| Objective：1.To research the effect and mechanism of duhuojisheng decoction on KOA,anddiscuss the synergistic effect of duhuojisheng decoction and arthroscopic debridment.2.By analysing the3D gait of prior and post treatment,discuss the application of3Dmotion capture system for functional rehabilitation of KOA.Methods：1.Influence of duhuojisheng decoction on synovial fluid from knee joints of rabbitswith osteoarthritis,by detecting the level of IL-1β、IL-6、TNF-α and MMP-3.34New Zealand rabbits were divided randomly into3groups,model group(12rabbits,immobilizing with gypsum for42days,then given saline water10ml per day,lasting6weeks),treatment group(12rabbits,the same way fixed after42days,then gave lavage dietof duhuojisheng decoction10ml per day,lasting6weeks), control group (10rabbits,givennothing),detect IL-1β、IL-6、TNF-αand MMP-3in synovial fluid using enzyme linkedimmunosorbent assay(ELISA) way,and then compared the level of each group.2.Influence of duhuojisheng decoction on synovial fluid of knee joints in patients withosteoarthritis.54KOA patients were treated with duhuojisheng decoction for6weeks,then collectthe samples of synovial fluid and detectthe level of IL-1β、IL-6、TNF-αand MMP-3byenzyme linked immunosorbent assay(ELISA),and compared the prior and post treatmentlevel of each group.3.The effects of duhuojisheng decoction and arthroscopic debridment on kneeosteoarthritis36patients with KOA were randomly divided into two groups, one proup were treated with arthroscopic debridment and another group duhuojisheng decoction combining witharthroscopic debridment,and they were followed up for an average period of6months,Lysholm functional scale of the knee and JOA scores were collected including prior andpost treatment.4.3D gait analysis of the patients with knee osteoarthritis(KOA)24patients with KOA were randomly divided into four groups,traditional Chinesemedicine group,operation group,traditional Chinese medicine and operation group, and theblank control group,every group composed of6patients,another6healthy volunteers madeup of the normal group. VICON3D motion capture system were applied to measure andcalculate kinematic parameters such as stride time、 cadence、 velocity and themaximum-flexion of the hip、knee and ankle joints,then analysis the difference of eachgroup.Results：After given duhuojisheng decoction for6weeks, the data of synovial fluid in modelgroup were IL-1β(259.71±19.956pg/ml)、 IL-6(273.5±47.528pg/ml)、 TNF-α (7.163±0.758ng/ml), MMP-3(16.824±1.674ng/ml)；treatment group IL-1β145.74±18.755pg/ml,IL-6128.76±15.668pg/ml,TNF-α3.263±0.234ng/ml,MMP-39.418±0.424ng/ml;blankgroup IL-1β25.52±6.614pg/ml,IL-619.32±3.773pg/ml,TNF-α1.249±0.201ng/ml,MMP-31.04±0.052ng/ml.P<0.05indicate that there is statistic difference among3groups.The data of synovial fluid in54patients with KOA after taking duhuojishengdecoction presented a intended result:IL-1β(prior treatment815.551±95.595pg/ml,posttreatment557.264±5.253pg/ml)； IL-6(prior treatment1401.783±185.057pg/ml,posttreatment995.131±126.482pg/ml)； TNF-α(prior treatment112.355±14.671ng/ml,posttreatment74.883±8.389ng/ml)；MMP-3(prior treatment10.919±1.173ng/ml，post treatment8.707±1.128ng/ml），P<0.01indicate that there is statistic difference,too.In36patients with KOA,the Lysholm functional score of the knee raised from52.6±8.8to85.8±6.2,the singe pain score raised from6.5±3.0to18.8±4.9；in theduhuojisheng decoction and arthroscopic debridment group,the Lysholm functional scoreof the knee raised from50.2±7.6to87.2±6.5,the single pain score raised from6.5±3.0to20.5±4.9;the subjective evaluation results:(arthroscopic debridment group;excellent3，good12，middle3，poor0,the excellent and good rate is72.2%;duhuojisheng decoction and arthroscopic debridment group,excellent2，good11，middle4，poor1,the excellentand good rate is83.3%), the result shows that Lysholm functional score of the knee isstatistically significant,so as the JOA subjective evaluation.The results of3D gait analysis:the stride（m) in traditional Chinese medicinegroup,operation group,traditional Chinese medicine with operation group,blank controlgroup and the normal group were0.536±0.061，0.615±0.0670.681±0.0790.503±0.0470.754±0.080，the cadence（1/s）were1.065±0.1311.164±0.1391.289±0.1620.951±0.1011.581±0.118,the velocity（m/s）were0.571±0.0710.881±0.0790.966±0.0860.478±0.0431.192±0.123,the maximum-flexion of the hip（0）8.440±0.9778.588±1.0038.963±1.1118.711±0.95010.293±1.523， The maximum-flexion of the knee （0）54.343±5.46957.210±4.80858.627±6.10352.266±5.44059.529±6.740，The maximum-flexion of theankl（e0）21.012±1.96123.188±2.57124.577±2.76519.843±2.16422.771±2.119。Thereare statistically significant in stride and velocity,but there is no difference in cadence andthe maximum-flexion.Conclusion：1.The study confirmed that duhuojisheng decoction can inhibit the expression ofIL-1β、IL-6、TNF-α and MMP-3in the synovial fluid of knee joint,and have effectiveresult on KOA.2.Arthroscopic debridment can enhance Lysholm functional score of the knee,and thestride and velocity of the gait period,which indicate that Arthroscopic debridment canrelease the pain and improve the joint function.3.Duhuojisheng decoction have synergism to combine with the Arthroscopicdebridment.3.3D motion capture system can describe and analysis the gait exactly, can be usedto evaluate the lower limp functional rehabilitation. |
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