骨痹汤对膝骨关节炎患者滑液中MMP-13、IL-1、TNF-α、TIMP-1的影响

Effect of Gubi Decoction on MMP-13,IL-1,TNF-α and TIMP-1 Level in Synovial Fluid in Knee Joints of Osteoarthritis Patient

目的:观察"骨痹汤"对膝骨关节炎(OA)滑液中基质金属蛋白酶-13(Matrix Metalloproteinase-13,MMP-13)、白介素-1(Interleukin-1,IL-1)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、组织型金属蛋白酶抑制剂-1(Tissue Inhibitor of Metalloproteinase-1,TIMP-1)水平的影响,探讨"骨痹汤"分子药理机制与临床疗效水平。方法:90例膝骨关节炎患者(119膝)随机分为骨痹汤治疗组、仙灵骨葆治疗组和对照组(口服硫酸氨基葡萄糖),于治疗前和治疗后8周抽取关节液标本,采用双抗体夹心酶联免疫吸附法测定MMP-13、IL-1、TNF-α、TIMP-1水平。结果:与治疗前比较,各组患者治疗8周后关节液中MMP-13、IL-1、TNF-α均明显降低(P<0.05);TIMP-1水平较治疗前明显升高(P<0.05);骨痹汤治疗组关节液中MMP-13、IL-1、TNF-α下降幅度较其余2组大(P<0.05),TIMP-1水平升高显著高于仙灵骨葆治疗组和对照组(P<0.05)。结论:骨痹汤可能通过降低关节炎液中MMP-13、IL-1、TNF-α水平,提高TIMP-1水平起到保护关节软骨的作用。骨痹汤治疗骨关节炎短期疗效较仙灵骨葆和硫酸氨基葡萄糖好。

Objective：To examine the expression of MMP - 13, IL - 1, TNF - α and TIMP - 1 in the synovial fluid in knee joints of osteoarthritis patients before and after being treated with Gubi decoction, and to explore the molecular pharmacological mechanisms and clinical efficacy. Methods：Ninety patients with osteoarthritis were recruited in the controlled trial, and randomly divided into Gubi de- coction group, Xianling Gubao Capsule group and control group （tablets of glucosamine sulfate）. The expression of MMP- 13, IL- 1, TNF - α and TIMP - 1 in the synovial fluid was measured by enzyme - linked immunosorbent assay （ ELISA ） before and after 8 weeks of treatment. Results：The level of MMP - 13, IL - 1, TNF - α in the synovial fluid decreased significantly after being treated for 8 weeks in Gubi decoction group, Xianling Gubao Capsule group and glucosamine sulfate group （P 〈 0.05 ）. On the contrary, the level of TIMP - 1 increased significantly after 8 weeks of treatment. Compared to Xianling Gubao Capsule group and glucosamine sulfate group, the level of MMP - 13, IL - 1, TNF - α decreased more sharply in Gubi decoction group（P 〈 0.05 ） , and also the increase of TIMP - 1 was significantly greater in Gubi decoction group（ P 〈 0. 05 ）. Conclusion： Gubi decoction may play a role in the protection of articular cartilage by decreasing MMP - 13, IL - 1, TNF - α and increasing TIMP - 1 levels in the synovial fluid. The short term effect of Gubi decoction in treatment of osteoarthritis was better than Xianling Gubao Capsule and glucosamine sulfate.