A Research On The Relationship Between TCM Syndrome Of Knee Osteoarthritis And β- Catenin Expression

Objective In this study, TCM syndrome characteristics,age,gender,body mass index(BMI),course of disease and X-ray grade,as well as the levels of β-catenin in synovial fluid and in serum of KOA patients were investigated to explore the relationships between TCM syndrome characteristics and the different indicators mentioned above. By doing so,this research aims to provide a new idea for future research on TCM syndrome.Methods 90 cases of KOA patients were chosen,and 9 of these patients were not included since their synovial fluid could not be extracted. 30 healthy volunteers were recruited for control group. Survey contents included the general information of patients, characteristics of TCM syndrome, X-ray grade and so on. At the same time,serum and synovial fluid were collected from included KOA patients, however, for healthy volunteers,only the serum was collected. Thereafter, The levels of β-catenin in both synovial fluid and serum were detected by enzyme-linked immunosorbent assay(ELISA).Finally, the correlation between β-catenin and TCM syndrome was analyzed by adopting modern statistical methods.Results(1) 81 KOA patients were surveyed,including 37 cases(45.68%)of kidney-marrow deficiency syndrome,29 cases(35.80%)of deficiency of yang and accumulation of cold syndrome and 15 cases( 18.52%) of blood stasis syndrome. No statistically significant differences(P>0.05)were found in gender,age,BMI and course of disease among the three groups of TCM patients.(2) In term of comparison of X-ray grade distribution between different TCM syndromes,the results demonstrated statistically significance(P<0.05) after the rank-sum test. Furthermore, this study found that the syndrome of kidney-marrow deficiency and the syndrome of deficiency of yang and accumulation of cold were more common in Classes I and II,while the syndrome of blood stasis was more common in Classes III and IV, revealing a lighter X-ray grade in kidney-marrow deficiency type and the type of deficiency of yang and accumulation of cold than that of the blood stasis type.(3) β-catenin was not detected in serum of healthy human, but was detected in both synovial fluid and serum of 81 KOA patients. The β-catenin concentration in synovial fluid of the three groups of TCM syndrome from high to low in turn were the blood stasis type, the type of deficiency of yang and accumulation of cold and kidney-marrow deficiency type. There were differences in the expressions of β-catenin in synovial fluid of the patients with different syndrome types.The comparisons of β-catenin in serum between different two groups were listed as follows:Comparison between kidney-marrow deficiency type and the type of deficiency of yang and accumulation of cold with no statistically significant difference(P>0.05); Comparison between kidney-marrow deficiency type and the blood stasis type with great statistically significant difference(P<0.01); Comparison between the type of deficiency of yang and accumulation of cold and the blood stasis type demonstrating statistical significance(P<0.01).(4) The levels of β-catenin in serum of three groups of TCM syndrome were higher than that of the control group,the difference was statistically significant(P<0.01). Further comparison between different two groups were listed below: Comparison between kidney-marrow deficiency type and the type of deficiency of yang and accumulation of cold showed no statistically significant difference(P>0.05); Comparison between kidney-marrow deficiency type and blood stasis type, as well as comparison between the type deficiency of yang and accumulation of cold and blood stasis type both revealed great statistically significant differences(P<0.01).Conclusion(1)The kidney-marrow deficiency type and the type of deficiency of yang and accumulation of cold were more common in the distribution of TCM syndrome type in KOA patients, and there was no significant correlation between gender, age, body mass index,course of disease and TCM syndrome type of KOA, respectively.( 2) In X-ray grade distribution,we founded that the X-ray levels in kidney-marrow deficiency type and the type of deficiency of yang and accumulation of cold were lighter than that of the blood stasis type.It is suggested that there is a certain correlation between the X-ray classification and TCM syndrome types, but whether the X-ray classification can be used as a reference index for TCM syndrome differentiation in KOA patients still remains to be further explored.(3)The excessive expression of β-catenin has a correlation with the incidence of osteoarthritis. It can be used as a biological marker for the diagnosis of KOA, and it provides a new idea for the early detection of KOA.(4)The levels of β-catenin both in synovial fluid and in serum of the blood stasis type were remarkably higher than the other two types. Therefore, β-catenin expression level can be used as a reference index for the blood stasis type of KOA, and moreover can be served as an objective and normative modern scientific and technological indexes for TCM Syndrome, and finally in the hope of providing theoretical guidance for the prevention and treatment of KOA with integrated traditional Chinese and Western medicine.