| Objective:1.First of all,through the research of evidence-based medicine,to evaluate the effectiveness of invigorating spleen and replenishing qi in the treatment of knee osteoarthritis.2.Secondly,on the basis of the above research,through the study of network pharmacology,we screened out the possible molecular mechanism of Buzhong Yiqi decoction in the treatment of knee osteoarthritis,so as to provide theoretical basis for related experimental research.3.Finally,through animal experimental study,clear Buzhong Yiqi decoction treatment of knee osteoarthritis rat cartilage protection and repair,evaluate the preventive and therapeutic effect of Buzhong Yiqi decoction on knee osteoarthritis and its potential mechanism.Materials and methods:1.Evidence-based medicine research: the randomized controlled trial literatures of CNKI,Wanfang data knowledge service platform,VIP database,Pubmed,Cochrane library on the treatment of knee osteoarthritis with spleen-invigorating and Qi-invigorating methods were searched by computer.The included literatures were evaluated by Cochrane risk bias assessment tool,and the data were analyzed by Rev Man5.3 software.The effect of invigorating spleen and replenishing qi in the treatment of knee osteoarthritis was systematically evaluated from five aspects: total effective rate,clinical control rate,VAS score,WOMAC score and serum SOD level.2.Network pharmacology research: search the traditional Chinese medicine system pharmacology database and analysis platform TCMSP and BAT-MAN database to get all the related targets of traditional Chinese medicine in Buzhong Yiqi decoction,and annotate them.Search Genecards human gene database to get all the genes related to knee osteoarthritis.The chemical components and overlapping genes of disease-related drugs of Buzhong Yiqi decoction and knee osteoarthritis were visualized by Cytoscape3.7.1 software,and the compound-disease-compound-target network diagram of traditional Chinese medicine was drawn.The 30 targets most closely related were screened,and the GO function and KEGG pathway enrichment analysis were carried out.3.Animal experimental study: the rats were divided into 6 groups: sham operation group,model group,positive control group,low-dose Buzhong Yiqi decoction group,middle-dose group and high-dose group.One week after the establishment of the model,the drug was given continuously for 6 weeks.The structure and cell morphology of articular cartilage were observed by gross observation,HE staining,Alcian blue staining and Masson staining under light microscope.The expression of joint inflammatory index IL-6 was detected by immunohistochemical method,and the expression of IL-6 and VEGFA in serum was detected by Elisa method.Result:1.Evidence-based medicine research: eighteen randomized controlled trials were included,all of them were Chinese literatures.1406 patients were treated mainly by invigorating qi,strengthening spleen and control group.Compared with conventional treatment,the method of invigorating spleen and replenishing qi had higher total effective rate(OR=3.71,95%CI=[2.39,5.77],P<0.00001)and clinical control rate(OR=2.62,95%CI=[1.90,3.60],P<0.00001),which could significantly improve the VAS,WOMAC score and serum SOD level of the patients,and the difference was statistically significant(P<0.05).2.Study on network pharmacology: 3120 active components of Simiao Powder were screened from TCMSP and BAT-MAN database,68 targets of main chemical components of Buzhong Yiqi decoction and joint action targets of knee osteoarthritis and knee osteoarthritis were obtained,and 645 PPI core genes were obtained.the results of GO functional enrichment analysis showed that a total of 83 biological enrichment processes were obtained.The results of KEGG pathway enrichment analysis showed that Buzhong Yiqi decoction could interfere with the progression of knee osteoarthritis by participating in the regulation of113 signal pathways.3.Animal experimental study: after taking samples,the general observation of the articular surface,HE,Alcian blue and Masson staining results showed that the articular surface and cell structure of the blank group were normal and in good condition;the articular surface of the model group was seriously worn,rough and uneven,the cartilage layer was disordered,and the number of chondrocytes was significantly less than that of the blank group;the situation of articular surface and chondrocytes in the positive control group was significantly better than that in the model group.The joint of the low dose group,the middle dose group and the high dose group was improved in varying degrees than that of the model group,and the articular surface condition of the high dose group was better than that of other administration groups,which was close to that of the positive control group.The expression of IL-6 and VEGFA in serum was detected by Elisa method.The results showed that the expression of IL6 and VEGFA in the model group was the highest,the blank group was the lowest,the positive control group was close to the blank group,the high dose group was the lowest,the middle dose group was the second,and the low dose group was the highest.The expression of IL-6 and VEGFA in cartilage detected by immunohistochemical method was in ascending order as follows: blank group,positive control group,high-dose group,middle-dose group,low-dose group and model group.Conclusion:1.The results of evidence-based medicine show that the therapy of invigorating the spleen and replenishing qi is effective in the treatment of knee osteoarthritis,which can significantly reduce the VAS and WOMAC scores,relieve pain and improve the quality of life of patients.2.Network pharmacological studies show that Buzhong Yiqi decoction is closely related to knee osteoarthritis,and its specific mechanism may be that NF-? B signal pathway regulates the expression of IL-6,VEGFA and other factors to regulate the disease progression of knee osteoarthritis.3.Animal experimental study found that Buzhong Yiqi decoction has a therapeutic effect on knee osteoarthritis model rats,which can significantly delay the injury of cartilage and reduce the expression of IL-6 and VEGFA in model rats. |
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