身痛逐瘀汤对痰瘀互结型膝骨关节炎患者血清IL-1β的调节作用

Regulating Effect of Shentong Zhuyu Decoction on Serum IL-1β and Its Influence on Hemorheology in Patients with Knee Osteoarthritis of Phlegm-stasis Pattern

目的:通过观察身痛逐瘀汤治疗痰瘀互结型膝骨关节炎患者与血清中IL-1β水平的相关性,探讨身痛逐瘀汤治疗骨关节炎的相关机制,并验证其临床疗效。方法:选取60例膝骨关节炎患者随机分为对照组和观察组,对照组患者采用口服双醋瑞因胶囊联合双氯酚酸纳缓释片治疗,观察组患者采用身痛逐瘀汤治疗,两组患者均4周为1个疗程,连续治疗2个疗程。比较两组患者治疗前后关节液及血清中白介素lβ(IL-lβ)含量、WOMAC关节指数评分、血液流变学、临床疗效评价及安全性分析,并进行统计分析。结果:治疗后两组患者关节液及血清中的IL-lβ的水平显著低于治疗前(P<0.05),并且观察组的IL-lβ水平与对照组比较均差异显著(P<0.05);治疗后观察组患者的血液流变学所有指标较对照组降低的更明显(P<0.05);观察组患者的WOMAC总分及各项评分均较对照组的下降幅度大(P<0.05);对照组治疗总有效率为76.7%,而观察组治疗总有效率为90.0%,两组比较差异具有统计学意义(P<0.05);观察组患者的不良反应显著少于对照组(P<0.05)。结论:身痛逐瘀汤治疗痰瘀互结型膝骨关节炎疗效确切,其机制可能与调节机体IL-lβ水平相关,为临床用药提供参考。

Objective: To observe the influence of Shentong Zhuyu decoction on serum level of IL-1β in the treatment of knee osteoarthritis of phlegm-stasis pattern,to discuss its action mechanism,and to verify its clinical curative effect.Methods: 60 cases of knee osteoarthritis were randomly divided into the control group and the observation group; the control group was treated with Diclofenac Sodium combined with Diacerein,whereas the observation group was treated with Shentong Zhuyu Decoction; the treatment was two courses of eight weeks. IL-1β level,WOMAC joint index,hemorheology,clinical efficacy and safety analysis were compared in the two groups before and after the treatment. Results: IL-1β level was significantly lowered in the synovial fluid and in serum after the treatment in the two groups( P <0. 05),of which there was statistical difference between the observation group and the control group( P < 0. 05). In terms of indexes of hemorheology,they decreased more obviously in the observation group after the treatment( P <0. 05). Scores of WOMAC were reduced more significantly in the observation group when compared to the control group( P < 0. 05). The total effective rate was 76. 7% in the control group,and it was 90. 0% in the observation group,there was statistical significance between the two groups( P < 0. 05). Adverse reactions were less in the observation group compared to those in the control group( P < 0. 05). Conclusion: Shentong Zhuyu decoction is effective in the treatment of knee osteoarthritis with phlegm-stasis syndrome,and its mechanism may be related to regulating the level of IL-1β,which provides reference for clinical medication.