独活寄生汤对膝骨性关节炎患者关节液基质金属蛋白酶-3、9和13水平的影响及疗效观察

Influence and curative effect observation of angelicae pubescentis and loranthi decoction on Matrix Metalloproteinase-3,9 and 13(MMP-3,9 and 13) levels in joint fluid of patients with knee osteoarthritis(KOA)

目的探讨独活寄生汤对膝骨性关节炎患者关节液基质金属蛋白酶-3、9和13水平的影响及疗效观察。方法 76例膝关节OA患者随机分为观察组和对照组。对照组予以口服双氯芬酸钠缓释片100 mg,1次/d,连用4周。观察组加用独活寄生汤加减口服,1剂/d,水煎300 mL,早晚分两次口服,连用4周。观察两组治疗前后关节液MMP-3、9和13水平的变化,并进行临床疗效分析。结果治疗4周后,两组关节液MMP-3、9和13水平均有明显下降(P<0.01或P<0.05),且观察组下降值明显高于对照组(P<0.05);观察组患者的临床总有效率94.74%,明显高于对照组的76.32%(χ2=5.21,P<0.05)。结论独活寄生汤治疗膝关节OA的具有较好的疗效,其作用与降低关节液MMP-3、9和13水平、减少对软骨细胞和软骨基质的破坏密切相关。

Objective To discuss influence and curative effect observation of angelicae pubescentis and loranthi decoction on Matrix Metalloproteinase-3,9 and 13 （MMP-3, 9 and 13） levels in joint fluid of patients with knee osteoarthritis （KOA）. Methods Seventy-six cases of patients with KOA were divided into observation group and control group at random. The patients in control group were given 100 mg Diclofenac Sodium Sustained Release Tablets once a day by the mouth for 4 weeks. The patients in observation group were additionally given 300 ml angelicae Pubescentis and Loranthi Decoction decocted with water through the mouth once a day for day and night for 4 weeks. The changes of MMP-3,9 and 13 levels in the joint fluid of patients in two groups before and after medical treatment,and the clinical curative effect was compared. Results After 4 weeks＇ medical treatment, MMP-3,9 and 13 levels in the joint fluid of patients in two groups obviously declined （P〈0.01 or P〈0.05）,and the declining rate in observation group was much higher than that in control group （P〈0.05）.The total clinical efficiency of patients in observation group was 94.74%, which was much higher than that in control group 76.32% （X2=5.21 ,P〈0.05）. Conclusion Angelicae Pubescentis and Loranthi Decoction has reliable curative effect on KOA,whose mechanism of action has close effect on reducing MMP- 3,9 and 13 levels in joint fluid and lightening the destroy on the cartilage cells and cartilage ground substance.