| Purpose:Through the clinical observation of the treatment of knee osteoarthritis(KOA)with the combination of Tuina and Chinese Herbal Ointment therapy,the effectiveness of the combination of Tuina and Chinese Herbal Ointment and the advantages of internal and external synergistic treatment of knee osteoarthritis were discussed.According to the conclusion of clinical observation,the mechanism of the treatment of knee osteoarthritis was further explored through animal experiments,which laid a foundation for the development of a new Tuina Ointment.Method:1.Preparation of Qianghuoguizhi:Select dry and clean cassia twig and lycium medicinal herbs,first extract the volatile oil of scented osmanthus by distillation,and then prepare the external scented colostrum paste according to the preparation method.2.Clinical observation:60 patients with KOA who met the inclusion criteria were selected for general exploratory clinical observation.The special treatment for treating KOA,medical ozone,was used as the basic treatment.The enrolled cases were randomly divided into:The Ointment-treated group and the blank group(without any treatment)were loaded into each group,30 cases in each group.After one course of treatment,the changes of WOMAC score and Lequesne index score before and after treatment were compared,and interleukin-1(IL-before and after treatment).1)Comparison of changes in interleukin-6(IL-6)content.Finally,compare the clinical efficacy of TCM and the safety assessment of adverse events.3.Animal experiment:32 healthy male New Zealand white rabbits with an average age of 8 months and a body weight of 2 kg were randomly divided into two groups:the combination of Tuina and Chinese Herbal Ointment group,the plaster group,the model group and the normal control group,with 8 rats in each group.The knee joint intra-articular injection method was used to prepare the model with the 2%papain aqueous solution.The normal control group did not receive any treatment.The model group was modeled on the right hind limb knee joint of the rabbit,and the other groups were treated with the same joint brake.Duration,no other special treatment;the Ointment group evenly applied the sputum collocation Ointment on the right knee joint of the rabbit and the Tuina was treated by the fixed researcher;the plaster group evenly applied the scented scented scented paste on the right knee joint of the rabbit.Treatment,in the other group of treatments,the joint brakes are fixed for the same length of time.Twenty of the experimental rabbits who successfully collected the synovial membrane were included in the study,the Ointment-moist group,the plaster-applied group,the model group and the normal control group,with 5 rats in each group.The serum levels of nitric oxide(NO)and IL-1 in the rabbits after treatment were detected.Contents of leukotriene 4(LTB4)and type II collagen(CTX-?),immunohistochemical semi-quantitative analysis method for the expression of IL-1 and matrix metalloproteinase-9(MMP-9)in rabbit knee synovium Histopathological changes in HE of synovial slices.Result:1.Clinical Observation(1)There were no significant differences in WOMAC total scores and scores,Lequesne index scores and scores between the two groups in the treatment group and the blank group before treatment.The difference was not statistically significant(P>0.05),and the treatment was over.The WOMAC total scores and scores,the Lequesne index total scores and the scores of the latter two groups were significantly lower than the previous ones,and the difference was statistically significant(P<0.01).The WOMAC total scores and various treatments after treatment in the patients in the treatment group The scores,the total score of Lequesne index and each score were significantly lower than those of the blank group,and the difference was statistically significant(P<0.01).(2)There was no significant difference in serum IL-1 and IL-6 levels between the two groups in the treatment group and the blank group before treatment.The difference was not statistically significant(P>0.05),which was comparable.The IL-serum in the serum of the two groups after treatment was completed.1.The content of IL-6 was significantly lower than that before treatment,and the difference was statistically significant(P<0.01).The serum IL-1 and IL-6 levels in the patients treated with the treatment group were significantly lower than those in the blank group.Academic significance(P<0.01);(3)After treatment,the excellent and good rate of TCM clinical efficacy in the two groups of patients:loading Ointment treatment group(83.30%),blank group(26.70%);the difference between the two groups of patients,the difference was statistically significant(P<0.01).2.Animal experiment(1)After treatment,the values of NO,IL-1,LTB4,and CTX-II in the serum of the experimental group of the three groups of the experimental group were compared with the IL-1 and MMP-9 values in the synovium and the model group.Statistically significant(P<0.001);the other three groups were compared with each other:the serum NO value of the Ointment group was not significantly different from the normal control group(P>0.05);the IL-1 in the serum of the Ointment group The values of LTB4 and CTX-? x.were significantly different from those of the normal control group in the synovium(P<0.05).The serum of the ointment group was NO,IL-1,LTB4,CTX-1.The values were statistically different from the IL-1 and MMP-9 values in the synovium and the normal control group(P<0.001).The values of NO,IL-1,LTB4,and CTX-II in the serum of the plaster group were slippery.The values of IL-1 and MMP-9 in the membrane were statistically different(P<0.05).(2)Synovial histopathological results:The model group had more inflammatory cell infiltration than the normal control group,and the synovial morphology changed.The morphology of the ointment group was improved and the inflammatory cell infiltration was reduced.The morphology of the ointment group became normal and the inflammatory infiltration was obvious.cut back;(3)Semi-quantitative analysis of synovial IL-1 immunohistochemistry:negative(-)expression in the normal control group and the Ointment group,moderate positive(++)expression in the plaster group,and strong positive in the model group(+++)Expression;semi-quantitative analysis of synovial MMP-9 immunohistochemistry:negative(-)expression in the normal control group,weak positive(+)expression in the Ointment group,moderate positive(++)expression in the plaster group,model The group showed strong positive(+++)expression.Conclusion:1.The combination of Tuina and Chinese Herbal Ointment on knee joint function and pain in KOA patients is significant,and the serum levels of IL-1 and IL-6 can be significantly reduced.2.Compared with the clinical efficacy of TCM,the excellent and good rate of treatment in the treatment group was significantly higher than that in the blank group.The combination of Tuina and Chinese Herbal Ointment therapy has significant clinical effect on the treatment of KOA.3.Both Ointment and combination of Tuina and Chinese Herbal Ointment therapy can effectively reduce the secretion of some inflammatory factors in serum and synovial membrane,promote the repair of synovial tissue,and restore the normal physiological function of synovial mem brane.4.Iin the semi-quantitative analysis of synovial membrane IL-1 and MMP-9 immuno-histochemistry,both the Ointmenty and normal groups showed negative expression;the synovial tissue pathological results showed that the morphology of the Ointmenty group was normal.Ointmenty therapy has the effect of repairing chondrocytes. |
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