The Basic And Clinical Study About Osteopractic Total Flavonoids In The Treatment Of Knee Osteoarthritis

Osteoarthritis(OA) is one of the most common pathological changes of the joints, in which most of the patients are elderly. With the development of society, the life extension of the population, as one of the chronic diseases in old age, the effect of the disease on the society and the human being is becoming more and more serious. According to the epidemiological survey, the current Chinese bone and arthritis patients about 100000000 people, bone arthritis eventually lead to joint deformity, disability, disability rate of 53%, is the first major chronic disease of adults. Therefore, bone arthritis is known as the second half of the disease".With the development of molecular biology, the understanding of osteoarthritis has been deep into the molecular level. Study found that matrix metalloproteinases(matrix metalloproteinase, MMPs) and metalloproteinase inhibitory factor(tissue inhibitor of metallo proteinase, TIMP) and interleukin 1 beta(IL-1) and prostaglandin E2(PGE2), nitric oxide(no) and cytokines in the pathogenesis of osteoarthritis has played a major role. Matrix metalloproteinases(MMPs) are the most important enzymes in the degradation of extracellular matrix(ECM), which plays a key role in the degradation of matrix components. It has been confirmed that MMP-1 and MMP-3 are significantly enhanced in the synovial fluid, especially in the synovial fluid of osteoarthritis. Inflammatory cytokine interleukin 1(IL-1) plays the most important role in the decomposition, degradation of cartilage cell degeneration. IL-1 induces the synthesis of chondrocytes in excess of nitric oxide(NO), which can increase the apoptosis of chondrocytes, decrease the synthesis of PG, and IL-1 can promote MMPs synthesis, and activate MMPs, so that the degradation of PG can be increased, and ultimately lead to the destruction of articular cartilage. In addition, IL-1 can stimulate the production of neutral protease and prostaglandin E, increase the inflammatory reaction of the joints, increase the activity of osteoclasts, promote bone resorption, and reduce the synthesis of TIMP-2.Knee joint bone arthritis is most commonly involved site. From the view point of TCM, knee osteoarthritis belongs to "Bi syndrome" category. Rhizoma Drynariae warm taste bitter, bitter to diarrhea can dry and temperature can move the energy spread, Drynaria into the kidney tonifying and bone, Buzhong,,, fill, and therefore, invigorate the circulation of blood, tonifying kidney, strengthening bone, continued injury pain relieving. Osteopractic total flavone as the main active ingredient of Rhizoma Drynariae, with anti knee osteoarthritis strong.Order to approach the mechanism of action of total flavonoids of Rhizoma Drynariae on osteoarthritis. This study firstly through the animal experiments to detect total flavonoids of Rhizoma Drynariae tissue of rabbit knee osteoarthritis model learn morphology and serum, synovial fluid and cartilage matrix metalloproteinases(MMPs) and matrix metalloproteinase-2 enzyme tissue inhibited the expression of metalloproteinases(TIMP) and interleukin 1 beta(IL-1) and prostaglandin E2(PGE2), nitric oxide(no) and other cytokines. The results show that total flavonoids of Rhizoma Drynariae can improve the ACLT model of knee osteoarthritis in rabbit articular cartilage morphology, and reduced the serum IL-1, PGE2 and nitric oxide of synovial fluid and cartilage of MMP-1, MMP-3, TIMP-1 and i NOS expression. Then we observed the effect of traditional Chinese medicine osteopractic total flavone on patients with osteoarthritis of the HSS knee function score and serum IL-1 beta and the level of PGE2. The results showed that oral osteopractic total flavone after 12 weeks, 22 cases of knee osteoarthritis patients with HSS score compared with that before treatment significantly improve, serum IL-1 beta and the level of PGE2 compared with that before treatment decreased significantly. These study results suggest the feasibility of treating knee osteoarthritis with single Chinese herb Rhizoma Drynariae of effective components of total flavonoids of Rhizoma Drynariae.Part I An experimental observation about osteopractic total flavone affect part of the cytokines in rabbit osteoarthritisObjective: To study traditional Chinese medicine Drynaria total flavonoids of the anterior cruciate ligament transection(ACLT) rabbit knee osteoarthritis model of some cytokines expression.Methods: 30 New Zealand white rabbits were randomly divided into five groups, sham operation group, ACLT4 weeks ACLT8 weeks, 4 weeks group, Drynaria the total flavonoids osteopractic total flavone 8 weeks group(n = 6). Established in accordance with the anterior cruciate ligament transection model of rabbit osteoarthritis of the knee. The animals were sacrificed at 4 and 8 weeks of experiment, testing the serum IL-1β, PGE2 and synovial fluid NO and detected by reverse transcription- polymerase chain reaction of articular cartilage in the MMP-1, MMP-3, TIMP-1 and i NOS expression.Results: sham operation group of serum IL-1β, PGE2, NO and cartilage of the synovial fluid MMP-1, MMP-3, TIMP-1, the expression of i NOS in the lower, the ACLT group compared with the sham operation group increased, and with the model extension of time expression gradually increased(P <0.05). Osteopractic total flavone group compared with the ACLT group during the same period decreased expression(P <0.05).Conclusion: IL-1β and PGE2 NO, i NOS and MMP-1 and MMP-3 and TIMP-1 and other a variety of cytokines play an important role in the pathogenesis of the rabbit knee osteoarthritis, leading to histological degeneration one of the reasons. Drynaria rhizome total flavonoids of its inhibition has a positive effect on the prevention and treatment of osteoarthritis of rabbit knee. Part The clinical observation of the osteopractic patients treated with Ⅱ total flavonoidsObjective: To study traditional Chinese medicine osteopractic flavonoids on the efficacy of patients with osteoarthritis and to investigate its mechanism.Methods: Patients with knee osteoarthritis in 22 cases, 12 weeks of oral osteopractic total flavonoids compared before and after treatment in patients with the HSS knee score and serum IL-1β and PGE2 content. Results: Oral osteopractic total flavonoids after 12 weeks, 22 patients with HSS function scores significantly improved compared with before treatment(P <0.05), serum inflammatory factors IL-1β and PGE2 levels than before treatment significantly decreased(P <0.01).Conclusion: After oral administration of traditional Chinese medicine osteopractic total flavonoids can improve knee osteoarthritis in patients with clinical symptoms. The mechanism may be related to serum levels of IL-1β and PGE2 reduce related.