Effects Of Duhuojisheng Mixture Combined With Nimodipine On The Early Knee Osteoarthritis:an Experimental Research And Preliminary Clinical Application

Objective:The study was to identify the efficacy and safety of Duhuojisheng Mixture Combined with Nimodipine on the Early Knee Osteoarthritis(KOA) by experimental study and clinical observation.Method:Animal experiment:The 21 model of early KOA rats were randomly divided into three groups:group A(n=6) gavaged with 2ml/kg saline, group B (n=7) gavaged with Duhuojisheng Mixture 2ml/kg, group C (n=8) gavaged with Duhuojisheng Mixture 2ml/kg and Nimodipine 4mg/kg. They were treated twice a day for 3 weeks. IL-1 beta, TNF alpha and PGE2 were tested in pretherapy and post-treatment by rats tail vein blood. The knee joint cartilages were observed by naked eye and light microscope when the rats were killed after treatment. Clinical observation:From June 2013 to May 2014, a total of 86 patients with early knee osteoarthritis, who were in accordance with the inclusion criteria, were randomly divided into two groups:A group (n=42) oral Duhuojisheng Mixture, B group (n=44) oral Duhuojisheng Mixture and Nimodipine. They are compared with score of WOMAC, effective rate and side effect rate after Six weeks treatment.Results:Animal experiment:After 3 weeks treatment, the inflammatory factors (IL-1β, TNF-a, PGE2) in group B and C were decreased, and the two groups had significant difference with group A (P<0.05). The content of IL-1β, TNF-α and PGE2 between group B and C were significantly difference (P<0.05). Mankin score:There was significant difference among the three groups (group A 9.86±1.56, group B 6.08±1.73, group C 4.07±1.27). Clinical observation:The knee score of pain, anchylosis and function were showed lower than pretherapy in group A and group B. Compared with the knee score of pain:The two groups were significant differences (P<0.05); Compared with the knee score of anchylosis: The two groups were no significant differences (P>0.05); Compared with the knee score of function:The two groups were significant differences (P<0.05); Compared with the total score of WOMAC:The two groups were significant differences (P<0.05). The clinical obvious effective rates were respectively 50.00% and 72.73%, there were significant differences (P<0.05). The side effect rate were respectively 2.38% and 2.27%, there were no significant differences (P>0.05).Conclusion:(1) Rat experiments have established that Duhuojisheng Mixture Combined with Nimodipine can reduce the expression of inflammatory cytokines such as IL-1 beta, TNF alpha and PGE2 in serum and delay the early KOA cartilage degeneration. (2) Clinical observation confirmed that Duhuojisheng Mixture Combined with Nimodipine is better than take Duhuojisheng Mixture alone in regulating metabolism of cartilage, relieve knee pain symptoms and improve the curative effect of knee joint function.