Clinical And Cexperimenrtal Investingation On Treating Primary Osteoarthritis Of The Knee With Gui Shao Tiao Gan Tang

Objective:gui shao tiao gan tang has a great effect in teating primary osteoarthritis of the knee, This investigationi is to search for therapeutic principle in treating primary osteoarthritis of he knee《which is abbreviated KOA below》with the gui shao tiao tang,through investigating the change of interleukin 1(IL-1)and nitrogen monoxidum(NO)of patient and rabbttis, And grade point variety and domestic rabbit model therapy the knee joint function grade point to in front and back judge(Lysholm) to the sufferer therapy in front and back joint cartilage a pathology a change,not only can we find the regularity of the traditional Chinese medicine,but also rise the clinical effect。Methods : Animals experiment and Clinical investigation 1Animals experiment according to the Japanese ghost head Kang Yan of build a mold method,Result in the knee bone arthritis model in the rabbit right knee joint the infusion papaya egg white Mao inside the chamber, Be divided into KOA model rabbit random model group, western medicine group, Chinese herbal medicine group, each group of 8, 8 normal rabbits is blank matched control(the brief name"blank group"), Remaining 4 for substitute to repair a rabbit.The Chinese herbal medicine group presses the 10 mls/kilogram/day standard to sample to return Shao to adjust liver herbal medicine a liquid to infuse stomach, everyday one for each early and late;Matched control adoption double the chlorine put out a pain to mix to hang a liquid to infuse stomach, everyday two times, 3 week for on treating a distance, total 2 treat a distance, in addition don't exert any intervention measure.Respectively collect to build before the mold, before therapy, treatment empress 3 week, treatment empress 6 week, joint slips the content of IL-1, NO in liquid, and light the mirror descend joint cartilage pathologic ppearance variety.2 Clinical investigation 40cases patience of our department were seleced from 2005.10 to 2006 .10, according to diagnosis standard made by rheumatism association of American ,excpet for the cases caused by trauma,infection,systemic,metabolism diseasea or endocrinopathy,inluding 25women and 15man; The knee bone arthritis diagnosis drawn up according to the American rheumatism association from my section October, 2005 outpatient in October, standard, select is tried patient's 40, Among them, female's 35, male 25, the age is 41-78 years old, average the age be 57.05 years old, according to X–ray classfy standard (formulating by kellgreen and awrence in 1965) , 4case were 0 grade , 11case wereⅠgrade , 13case were 11grade , 7case wereⅢgrade , 6case wereⅣgrade , all case are random divided into a Chinese herbal medicine group and western medicine group, each 20 patients. The matched control takes orally a pair of chlorines to put out a painful slice a 50 mgs, everyday two times; The Chinese herbal medicine group takes orally to return Shao to adjust liver soup, everyday 1;3 week for ontreating a distance, total 2 treat a distance. respectively before collecting a patient a treatment, 3 weeks after the treatment, the joint liquid for 6 weeks after the treatment, and measure IL-1, NO density data, before calculate treatment, empress of Lysholm integral calculus.Result:After building a mold it is thus clear that the bone small beam has a great deal of cell to invade smooth, a little amount red cell, explain to build mold success。1 Each index sign is to the influence of the content of IL-1, NO in the KOA rabbit joint liquid。1.1.1Each hour the NO content in the related stanza liquidCompared with oneself before the mold,Chinese herbal medicine group(57.55±3.06), western medicine group (58.58±4.56) after curing for 3 weeks(71.22±3.84)and(76.58±1.74) and after(62.11±4.12,69.74±6.17)6 weeks the NO content in the joint liquid have obvious hour mutually effect relation;(P< 0.05),the model group (58.15±4.96), blank group (57.54±3.42) didn't show Zhao difference(P>0.05) after curing for 3 weeks(80.49±3.52,58.22±4.27) and after 6 weeks(81.78±5.28,58.50±2.96) (P<0.05)。1.1.2 Therapy the NO content in ex- rabbit knee joint liquidCompared with the model group (79.21±2.54), the content NO didn't show Zhao difference(P>0.05) in the Chinese herbal medicine group (79.21±3.07), western medicine group (77.76±3.93) rabbit joint liquid and explain that the NO content in the treatment ex- rabbit knee joint liquid has consistency.1.1.3 3 weeks after therapy, Chinese herbal medicine is to the influence of the NO content in the rabbit knee joint liquidCompared with the model group(80.49±3.52), the content NO obviously lower(P<0.05) in the Chinese herbal medicine group(71.22±3.84), western medicine group (76.58±1.74) rabbit joint liquid, but the Chinese herbal medicine group surpass a western medicine group (P<0.05).1.1.4 after 6 weeks therapy, Chinese herbal medicine is to the influence of the NO content in the rabbit knee joint liquid.Compared with the model group(81.78±5.28), the content NO obviously lowers in the Chinese herbal medicine group(62.11±4.12), the matched control(69.74±6.17) rabbit joint liquid;(P<0.05)Chinese herbal medicine group(62.11±4.12) and western medicine group (69.74±6.17) compared to show obviously difference(P<0.05), compared with blank group(58.50±2.96) and don't show obviously difference(P>0.05), but not yet neared a blank group.1.2.1Each hour the content of IL-1 in the related stanza liquidCompared with oneself before the mold compare, Chinese herbal medicine group(5.90±1.23), western medicine group (5.90±.95),after therapy for 3 weeks(15.84±3.16,17.90±2.36) and after(8.84±1.55,14.06±2.83)6 weeks the content IL-1 in the joint liquid have obvious hour mutually effect relation;(P< 0.05),Model group(5.78±1.02) and blank group(5.78±1.04) didn't show obviously difference(P>0.05) after curing for 3 weeks(18.76±1.21,6.04±1.51) and after 6 weeks(19.65±2.50,5.80±.51), but 2 groups all have already increased high trend.1.2.2 Therapy the content IL-1 in ex- rabbit knee joint liquidCompared with the model group(17.98±2.54), the content IL-1 didn't show obviously difference(P>0.05) in the Chinese herbal medicine group(18.76±3.87), western medicine group (18.03±3.32) rabbit joint liquid and explain that the content of IL-1 in the treatment ex-rabbit knee joint liquid has consistency. 1.2.3 3 weeks after therapy, Chinese herbal medicine is to the influence of the content IL-1 in the rabbit knee joint liquidCompared with the model group(18.76±1.21), the content IL-1 obviously lower(P<0.05) in the Chinese herbal medicine group(15.84±3.16), western medicine group (17.90±2.36) rabbit joint liquid, but the Chinese herbal medicine group surpass a matched control.(P<0.05).1.2.4 After therapy for six weeks, Chinese herbal medicine is to the influence of the content IL-1 in the rabbit knee joint liquidCompared with the model group(19.65±2.50), the content IL-1 obviously lower(P<0.05) in the Chinese herbal medicine group(8.84±1.55), western medicine group (14.06±2.83) rabbit joint liquid, but the Chinese herbal medicine group surpass a western medicine group;(P<0.05) Comparing with blank group(5.80±1.51) didn't show Zhao difference(P>0.05), but not yet neared a blank group.2 Chinese herbal medicine to each sufferer knee joint the liquid moderate the influence of the content of NO and IL-12.1.1Each hour the NO content in the related stanza liquidCompared with the oneself therapy front compare, the Chineseherbal medicine group(191.81±16.33),western medicine group (192.67±7.00) therapy after 3 weeks(158.95±5.09,173.19±3.56) and after(146.31±7.53,166.01±4.59)6 weeks the NO content in the joint liquid to have obvious hour mutually effect relation.(P<0.05).2.1.2Therapy an ex- sufferer the variety of NO content in the joint liquidChinese herbal medicine group(191.81±16.33) knee joint the NO density data and western medicine group (192.67±7.00) in liquid's compare have never shown Zhao difference(P>0.05) to explain that curing an ex- sufferer the NO density in the joint liquid has consistency.2.1.3 three weeks after treatment the variety of NO content in the sufferer joint liquidChinese herbal medicine group(158.95±5.09) knee joint NO density in liquid the data be all obviously low at the western medicine group (173.19±3.56)(P<0.01orP<0.05) and the Chinese herbal medicine group obviously surpasses a western medicine group.(P<0.01).2.1.4 Through therapy after 6 weeks the influence of the NO content in the joint liquidChinese herbal medicine group(146.31±7.53) knee joint NO density in liquid the data be all obviously low at the western medicine group (166.01±4.59)(P<0.01 or P<0.05) , the Chinese herbal medicine group obviously surpasses a western medicine group (P<0.01).2.2.1Each hour the content of IL-1 in the related stanza liquidCompared with the oneself therapy front compare, Chinese herbal medicine group(292.73±5.73), western medicine group (290.19±6.89) after curing for 3 weeks(263.50±6.27,273.67±3.97) and after6 weeks (245.86±9.19 and 265.62±3.97) the content IL-1 in the joint liquid have obvious hour mutually effect relation.(P<0.05).2.2.2 Therapy an ex- sufferer the variety of content IL-1 in the joint liquid.Chinese herbal medicine group(292.73±5.73) knee joint data and western medicine group (290.19±6.89) of the density IL-1 in liquid's compare have never shown Zhao difference(P> 0.05) to explain that curing an ex- sufferer the density of IL-1 in the joint liquid has consistency.2.2.3 Therapy after 3 weeks the influence of the content of IL-1 in the joint liquid.Chinese herbal medicine group(263.50±6.27) knee joint density IL-1 in liquid the data be all obviously low at the western medicine group (273.67±3.97),(P<0.01 or P<0.05).2.2.4 After therapy 6 weeks the influence of the content IL-1 in the joint liquid.Chinese herbal medicine group(245.86±9.19) knee joint density IL-1 in liquid the data be all obviously low at the western medicine group (265.62±3.97)(P<0.01 or P<0.05) and the Chinese herbal medicine group obviously surpasses a western medicine group (P<0.01).3 Two groups of treatments in front and back Lysholm integral calculus.Be express by x2 related covariance analysises, Chinese herbal medicine group improvement symptom and the body advertise for always efficient is 90% ,western medicine group total efficient is 65%, the Chinese herbal medicine group and western medicine group two group of have covariance to learn meaning(P<0.05), Chinese herbal medicine group curative effect better than western medicine group (P<0.05).Conclusion:The IL-1 and the NO goes up in the joint liquid of the conclusion knee bone arthritis, to the cartilage cell, ossification cell, break bone cell and slip film organization and various cell Ji quality to synthesize etc. produce a harmful function, repress collagen and egg white to gather sugar to synthesize thus and cause cell Diao Wu is end to injure the joints creation but influence joint function, become the knee bone the main reason of the arthritis.Return the Shao's adjusting liver soup and double chlorine to put out a painful slice all can obviously lower IL-1 and NO density level in the knee bone joint liquid, alleviate joint ache and attain a treatment purpose thus.Put out a painful slice a comparison with double chlorine, the clinical effect which returns Shao to adjust liver soup obviously surpasses a pair of chlorines to put out a painful slice, and returns Shao to adjust liver soup side effect small, easily take over a long period of time etc. the advantage be what double chlorine put out a painful slice kick the beam.