当归拈痛汤对湿热痹阻型膝骨性关节炎临床疗效及TNF-α、IL-1、NO的影响

Clinical Effects of Danggui Niantong Decoction in the Treatment of Knee Osteoarthritis of Damp-heat Obstructing Pattern and Its Influence on the Levels of TNF-α, IL-1 and NO

目的:观察与评估当归拈痛汤治疗湿热痹阻型膝骨性关节炎(knee osteoarthritis,KOA)的疗效及对关节液肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素1(interleukin-1,IL-1)及一氧化氮(nitric oxide,NO)的影响。方法:将106例湿热痹阻型KOA患者按随机、对照的原则分为观察组和对照组,每组53例。观察组给予当归拈痛汤治疗,对照组给予盐酸氨基葡萄糖片治疗,两组均持续治疗4周。比较两组临床疗效、视觉模拟疼痛评分(visual analogue scales,VAS)、西安大略和麦克马斯特大学(Western Ontario and McMaster universities,WOMAC)骨关节炎指数评分量表评分,ELISA法检测关节液中TNF-α、IL-1、NO的含量。结果:观察组总有效率[88.79%(46/52)]与对照组总有效率[88.70%(45/52)]比较,差异无统计学意义(P>0.05)。治疗后,两组VAS、WOMAC评分,TNF-α、IL-1、NO水平均较治疗前明显降低(P<0.05),且上述指标观察组低于照组(P<0.05)。结论:当归拈痛汤可缓解湿热痹阻型KOA患者疼痛症状,改善膝关节活动功能,且可干预炎症反应,下调关节液中TNF-α、IL-1、NO含量,从而提高综合疗效,可能是治疗KOA的潜在作用机制。

Objective:To observe and evaluate clinical effects of Danggui Niantong decoction in the treatment of KOA of damp-heat arthralgia and obstructing pattern and its influence on the levels of TNF-α,IL-1 and NO in articular fluid.Methods:All 106 patients were allocated into the observation group and the control group according to the principle of randomization and control,53 cases in each group.The observation group was treated with Danggui Niantong decoction,and the control group with glucosamine hydrochloride tablets,both groups were treated for four weeks consecutively.To compare clinical effects,VAS,WOMAC scores between both groups,ELISA method was used to detect the contents of TNFα,IL-1 and NO in articular fluid.Results:The difference had no statistical meaning in the comparisons of total effective rates between the observation group[88.79%(46/52)]and the control group[88.70%(45/52)](P>0.05);after treating,VAS,WOMAC scores,the levels of TNFα,IL-1 and NO of both groups lowered notably compared with these before treating(P<0.05).the observation group was lower than the control group in the above indexes(P<0.05).Conclusion:Danggui Niantong decoction could relieve the pain of KOA patients,improve knee movement function,and down regulate the levels of TNFα,IL-1 and NO in articular fluid,intervene inflammatory reaction,thus to raise comprehensive effects,and that might be the potential mechanism of treating KOA.