补肾活血颗粒治疗膝骨性关节炎的临床观察及机制探讨

Clinical Observation and Mechanism Discussion of Bushen Huoxue Granules in the Treatment of Knee Osteoarthritis

目的观察补肾活血颗粒治疗肾虚血瘀型膝骨性关节炎的临床疗效及其对细胞因子IL-1β、NO及TGF-β1的影响,初步探讨其治疗机制。方法采用随机数字表法,将70例肾虚血瘀型膝骨性关节炎患者分为治疗组和对照组(各35例),治疗组依医嘱服用补肾活血颗粒,对照组服用洛索洛芬钠片,2组患者均常规给予胃黏膜保护剂,比较2组临床疗效及膝关节液中细胞因子IL-1β、NO及TGF-β1水平的变化。结果治疗组及对照组临床总有效率分别为78.12%、75.76%,差异无统计学意义(P>0.05);但经过6周治疗后,治疗组中患者关节液细胞因子IL-1β、NO水平低于对照组,保护性因子TGF-β1则高于对照组。结论补肾活血颗粒可缓解关节疼痛,改善关节功能,同时可降低KOA患者关节液中IL-1β、NO浓度,提高保护性因子TGF-β1的水平,值得在临床上推广。

Objective:To observe the clinical effects of Bushen Huoxue Granules in the treatment of knee osteoarthritis patients with kidney deficiency and blood stasis type and its effect on the cytokines IL-1β,NO and TGF-β1,and to explore its therapeutic mechanism.Methods:70 knee osteoarthritis patients with kidney deficiency and blood stasis type were divided into a treatment group and a control group,35 cases per group by using random number table method.The treatment group took Bushen Huoxue Granules according to the doctor's orders,and the control group took loxoprofen sodium tablets.The patients in both groups were routinely given gastric mucosal protective agents.The clinical effects and the changes of cytokines IL-1β,NO and TGF-β1 in knee joint fluid were compared between the two groups.Results:The total clinical effective rates of the treatment group and the control group were 78.12%and 75.76%,respectively,with no significant difference(P>0.05).But after 6-week treatment,the joint fluid cytokines IL-1β,NO and TGF-β1level of the patients in the treatment group were lower than those of the patients in the control group,and the protective factor TGF-β1 was higher than that of the control group.Conclusion:Bushen Huoxue Granules can alleviate joint pain and improve joint function.At the same time,it can reduce the concentration of IL-1βand NO in the joint fluid of KOA patients and increase the level of protective factor TGF-β1,worthy of clinical application.