Experimental And Clinical Study Of Guanjiezhitong Capsule In The Treatment Of Osteoarthritis Of Knee Joint

Objective To observe the efficacy of Guanjiezhitong capsule (GJZTC) for treatment of knee osteoarthritis(KOA), and explore the mechanism in the effect of GJZTC and the mechanism of KOA.Methods In the experiment study, 32 New Zealand rabbits were randomly divided into 4 groups: Group A(the normal group), Group B(the model group), Group C(the control group) and Group D(the treated group). KOA models were created in Group B, C and D by Hulth' s operation methods. The rabbits in Group C were treated with Zhuangguguanjie pill(ZGGJP) and GJZTC was used in Group D. 8 weeks later, to make CR of the knee , and determine the content of Superoxide Dismutase(SOD) and Nitric Oxide (NO) both in serum and joint fluids. Then to kill the rabbits and get the femoral condyle for light microscopic study, DNA contents within cartilage cells were measured as well. To detect the apoptosis of cartilage cells by TUNEL and agarose gel electrophoresis of DNA. The plateau of tibia was made for determining the contents of uronic acid(UA) , hydroxyproline(HOP) and water tatio(WR). In the clinical study GJZTC was used in 30 cases of KOA as the control group compared with 30 cases treated by ZGGJP for curative effect observation.Results The experiment study showed in group B the degeneration of articular cartilage and the inflammation of synovium occurred in the knee joints of the rabbits, the contents of SOD were apparently lower and the contents of NO were apparently higher in the joint fluids, the apoptosis of cartilage was superfluous, the contents of abnormal chromatin in karyon wereincreased, the ladders of DNA were apparent, the contents of UA were obviously reduced, and the types of collagen were changed. The results in Groups C and D are between Group A and B. The contents of abnormal chromatin in karyon and UA had no significant difference from Group A (P>0.05), the apoptosis of cartilage was disperse and less, the ladders of DNA were obscure. The change of SOD and NO contents was remarkable than that in Group C(P<0. 05). In the clinical study the effective rate,the change of scores in symptoms, and the disappearance rate on pain and swell were all superior to those in the control group.Conclusions Derived free radicals and NO may play important roles inthe developing process of KOA;Superfluous apoptosis of cartilage may be one of the pathway involved in the mechanism of articular cartilage degeneration;Oxidative DNA damage may be the molecular mechanism of KOA;The main pathological changes in KOA include degeneration of articular cartilage cells, inhibition on anabolism and enhancement on catabolism of cartilage matrix, and type-transformation chondral collagenous fibers. Because GJZTC can increase the content of SOD, decrease the content of NO in the joint fluids, reduce the apoptosis, relieve oxidative DNA damage, stimulate the anabolism of cartilage matrix and inhibit the catabolism of it, slow down the type-transformation chondral collagenous fibers and alleviate the inflammation of synovium, it can improve the symptoms of KOA effectively and promote the repair of knee joint.