| Objective:Under the guidance of the theory of Traditional Chinese Medicine (TCM), union with the research method of modern medicine , this paper sought to observe the effect of Guan jie kang (a complex prescription of Chinese native medicine) to treat knee osteoarthritis and probe into the curative mechanism . Via experimental and clinical research , it laid foundation for further clinical promotion and utilization to treat knee osteoarthritis by Guan jie kang Methods:Experimental research: The News Zealand rabbits as the experimental models were caused to suffer from osteoarthritis with their left knee joints injected by papain.. A method based on completely random divided design was used on the study , rabbits were divided into six groups: Group A was normal group which was not injected by papain , Group B1 and Group B2 were blank contrast groups which were treated with nothing and fed with only fodder;Group C was treated with Guan jie kang;Group D was treated with western medicine;Group E was treated with Chinese native medicine . Two weeks later after their left knee joints were injected by papain , all the rabbits in Group B2 were killed and histological evaluation on osteoarthritic cartilage of left knee joint pathology specimen were performed. At the same time , Group C was treated with Guan jie kang;Group D was treated with celecoxib;Group E was treated with Zhuang gu guan jie wan , four weeks later , all the rabbits of the experimental models were killed and histological evaluation on osteoarthritic cartilage of their left knee joint pathology specimen were performed . The proteoglycan changes of matrix metabolism index of each group were examined by chemical colorimetry , the expression of interleukin— 1β (IL— 1β) and transforming growth factor-β1 (TGF-β1) were tested by immunohistochemistry.Clinical research: According to The revision classified standard of American rheumatism association' s osteoarthritis In 1995 and The II issueof clinical test plan for knee osteoarthritis , the clinical cases were collected and divided into Guan jie kang group and celecoxib group randomly , which would be treated for 6 weeks separately . When the treatments were accomplished , the changes of main symptoms and signs(ache of the knee > function of the knee ) and curative effects according to the theory of TCM were observed , using the improvement grades standard , the contrasts were performed between the same group and the different groups . Result:Experimental research: 1.Roughly observed result: Pathology demonstrated roughly that the articular cartilage of group A was normal, the articular cartilage of B — E groups had draw back changes of varied degree . 2. The result of the pathology grade : the pathology grade of group B2 is lighter than that of group A, which had statistical significance(P<0. 01) , the pathology grade of group Bl was lighter than that of group B2, which had statistical significance (P<0. 01) , the pathology grade of the treatment groups was lighter than that of group Bl (P<0. 01) , but higner than that of group B2 , the pathology grades of group C was the best among the groups of C, D and E, the difference between group D and group E did not have statistical significance(P>0.05). which indicated that all the treatment groups could improve the protein polysaccharide contents of the cartilage matrix , and the group of C had the best result among them. 3. The result of the immunohistochemistry examination : The immunohistochemistry dyeing was showed in the cartilage cell's cytoblastema . The immunohistochemistry examination demonstrated that the positive unit of TGF-0 1 in group C, D, E was obviously higher than that of group Bl (P<0. 01), the positive unit of TGF-0 1 in group C is the higher than that of group D or group E , (P<0. 01), which showed that all the treatment groups could improve the expression of TGF-0 1 , but the group of C had the best result and the group of D had the worst result among them. The positive unit of IL—1 ￡ in group C, D was obviously less than that of group Bl (P<0. 01), the positive unit of IL—IP in group D was less than that of group C (P<0. 01), the difference between group E and group Bl did not have significant difference , which indicated that the group of D had the best result to reduce the expression of IL—1 & , and the group of E did not have obvious value to reduce the expression of IL—IP.Clinical research : 1.Comparison of integral : Compared with the integrals of symptoms and signs before treated , all the integrals in Guan jie kang group or celecoxib group had significant difference after the treatment course had ended, which showed that both Guan jie kang and celecoxib could relieve the symptoms and signs related to knee osteoarthritis . 2. Comparison of integral change : The integral change of patient's symptoms and signs between Guan jie kang group and celecoxibgroup did not have significant difference (P>0. 05), which showed that the integral change between Guan jie kang group and celecoxib group did not have statistical significance , but the function integral change> the ache integral change and the symptom integral change according to the theory of TCM had significant difference (P<0. 05), which indicated that celecoxib was better to alleviate the osteoarthritis patient' s ache symptom, but Guan jie kang was better to improve the patient's function and alleviate the symptom integral change according to the theory of TCM .3.Comparison of clinical curative effect : The total clinical curative effect did not have significant difference between Guan jie kang group and celecoxib group (P>0. 05), which indicated that both Guan jie kang group and the celecoxib group had the same result to relieve the clinical symptoms and signs . 4. Comparison of curative effect according to the theory of TCM: The curative effect had significant difference between Guan jie kang group and celecoxib group (P<0. 01), which indicated that the Guan jie kang group had certain superiority to alleviate the symptom according to the theory of TCM than that of celecoxib group.Statistical method: numeration data is analysed with X2-test, measurement data is analysed with t-test. Conclusion:1. Guan jie kang could promote the cartilage matrix to synthesis, suppress the cartilage matrix to decompose, then to promote the damage articular cartilage to repair.2. The curative mechanism of Guan jie kang to treate knee osteoarthritis laid on it that Guan jie kang could enhance the expression of TGF-3 1 and reduce the expression of IL— IP in the osteoarthritis cartilage .which would promote the damage articular cartilage to repair directly or indirectly .3. The clinical research showed that the total clinical curative effect between Guan jie kang group and celecoxib group did not have significant difference, but Guan jie kang had certain superiority to alleviate the symptom according to the theory of TCM , which indicated that the clinical curative effect of Guan jie kang was effective and secure . It was valuable to promote the clinical application of Guan jie kang to treat knee osteoarthritis.4. The theory of TCM to tonify kidney and drive blood should be one of the main principles to treat osteoarthritis .
|
PDF Full Text Request