Analysis And Clinical Observation Of "component-target Gene" Of Heiguteng Zhuifeng Huoluo Capsule In The Treatment Of KOA

Objective:Through analyzing effective components of drugs,The target genes for the treatment of Knee Osteoarthritis(KOA)was obtained based on bioinformatics analysis,To observe the clinical efficacy of Heiguteng Zhuifeng Huoluo Capsule on KOA patients with cold-dampness obstruction syndrome,To provide theoretical basis for treatment.Method:1.The effective components of heguteng choufeng huoluo capsules were analyzed and determined by high performance liquid chromatography(HPLC).2.The bioinformatics research methods was used to analyze potential target genes of Heiguteng Zhuifeng Huoluo Capsule and KOA,PPI analysis(Protein-protein Interaction analysis),GO analysis(Gene Ontology analysis)and KEGG pathway analysis(Kyoto Encyclopedia of Genes and Genomes Pathway Analysis)were conducted to obtain relatively core genes for subsequent analysis and clinical trials.3.80 KOA patients who met the inclusion criteria were randomly divided into control group and treatment group,40 cases each.The control group was treated with Meloxicam Tablets and Glucosamine Hydrochloride Capsules,while the treatment group was treated with Meloxicam Tablets and Glucosamine Hydrochloride Capsule and Heiguteng Zhuifeng Huoluo Capsule.The levels of MMP9(Matrix metalloproteinase-9)and the expressions of PRKCA(Protein Kinase C Alpha)in serum were measured by enzyme-linked immunosorbent assay(ELISA).VAS score(Visual analogue score),ISOA score(Index ofseverity for osteoarthritis score),TCM syndrome score and therapeutic effect were calculated,safety indicators were observed.SPSS23.0 software was used for statistical analysis.Results:1.The main ingredients of Heiguteng Zhuifeng Huoluo Capsule are sinomenine,periplocin,rutin,luteolin,oleanolic acid,ursolic acid.The 1g Heiguteng Zhuifeng Huoluo Capsule contained sinomenine 1.50mg,periplocin 68.7 ?g and rutin 0.171 mg.2.The drug may interfere with 62 genes,which were analyzed and screened for 30 genes,including INS?PTGS2?TNF?ESR1?CASP3?JUN?PPARG?MMP9?AR?IL4?NR3C1?CALCA?NFKB1?GSK3B?CASP8?SNAI1?SOX9?VDR?CNR1?PGR?PRKCA?WNT5A?ADRB2?TGFB1?CASP9?TRPV1?NR1H4?ANXA1?NCOA3?OPRM1 are mainly concentrated in Enzyme activity?IL-17?TNF?PI3K-Akt?MAPK?ErbB?HIF-1?VEGF?Fc?RI?mTOR signaling pathway.3.Clinical efficacy:1)VAS score,ISOA score,TCM syndrome score and therapeutic effect of the two groups before and after treatment had statistical significance(p<0.05),while that of the treatment group was statistically significant compared with the control group(p<0.05).2)After 4w treatment,the serum MMP9 and PRKCA in the treatment group had statistical significance compared with that before treatment in the same group,the comparison between the two groups after treatment was statistically significant(p<0.05).Conclusion:The main ingredients of Heiguteng Zhuifeng Huoluo Capsule including sinomenine,periplocin and rutin,they effectively inhibited the expression levels of MMP9 and PRKCA in serum possibly through MPAK?NF-kB?PI3K/Akt?VEGF signaling pathway,VAS score,ISOA score and TCM syndrome score of KOA patients were decreased,Effective treatment can improve the joint symptoms and function of KOA patients with cold-dampness obstruction syndrome and delay the disease development.