膝骨性关节炎中医证型与一氧化氮、白介素1β、转化生长因子β1的关系研究

CLINICAL RESEARCH ON THE RELATION OF TCM SYNDROME TYPES OF OSTEOARTHRITIS IN KNEE JOINTS WITH NITROGEN MONOXIDUM,INTERLEUKIN 1β AND TRANSFORMING GROWTH FACTOR β1

目的:探讨膝骨性关节炎患者中医证型与体内一氧化氮(NO)、白介素1β(IL-1β)、转化生长因子-β1(TGF-β1)水平的关系。方法:对240例膝骨性关节炎患者(观察组)和60名健康人(对照组)血清中NO、IL-1β、TGF-β1的水平进行测定。结果:肝肾亏虚、气滞血瘀、肝肾亏虚并气滞血瘀证3个观察组治疗前血清中NO、IL-1β的水平均显著高于对照组(P<0.01),而TGF-β1水平均显著低于对照组(P<0.01)。3个观察组治疗后血清中NO、IL-1β的水平均高于对照组(P<0.05),而TGF-β1水平均低于对照组(P<0.05)。3个观察组治疗后血清中NO、IL-1β水平均低于治疗前(P<0.05),TGF-β1水平均高于治疗前(P<0.05)。3个观察组之间治疗前比较,肝肾亏虚并气滞血瘀组NO、IL-1β的水平高于肝肾亏虚组(P<0.01)和气滞血瘀组(P<0.05),而TGF-β1的水平低于肝肾亏虚组(P<0.01)和气滞血瘀组(P<0.05);气滞血瘀组NO、IL-1β的水平高于肝肾亏虚组(P<0.05),而TGF-β1的水平低于肝肾亏虚组(P<0.05)。3个观察组之间治疗后比较,肝肾亏虚并气滞血瘀组NO、IL-1β的水平高于肝肾亏虚组(P<0.05)和气滞血瘀组(P<0.05),而TGF-β1的水平低于肝肾亏虚组(P<0.05)和气滞血瘀组(P<0.05);气滞血瘀组NO、IL-1β的水平高于肝肾亏虚组(P<0.05),而TGF-β1的水平低于肝肾亏虚组(P<0.05)。结论:一氧化氮、白介素1β、转化生长因子-β1与膝骨性关节炎的发病有关;经过中医治疗,NO、IL-1β、TGF-β1的水平发生了变化,中医治疗可能在一定程度上是通过NO、IL-1β、TGF-β1水平的变化起效的;膝骨性关节炎患者的中医证型与体内一氧化氮、白介素1β、转化生长因子β1有一定的相关性。

Objective:To approach the relation of TCM syndrome types of osteoarthritis in knee joints with level of nitrogen monoxidum(NO),interleukin-1β(IL-1β) and transforming growth factor-β1(TGF-β1) in blood serum.Methods:240 cases of patients with osteoarthritis in knee joints and 60 cases of normal control were chosen for the experiment.240 cases of patients were divided into three model groups,group A(deficiency of the liver and kidney),group B(qi-stagnancy and blood stasis) and group C(deficiency of the liver and kidney as well as qi-stagnancy and blood stasis).Levels of NO,IL-1β and TGF-β1 in blood serum were determined.Results:Before treatment,levels of NO and IL-1β in blood serum were significantly higher in three model groups than those in control group(P < 0.01),but level of TGF-β1 in blood serum was significantly lower in three model groups than that in control group(P < 0.01).After treatment,the same phenomenon was seen(P < 0.05).In three model groups,levels of NO and IL-1β were lower after treatment than those before treatment P < 0.05),but situation of TGF-β1 is just opposite(P < 0.05).Before and after treatment,levels of NO and IL-1β were higher in group C than those in group A and group B(P < 0.05),but situation of TGF-β1 is just opposite(P < 0.05).Levels of NO and IL-1β were higher in group B than those in group A(P < 0.05),but situation of TGF-β1 is just opposite(P < 0.05).Conclusion:Levels of NO,IL-1β and TGF-β1 have relation to incidence of osteoarthritis in knee joints.Chinese medicine treatment can change levels of NO,IL-1β and TGF-β1 in blood serum.TCM syndrome types of osteoarthritis in knee joints have correlation to levels of NO,IL-1β and TGF-β1 in blood serum.