膝骨关节炎痰瘀互结证和肝肾亏虚证患者关节液诱导型一氧化氮合成酶和胰岛素样生长因子-1浓度特点研究

Study on iNOS and IGF-1 Concentration in Articular Fluid of Patients with Phlegm-Blood Stasis Syndrome and LiverKidney Deficiency Syndrome of Knee Osteoarthritis

目的:探究膝骨关节炎痰瘀互结证和肝肾亏虚证患者关节液诱导型一氧化氮合成酶(iNOS)、胰岛素样生长因子-1(IGF-1)的浓度特点及其与证候评分的相关性。方法:纳入膝骨关节炎痰瘀互结证和肝肾亏虚证患者共计47例,测定患者的关节液iNOS、IGF-1浓度、应用中医证候量表量化证候评分,分析其关节液iNOS、IGF-1浓度的特点及其与中医证候评分的相关性。结果:膝骨关节炎肝肾亏虚证和痰瘀互结证患者一般情况比较差异无统计学意义(P>0.05);膝骨关节炎痰瘀互结证患者关节液iNOS浓度水平高于肝肾亏虚证患者(P<0.05),膝骨关节炎肝肾亏虚证患者关节液IGF-1浓度水平低于痰瘀互结证患者的(P<0.05);膝骨关节炎痰瘀互结证患者中医证候评分与关节液iNOS浓度水平正相关(r=0.167,P<0.05);膝骨关节炎肝肾亏虚证患者中医证候评分与关节液IGF-1浓度水平负相关(r=-0.189,P<0.05)。结论:膝骨关节炎痰瘀互结证和肝肾亏虚证患者关节液iNOS、IGF-1浓度特点不同,可以在一定程度上反映中医证候的严重程度,与中医病因病机的分析一致,上述膝骨关节炎不同证候患者关节液炎症因子浓度特点的不同,可能与JAK2/STAT3信号通路的激活程度不同有关。

Objective:To investigate the concentration characteristics of inducible nitric oxide synthase(iNOS) and insulin-like growth factor-1(IGF-1) in joint fluid and its correlation with the degree of syndrome in knee osteoarthritis(KOA) patients with phlegm-blood stasis syndrome and liver-kidney deficiency syndrome.Methods:The concentrations of iNOS and IGF-1 in articular fluid of 47 patients with different syndromes of KOA were measured and quantified by traditional Chinese medicine(TCM) syndrome scale. The characteristics of iNOS and IGF-1 concentration in articular fluid of patients with different syndrome types and their correlation with TCM syndrome score were analyzed.Results:Liver-kidney deficiency syndrome and phlegm-blood stasis syndrome in patients with KOA showed no statistically significant difference in general(P>0.05). KOA patients with phlegm-blood stasis syndrome iNOS in joint fluid concentration was higher than that of patients with liver-kidney deficiency syndrome(P<0.05), and the concentration of IGF-1 in articular fluid in patients with liver-kidney deficiency syndrome was lower than that in patients with phlegm-blood stasis syndrome of KOA(P<0.05). TCM syndrome score of patients with phlegm-blood stasis syndrome of knee osteoarthritis was positively correlated with iNOS concentration level of joint fluid(r=0.167, P<0.05). Liver-kidney deficiency syndrome in patients with KOA in TCM syndrome score showed negatively correlation with the level of IGF-1 in articular fluid(r=-0.189, P<0.05). Conclusion:The concentration characteristics of iNOS and IGF-1 in articulation fluid of patients with phlegm-blood stasis interaction syndrome and liver-kidney deficiency syndrome of KOA are different, which can reflect the severity of TCM syndrome to a certain extent, which is consistent with the analysis of etiology and pathogenesis of TCM. The difference in the concentration characteristics of inflammatory factors in joint fluid of patients with different syndromes of KOA may be related to the different activation of JAK2/STAT3 signal pathway.