补肾活血汤熏洗治疗早中期膝关节骨性关节炎及其部分作用机制研究

Study on Effect and Mechanism of Bushenhuoxue Decoction Fumigation and Washing on Early-Middle Period of Knee Osteoarthritis

目的观察补肾活血汤熏洗治疗膝关节骨性关节炎的临床疗效及对关节滑液中基质金属蛋白酶-3(MMP-3)和白介素1β(IL-1β)的影响。方法对60例骨性关节炎(74膝)患者进行补肾活血汤熏洗治疗,观察治疗前后患者Lysholm’s膝关节评分以及关节滑液中MMP-3和IL-1β变化。结果治疗4周,进行平均28.2个月(24～40月)的随访,结果优40例47膝、良11例15膝、中4例5膝、差5例7膝,总优良率为83.78%,患者Lysholm’s膝关节评分、关节滑液MMP-3、IL-1β较治疗前明显改善。结论补肾活血汤熏洗治疗早中期膝骨性关节炎疗效显著,其作用机制可能通过降低MMP-3、IL-1β的水平,减轻滑膜炎症和关节软骨的破坏,从而发挥对骨性关节炎的治疗作用。

Objective： To evaluate effects of fumigation and washing with Bushenhuoxue Decoction on the clinical effect of knee osteoarthritis patients and the MMP-3 and IL-1β in joint synovia of patients.Methods： 60 patients（74knees） were fumigation and washing with Bushenhuoxue Decoction.The Lysholm＇s knee score,the MMP-3 and the IL-1β of each patient were observed before and after treatment.Results： After 4 weeks of therapy,with average follow-up of 28.2 months（24~40months）,the curative effect showed 40 patients（47knees） in excellent,11 patients（15knees） in fine,4 patients（5knees） in midst and 5 patient（7 knees） in bad.The total fineness rate was 83.78%.The Lysholm＇s knee score,the MMP-3 and the IL-1β were improved significantly after treatment.Conclusion： Fumigation and washing with Bushenhuoxue Decoction is an effective method for early metaphase period knee osteoarthriti.The mechanism could be through decrease concentration such as MMP-3 and the IL-1β and alleviation of synovial inflammation and joint cartilage damage.