膝关节骨性关节炎中医证候分型与血清中MDA、SOD、NO含量相关性研究

The Study of Correlation Between TCM Syndrome Classification and Serum MDA and SOD and NO Levels in Patients with Knee Osteoarthritis

目的:探讨膝关节骨性关节炎(knee osteoarthritis,KOA)中医证候分型与患者血清中丙二醛(maledic diadehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、硝酸还原酶法测定一氧化氮(nitric Oxide,NO)含量之间的相互关系。方法:将符合KOA诊断标准的96例患者按中医学证候分型标准分为风湿热痹证组30例,风寒湿痹证组24例,肝肾亏虚证组24例和瘀血痹阻证组18例。抽取各组对象的晨起空腹血液,硫代巴比妥法测MDA,黄嘌呤氧化酶法测定SOD,硝酸还原酶法测定NO。结果:各证型MDA含量比较,差异具有统计学意义(P<0.05)。风湿热痹证组和风寒湿痹证SOD值低于肝肾亏虚证组,差异具有统计学意义(P<0.05)。NO含量和风湿热痹证组、风寒湿痹证组及瘀血痹阻证组NO含量低于肝肾亏虚证组,差异具有统计学意义(P<0.05)。结论:KOA患者血清中MDA、SOD、NO的含量变化为反应自由基变化情况指标和反应软骨细胞凋亡的相关指标,可以作为中医膝关节骨性关节炎宏观辨证分型的依据。

Objective： To explore the correlation between TCM syndrome classification and serum MDA,SOD and NO levels in patients with knee osteoarthritis（ KOA）. Methods： Ninety-six patients with osteoarthritis of the knee were divided into group of rheumatic heat arthralgia syndrome; group of wind cold damp arthralgia syndrome; group of liver-kidney deficiency syndrome group; group of blood stasis and arthralgia syndrome according to standard of TCM syndrome types. The early morning blood of each group was extracted. Maledic diadehyde（ MDA） was measured by thiobarbituric acid,and superoxide dismutase（ SOD）was determined by xanthine oxidase method,and nitric oxide（ NO） was determined by nitrate reductase. Results： The MDA content of each syndrome type was statistically different（ P〈0. 05）. The SOD levels of group of rheumatic heat arthralgia syndrome and group of wind cold damp arthralgia syndrome were lower than those of group of liver-kidney deficiency syndrome group,and the difference was statistically significant（ P〈0. 05）. The NO levels of rheumatic heat arthralgia syndrome and group of wind cold damp arthralgia syndrome and group of blood stasis and arthralgia syndrome were lower than those of group of liver-kidney deficiency syndrome group,and the difference was statistically significant（ P〈0. 05）. Conclusion： The changes of MDA,SOD and NO in the serum of KOA patients as indicators of changes in free radicals and indicators related to apoptosis of chondrocytes can be used as the basis for the macroscopic syndrome differentiation of osteoarthritis of the knee joint of traditional Chinese medicine.