独活寄生汤治疗肝肾亏虚型膝骨关节炎患者血清赖氨酸,β-隐黄素含量变化及其与疼痛的相关性

Changes of Serum Lysine and β-cryptoxanthin in Patients with Hepatorenal Deficiency Type Knee Osteoarthritis Treated with Duhuo Jisheng Tang and Its Correlation with Pain

目的：观察独活寄生汤治疗肝肾亏虚型膝骨关节炎（KOA）患者血清赖氨酸,β-隐黄素含量变化及其与疼痛的相关性。方法：将73例天津中医药大学第一附属医院确诊的KOA患者随机分为观察组（42例）及对照组（31例）,观察组给予独活寄生汤150 m L/次,2次/d口服,对照组给予硫酸氨基葡萄糖胶囊0.5 g/次,3次/d口服,两组患者均治疗4周,以膝关节视觉模拟评分法（visual analogue scalescore,VAS）,压痛值评定治疗前后疼痛变化情况;酶联免疫吸附试验（ELISA）检测各组患者血清中前列腺素E2（PGE2）,P物质（SP）,多巴胺（DA）,5-羟色胺（5-HT）含量;赖氨酸含量采用全自动氨基酸分析仪进行检测;采用高效液相色谱法检测β-隐黄素血清含量;采用Pearson相关性检验分析赖氨酸,β-隐黄素与VAS评分,压痛值,PGE2,SP,DA,5-HT相关性。结果：与本组治疗前比较,治疗后对照组、观察组患者VAS评分升高,压痛值降低（P〈0.05）,治疗后与对照组相比,观察组VAS评分升高,痛值降低（P〈0.05）;与本组治疗前相比,治疗后两组患者血清PGE2,SP,DA及5-HT含量均下降,治疗后与对照组相比,观察组患者血清PGE2,SP,DA及5-HT含量明显下降（P〈0.05）;对照组治疗前后血清赖氨酸,β-隐黄素含量无明显变化,观察组治疗后较治疗前血清赖氨酸,β-隐黄素含量升高（P〈0.05）;两组患者治疗前后血清赖氨酸,β-隐黄素与压痛值呈正相关（P〈0.05）,与VAS,PGE2,SP,DA,5-HT均呈负相关（P〈0.05）。结论：独活寄生汤治疗肝肾亏虚型KOA可明显缓解疼痛,可能与赖氨酸,β-隐黄素血清含量升高有关。

Objective： To observe the changes of serum lysine and β-cryptoxantin in patients with hepatorenal deficiency type knee osteoarthritis treated with Duhuo Jisheng Tang and its correlation with pain.Method： Totally 73 KOA patients diagnosed at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were randomly divided into observation group（ 42 cases） and control group（ 31 cases）. The observation group was orally given Duhuo Jisheng Tang,150 m L/times,2 times/d,while the control group was orally given glucosamine sulfate,0. 5 g/times,3 times/d. Both groups were treated for 4 weeks. The knee joint visual analogue scale（ VAS） and tenderness value were used to evaluate the changes of pain before and after treatment. Serum levels of prostaglandin E2（ PGE2）,substance P（ SP）,dopamine（ DA） and serotonin（ 5-HT）were measured by enzyme-linked immunosorbent assay（ ELISA）. The content of lysine was detected by automatic amino acid analyzer,and the content of serum β-cryptoxantin was determined by HPLC. Pearson correlation test was used to analyze the correlation between lysine,β-cryptoxanthin and VAS scores,tenderness value,PGE2,SP,DA and 5-HT. Result： Compared with before treatment,patients in control group and observation group after treatment had higher VAS scores and lower tenderness（ P〈0. 05）. After treatment,the VAS score of the observation group was higher,and the pain value was lower than that of control group（ P〈0. 05）. Compared with before treatment,the levels of PGE2,SP,DA and 5-HT in control group and observation group decreased after treatment. Compared with control group,the serum levels of PGE2,SP,DA and 5-HT in observation group decreased significantly（ P〈0. 05） after treatment. The serum levels of lysine and β-cryptoxanthin in the control group had no significant changes before and after treatment. The serum levels of lysine and β-cryptoxanthin in the observation group were significantly higher than those before treatment（ P〈0. 05）. Serum lysine andβ-cryptoxanthin were positively correlated with tenderness before and after treatment in both groups（ P〈0. 05）,but negatively correlated with VAS,PGE2,SP,DA and 5-HT（ P〈0. 05）. Conclusion： Duhuo Jisheng Tang can significantly relieve the pain in treatment of KOA,which may be related to the increase of contents of lysine andβ-cryptoxanthin.