| ObjectiveTo investigate the clinical efficacy of platelet-rich plasma combined with the Xianlinggubao capsule in the treatment of knee osteoarthritis,and to analyze the literature of platelet-rich plasma and Xianlinggubao capsule respectively,in order to obtain the current development trends in this field.MethodsSearching through Web of Science database,using“Platelet-Rich plasma"and "Knee Osteoarthritis" as keywords,we can get the year of publication,author,country/region,name of source publications,keywords and abstracts of research directions.The Xianling Gubao capsule was searched and analyzed by Wanfang database,and indexed according to the year of publication,author,research institute,source publications,support fund and keyword frequency.Vos viewer software produced by Leiden University in the Netherlands and Excel software was used to analyze the PRP or Xianlinggubao capsules used in KOA literature and related data from 2008 to 2018.A total of 71 patients with knee osteoarthritis were enrolled in the inpatient department.The patients were randomly divided into an experimental group and control group using the random number table.The gender,age and body mass index and the Kellgren-Lawrence classification of the patients was recorded.In the control group,oral Xianling Gubao capsule was used in combination with intra-articular injection of hyaluronic acid,and the experimental group patients were treated by Xianling Gubao capsule and intra-articular injection of platelet-rich plasma.Before and after treatment,the Western American Ontario and McMaster University Osteoarthritis Index(WOMAC)score,IKDC score and VAS pain score were tested.Serum levels of MMP-13 and COMP were also observed.ResultsPRP has been used in KOA treatment for 589 articles,of which the largest number was in 2018(126 articles).From 2008 to 2018,the number of global literature increased year by year-In the field of treatment of KOA with Xianling Gubao,92 articles were obtained,of which 17 were published in 2017.From 2003 to 2018,the number of documents fluctuated upward,but declined significantly in 2018.Among the PRP treatments for KOA,the United States has the largest number(200 articles),followed by Italy(70 articles)and China(49 articles).In terms of the total cited frequency,the United States has the highest total cited frequency(3276 times),Italy(2097 times)ranks second,followed by Korea(586 times).Meanwhile,the H index of American literature is the highest(30),followed by Italy(23)and Korea(12).In the field of PRP therapy for KOA,Rush University published the most papers(21),followed by the American Special Surgery Hospital(17),and Rizoli Orthopedic Institute(14)ranked third.As for the treatment of KOA with Xianlinggubao,the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Wuhan Hospital of Traditional Chinese Medicine and Guiyang Hospital of Traditional Chinese Medicine published the most literature(3 articles each).According to the key words,the research directions of PRP applied to KOA in the world can be divided into four categories:clinical trials,comparison of therapeutic schemes,experimental discussions,and Research on efficacy and safety.The key words in the literature on the treatment of KOA by Xianling Gubao Capsule mainly involve clinical efficacy,sodium hyaluronate,traditional Chinese medicine therapy and pain.This study included 36 cases in the experimental group and 35 cases in the control group.The IKDC scores of both groups after treatment were higher than those before treatment(P<0.01),and the IKDC scores of the experimental group were also higher than those of the control group.The IKDC scores of the experimental group before treatment were 40.17+6.44,77.47+2.29 after six months of treatment,and those of the control group were 67.91+6.00 from 39.64+7.07 before treatment,with statistical significance(P<0.01).After receiving different treatment schemes,the WOMAC score of the experimental group and the control group decreased to a certain extent,and the difference was statistically significant(P<0.01).The WOMAC score of the control group was lower than that of the experimental group,and the difference was statistically significant(P<0.05).The WOMAC score of the experimental group before treatment was 53.19±7.33,and that of the six months after treatment was 22.08±1.95.The control group decreased from 52.75±6.18 to 27.26±4.39 in six months,and the difference was statistically significant(P<0.05).The VAS pain score of the two groups was lower than that before treatment,and the difference was statistically significant(P<0.01).The VAS pain score of the experimental group decreased from 4.93±1.04 before treatment to 1.33±0.99 after six months,while that of the control group decreased from 4.51±0.85 before treatment to 2.68±0.81 after six months.The difference between the two groups was statistically significant.Learning significance(P<0.01).After 6 weeks of treatment,the serum COMP and MMP-13 in the experimental group and the control group decreased to a certain extent,with statistical significance(P<0.01),and the decrease in the experimental group was greater than that in the control group(P<0.01).The serum COMP content in the experimental group decreased from 14.75±0.80 mu/1 before treatment to 5.75±0.32mu/l,while that in the control group decreased from 14.58±1.07mu/l to 7.27±0.21mu/l;and that in the experimental group decreased from 14.58±1.07mu/l to 7.27±0.21mu/The content of MMP-13 also decreased from 37.66±5.39 ug/1 before treatment to 15.66±3.88ug/l,while that of control group decreased from 36.95±6.68 ug/1 before treatment to 18.19±5.39ug/l(P<0.01).ConclusionsGlobal trend analysis indicates that the research on PRP for KOA is deepening and the number of papers is increasing.The United States is the biggest contributor.Current research directions are mainly focused on "clinical trials","comparison of treatment options","experimental discussions","efficacy and safety".In the treatment of KOA,Xianling Gubao Capsule mainly focuses on its clinical efficacy,combined with sodium hyaluronate or other traditional Chinese medicine therapy.According to the comparison of pain(VAS score)and knee joint function score(WOMAC,IKDC score),platelet-rich plasma combined with Xianlinggubao capsule can effectively treat KOA.The overall therapeutic effect is better than that of hyaluronic acid group,and it can effectively control the inflammatory factors of KOA.After treatment,the expression levels of COMP and MMP-13 in serum of patients decreased significantly. |
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