| Objective: 1.This study compared the treatment of zhuang medicine longzhan tongbi prescription and basic drugs for knee osteoarthritis was compared to evaluate the efficacy of zhuang medicine longzhan tongbi prescription for knee osteoarthritis;2.In this study,by observing the contents of IL-1β,IL-10,TIMP-1 and MMP-3 in the soft synovial membrane of knee osteoarthritis induced by papain in rats with zhuang medicine longzhan tongbi recipe and the pathological changes of the periosteum of the joint,the anti-inflammatory mechanism of zhuang medicine longzhan tongbi recipe on knee osteoarthritis was discussed.Methods:1.Clinical study: 60 patients with knee osteoarthritis who met the diagnostic,inclusion and exclusion criteria were selected and randomly divided into treatment group(n=30)and control group(n=30).Control group orally given double phenolic acid sodium chloride double release of enteric capsules,the treatment group to double phenolic acid sodium chloride double release of enteric capsules treatment,combined with oral zhuang medicine dragon drill through bi one treatment,the treatment for two weeks,two groups of patients before treatment,treatment 2 weeks and 4 weeks return visit to effect change,to visual VAS pain assessment and evaluate the WOMAC knee joint function assessment.2.Experimental study: 50 successful osteoarthritis model rats were randomly divided into model group,zhuang drug longzhan tongbi prescription high and low dose group,and glucosamine positive drug control group,10 rats in each group.Ten healthy male SD rats were selected as the normal control group.The zhuang medicine longzhan tongbi prescription was given by gavage at a set dose,the glucosamine positive drug control group was given by gavage at a prescribed dose,and the treatment lasted for 30 days.The normal group and the model group were given distilled water by gavage.After the experiment,the contents of IL-1β,IL-10,MMP-3 and TIMP-1 were measured in the periosteum of the knee joint of the rats,and the periosteum of the knee joint was analyzed by HE staining.Results:1.Clinical observation results:(1)visual VAS score of pain was compared between the treatment group(6.27±0.98)and the control group(6.23±0.97)before the implementation of the program,with no statistically significant difference(P>0.05).The two groups were comparable.After treatment,intra-group comparison was conducted before and after treatment in the treatment group(2.70±0.84)and the control group(3.27±1.08),and the comparison of pain simulation VAS score was statistically significant(P<0.05),indicating that the pain simulation VAS score in both groups was decreased after treatment compared with that before treatment.After 4 weeks of follow-up,the comparison between the treatment group(3.60±1.07)and the control group(5.70±0.88)was statistically significant(P=0.00<0.05),indicating that the treatment group was superior to the control group in the score of pain recurrence.(2)comparison of WOMAC score of knee joint function,comparison of joint pain,joint stiffness and daily activity limitation before treatment between groups,the difference was not statistically significant(P>0.05),the two groups were comparable.After treatment,the treatment group and control group before and after treatment group comparison,joint pain,joint stiffness and limited daily activities were statistically significant(P<0.05),indicating that the two groups after treatment,the knee joint function WOMAC score of joint pain,joint stiffness and limited daily activity was reduced.TheAfter 4 weeks of follow-up,the comparison of joint pain,joint stiffness and limitation of daily activities between the treatment group and the pre-treatment group showed statistical significance(P<0.05),indicating that the combination of internal and external administration of longzhan tongbi prescription,a zhuang medicine,had better long-term efficacy than that of the western medicine group.(3)comparison of effective cases,the treatment group cured 7 cases,16 cases of significant effect,3 cases of effective,4 cases of ineffective,the total effective rate of 86.67%;In the control group,6 cases were cured,14 cases were significantly effective,5 cases were effective and 5 cases were ineffective,with a total effective rate of 83.33%.Ridi test showed no statistically significant difference(P=0.49>0.05),indicating that there was little difference in clinical efficacy between the two groups.(4)adverse reactions of patients in the two groups were mainly manifested in nausea,nausea and other gastrointestinal reactions,which could improve by themselves without treatment.The total adverse reaction rate in the treatment group was 3.33%,and the total adverse reaction rate in the control group was 10.00%.Ridit test showed no statistical significance(P=0.67>0.05).2.Experimental results :(1)ELISA test results:(1)IL-1β content: compared with the normal group,the IL-1β content was up-regulated in the model group,and the difference was statistically significant(P<0.05).Compared with the model group,there were significant differences in the medium dose group of zhuang medicine longzhan tongbi prescription(P<0.01).(2)IL-10 content: compared with the normal group,the IL-10 content in the model group was down-regulated,and the difference was statistically significant(P<0.01).Compared with the model group,there was a significant difference between the medium dose group and the high dose group(P<0.05).(3)MMP-3 content: compared with the normal group,MMP-3 content was up-regulated in the model group,and the difference was statistically significant(P<0.05).Compared with the model group,there was a significant difference between the medium dose group and the high dose group(P<0.05),and MMP-3 was down-regulated after the use of the zhuang yao long zhan tong bi fang,and the zhuang yao long zhan tong bi fang was down-regulated significantly in the high dose group.(4)TIMP-1 content: compared with the normal group,the timp-1 content in the model group was significantly increased,and the difference was statistically significant(P<0.01).Compared with the model group,there was a statistically significant difference between the medium dose group and the high dose group(P<0.05).After the use of the zhuang yao long zhan tong bi fang,TIMP-1 was up-regulated,while the zhuang yao long zhan tong bi fang was up-regulated.(2)pathological HE staining results of synovial membrane of the knee: compared with the normal group,Mankin’s score of the model group was significantly increased,and the difference was statistically significant(P<0.01).Compared with the model group,the scores of the medium dose group and the high dose group were down-regulated,and the difference was statistically significant(P<0.05).Conclusion:1.Both the internal and external administration group of zhuang yao longzhan tongbi prescription and the western medicine group could reduce the patients’ VAS score and WOMAC score of knee joint function,and the internal and external administration group of zhuang yao longzhan tongbi prescription performed better in alleviating knee joint pain,improving local joint stiffness and joint function.In terms of effective rate,the internal and external use group of zhuangyao longzhan tongbi prescription has the same efficacy as the western medicine group,but the internal and external use group of zhuangyao longzhan tongbi prescription is superior to the western medicine group in terms of long-term efficacy such as pain recurrence.2.The mechanism of action of the zhuang medicine longzhan tongbi prescription in the treatment of osteoarthritis may regulate the effect of inflammatory cytokines such as IL-1β,IL-10,MMP-3 and TIMP-1 on articular cartilage matrix,and change the arrangement of chondrocyte structure,so as to delay the degeneration of cartilage and promote cartilage repair. |
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