黄精制剂治疗膝关节骨性关节炎临床观察

Clinical Observation of Preparations of Rhizoma Polygonati for Knee Joint Osteoarthritis

目的:观察黄精制剂对膝关节骨性关节炎患者的疼痛及膝关节活动度,血清中白细胞介素-1(IL-1)、白细胞介素-33(IL-33)及基质金属蛋白酶-13(MMP-13)含量变化的影响,探究黄精制剂治疗膝关节骨性关节炎的临床疗效及作用机制。方法:收集膝关节骨性关节炎患者,共100例。采用电脑随机数字表法分为治疗组50例(脱落5例),对照组50例(脱落8例)。治疗组予黄精制剂和非甾体类抗炎药治疗,对照组仅用非甾体类抗炎药治疗,分别于治疗前,治疗3月后、治疗6月后进行视觉模拟评分法(VAS)疼痛评分及膝关节活动度检测,并抽取患者静脉血液,分析IL-1、IL-33及MMP-13含量。比较分析2组IL-1,IL-33及MMP-13含量的变化。结果:(1)治疗组治疗前、治疗3月后、治疗6月后比较,在VAS平躺时疼痛评分、坐立时疼痛评分、站立时疼痛评分,膝关节屈曲、伸直活动度,炎症指标IL-1、IL-33、MMP-13含量,差异均有统计学意义(P<0.05),存在时间效应;(2)VAS总体疼痛评分、平躺时疼痛评分、坐立时疼痛评分、站立时疼痛评分、行走时疼痛评分,膝关节屈曲、伸直活动度,炎症指标IL-1、IL-33、MMP-13含量的分组因素均与时间因素不存在交互效应,差异均无统计学意义(P>0.05)。结论:黄精制剂能缓解膝关节疼痛及提高关节活动度,减少膝关节骨性关节炎患者血清中IL-1、IL-33及MMP-13的含量,有效抑制炎症反应,延缓患者病情的进一步进展。

Objective：To observe the effect of preparations of rhizoma polygonati on pain and knee range of motion as well as the changes of concentration of serum interleukin-1（IL-1）,interleukin-33（IL-33）and matrix metalloproteinase-13（MMP-13）of patients with knee joint osteoarthritis.To discuss the clinical effect and functional mechanism of the treatment with rhizoma polygonati for knee joint osteoarthritis.Methods：Collected 100 cases of patients with knee joint osteoarthritis.Divided them into the treatment group being 50 cases（5 cases dropped out）and the control group being 50 cases（8 cases dropped out）randomly.The treatment group was given the preparations of rhizoma polygonati and non-steroidal anti-inflammatory drugs for treatment,while the control group only received non-steroidal anti-inflammatory drugs for treatment.After treatment for 3 months and 6 months,detected the VAS pain score,drew venous blood of patients,and analyzed the concentration of IL-1,IL-33 and MMP-13.Compared and analyzed the changes of the concentration of IL-1,IL-33 and MMP-13.Results：（1）Before treatment and after treatment for 3 months and 6 months,compared the VAS pain scores when patients lay flat,sat down,and stood up,and the concentration of inflammatory indexes including IL-1,IL-33 and MMP-13 in the treatment group,there were significant differences being found（P 0.05）,and there existed time effects.（2）There existed no interaction effects between the grouping factors of the total VAS pain scores when patients lay flat,sat down,stood up and walked,the knee range of motion of flexion and extension as well as the concentration of inflammatory indexes including IL-1,IL-33 and MMP-13 and time factors,differences being insignificant（P 0.05）.Conclusion：Preparations of rhizoma polygonati can effectively relieve knee joint pain and enhance knee range of motion,reduce the concentration of serum IL-1,IL-33 and MMP-13 of patients with knee joint osteoarthritis,effectively inhibit inflammatory reaction,and delay the further disease progression of patients.