骨痛散对膝骨关节炎患者IL-1β、TNF-α、MMP-3表达的影响

Effect of Gutong Powder on the Expression of IL-1β, TNF-α and MMP-3 in the Patients with Knee Osteoarthritis

目的:观察中药骨痛散封包治疗膝关节骨性关节炎(KOA)的临床疗效,以及其对膝关节影像学改变及炎症因子表达情况。方法:将70例KOA患者按随机数字表法分为2组。治疗组35例给予骨痛散封包治疗;对照组35例给予骨通贴膏联合盐酸氨基葡萄糖胶囊治疗。2组均经治疗4周后进行统计,并比较2组治疗前后膝关节影像学改变及关节液中IL-1β(interleukin-1,IL-1β)、TNF-α(tumor necrosis factor-α,TNF-α)及外周血中MMP-3表达量。结果:对照组和治疗组患者的膝关节X线表现较治疗前无显著改变;各组患者治疗4周后临床症状有所减轻;治疗组关节液和外周血中炎症因子及金属蛋白酶表达量较对照组降低(P<0.05)。结论:中药骨痛散封包治疗KOA可显著改善患者临床症状,减轻骨关节炎患者的炎症反应,临床疗效与骨通贴膏联合盐酸氨基葡萄糖胶囊治疗效果相似。

Objective： To observe the clinical efficacy of Gutong San capsule in the treatment of knee osteoarthritis（KOA）, as well as the imaging changes and expression of inflammatory factors in the knee joint. Methods： 70 patients with KOA were divided into two groups according to random number table. The treatment group 35 cases given Gutong powder package treatment; control group of 35 cases given Gutong powder combined with glucosamine hydrochloride capsule treatment. The changes of knee joint imaging and the expressions of interleukin-1（IL-1β） and tumor necrosis factor-α（TNF-α） in synovial fluid of the two groups were compared before and after treatment and the expression of MMP-3 in peripheral blood. Results： The X-ray findings of knee joint in control group and treatment group had no significant change compared with that before treatment. The clinical symptoms of the patients in each group were alleviated after 4 weeks of treatment. The expression of inflammatory cytokines and metalloproteinase in the synovial fluid and peripheral blood in the treatment group were lower than those in the control group（P0.05）. Conclusion： KOA can significantly improve the clinical symptoms and relieve the inflammatory reaction in patients with osteoarthritis. The clinical curative effect is similar to that of Gutong powder and glucosamine hydrochloride capsules.