补肾活血中药联合关节镜下自体骨软骨移植修复术治疗膝骨关节炎软骨缺损疗效观察及对血清β连环素、Diekkopf-1的影响

Effect of Bushen Huoxue Chinese herbs combined with osteochondral autologous transplantationunder arthroscopy forknee osteoarthritiscomplicated by cartilage defect and its effect on serumβ-catenin and Diekkopf-1

目的观察补肾活血中药联合关节镜下自体骨软骨移植修复术治疗膝骨关节炎软骨缺损的疗效及对血清β连环素(β-catenin)、Diekkopf-1(DKK-1)的影响。方法将84例膝骨关节炎软骨缺损患者按照随机数字表法分为2组,每组42例。2组患者均行关节镜下自体骨软骨移植修复术治疗,术后行常规对症处理,治疗组在此基础上于术后1 d加服补肾活血中药。2组均连续治疗8周,8周后统计疗效。比较2组患者治疗前后中医证候评分,血清β-catenin、DKK-1水平,膝关节损伤和骨关节炎预后量表(KOOS)评分变化情况,并评价治疗安全性。结果治疗组总有效率[97.62%(41//42)]高于对照组[85.71%(36/42)](P<0.05)。治疗后2组各项中医证候评分及总分均明显低于本组治疗前(P<0.05),且治疗组均明显低于对照组(P<0.05)。治疗后2组血清β-catenin水平均明显低于本组治疗前(P<0.05),血清DKK-1水平均明显高于本组治疗前(P<0.05),且治疗后治疗组血清β-catenin水平明显低于对照组(P<0.05),血清DKK-1水平明显高于对照组(P<0.05)。治疗后2组KOOS各维度评分均明显高于本组治疗前(P<0.05),且治疗组均明显高于对照组(P<0.05)。2组治疗安全性比较差异无统计学意义(P>0.05)。结论补肾活血中药联合关节镜下自体骨软骨移植修复术治疗膝骨关节炎软骨缺损疗效较好,可有效降低血清β-catenin含量,提高DKK-1含量,促进膝关节功能恢复,且治疗安全性较好。

Objective To observe the curative effect of Bushen Huoxue Chinese herbs combined with osteochondral autogenous transplantation(OAT) under arthroscopy for knee osteoarthritis complicated bycartilage defect and its effect on serumβ-catenin and Diekkopf-1(DKK-1).Methods Totally 84 patients with knee osteoarthritis complicated by cartilage defect were randomly divided into treatment groups and control group,42 cases per group.OAT under arthroscopy were porformed in patients of groups,and routine treatment of postoperative was carried out.Patients in treatment group were additionally treated with Bushen Huoxue Chinese herbs one day after operation on this basis.Treated for 8 weekscontinuously,and curative effect was counted after treatment.The key observation was Traditional Chinese medicine(TCM) syndrome scores,serumβ-catenin and DKK-1,Knee Injury and Osteoarthritis Outcome Score(KOOS) before and after treatmentbetween groups,and the safety was evaluated.Results The total effective rates in treatment group were better than those in control group [97.62%(41/42) vs85.71%(36/42),(P < 0.05),respectively].Compared with before treatment,TCM syndrome scores and total scores after treatment in groups was lower(P < 0.05),which in treatment group was significantly decreased(P < 0.05);serum β-catenin after treatment in groups was lower(P < 0.05),which in treatment group was significantly decreased(P < 0.05);while serum DKK-1 in groups was higher(P < 0.05),which in treatment group was significantly increased(P < 0.05);KOOS in groups was higher(P < 0.05),which in treatment group was significantly increased(P < 0.05);and there was no significant difference in safety between groups(P > 0.05).Conclusion For patients with knee osteoarthritis complicated bycartilage defect,Bushen Huoxue Chinese herbs combined with OAT under arthroscopy can effectively reduce serumβ-catenin content,increase DKK-1 content,promote recovery of knee joint function,and with good safety.