for Micro-CT imaging.The degree of osteoarthritis of the knee joint was observed by the physical examination,and the pathological changes of the soft tissue were observed by HE staining of pathological sections.Results1.Clinical StudyThere was no significant difference between the treatment group and the control group in terms of gender,age,and K-L classification data(P>0.05).After treatment,the VAS score,WOMAC pain score,stiffness score,and difficulty in daily activities scores of the two groups were all lower than before treatment,with significant differences(P<0.05);after treatment,the two groups were compared,the VAS score and WOMAC pain score of the treatment group were lower than those of the control group(P<0.05),and the difference in scores before and after treatment was greater than that of the treatment group(P<0.05);there was no significant difference in WOMAC stiffness scores between the two groups after treatment(P=0.593>0.05),but there is a significant difference in the score difference before and after treatment(P=0.019<0.05),and the difference in the treatment group is larger than that in the control group;there is no significant difference in the WOMAC difficulty of daily activities score after treatment(P= 0.880>0.05),and there was no significant difference in the score difference before and after treatment(P=0.882>0.05).During the treatment period,the two groups had no gastrointestinal and other adverse reactions due to the medication.2.Experimental StudyMicro-CT examination of the rat’s knee joint showed no obvious abnormalities in the articular surface of the knee joint in the blank group.While in the model group,the knee joint in the model group showed unclear articular surface,rough and uneven surface,obvious asymmetrical joint space,and upper femoral joints.Facial loss and ulceration,moderate stenosis of the medial tibia,osteophyte formation of various sizes on the medial and lateral tibia,uneven subchondral bone density and high density shadows,suggesting obvious imaging features of knee osteoarthritis.In the traditional chinese medicine group,the contour of the articular surface was basically clear and complete,the joint space of the medial tibia was narrow,and the formation of small osteophytes was seen on the medial tibia and tibial intercondylar crest.The knee joint of the mouse in the western medicine group had a clear articular surface contour,and the joint space is basically the same,and the lateral tibia is seen osteophytes were formed.There was osteophyte formation in the tibial intercondylar crest,and the subchondral bone is dense.The comparison of rat serum IL-1,IL-6,TNF-α content results,followed by blank group,traditional Chinese medicine group,western medicine group,and model group.However,in the determination of TNF-α content,although the western medicine group was lower than the model group,there was no significant difference(P=0.880>0.05)HE staining of rat articular cartilage and Mankin’s score showed that the knee articular cartilage of the blank group was almost normal;the cartilage surface of the model group had obvious cracks,which could even penetrate the entire transition layer,the cartilage layer became thinner,and scattered clusters of cells.The columnar sequence of chondrocytes was broken,local proliferation,the density of chondrocytes decreased,and the tide line showed an irregular shape,showing obvious knee joint cartilage damage;the knee joint structure of the rats in the Chinese medicine group was still intact,with a small number of scattered cells.In clusters,there are more flat cells under the cartilage layer than in the blank group,and the matrix was evenly stained;in the western medicine group,there were small horizontal strip-shaped defects on the surface of the cartilage of the rat,with free ends,clusters of cells in the subchondral layer,and local cartilage thickening.The chondrocytes were arranged irregularly,the matrix dyeing uniformity was poor,and the integrity of the tide line structure was poor.According to the staining results of HE pathological sections of rat knee cartilage,refer to Mankin’s scoring system for scoring,followed by model group,western medicine group,traditional Chinese medicine group,and blank group.Conclusion1.After research,it could be known that on the basis of basic treatment,Professor Huang Feng’s basic experience in treating KOA could improve the pain,stiffness,and functional symptoms of KOA patients with liver and kidney deficiency and blood stasis blocking dampness syndrome,and it was safer.2.It could be inferred that Professor Huang Feng’s basic experience of traditional Chinese medicine for treating KOA could delay the pathological progress of articular cartilage by reducing the levels of inflammatory factors such as IL-1,IL-6 and TNF-α. |
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