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[1]康武林,袁普衛(wèi),李小群,等.口服蠲痹湯和鹽酸氨基葡萄糖膠囊治療膝骨關節(jié)炎的療效觀察及作用機制研究[J].中醫(yī)正骨,2016,28(09):19-22.
　KANG Wulin,YUAN Puwei,LI Xiaoqun,et al.A clinical study on the curative effect and mechanism of action of oral applications of Juanbi Tang(蠲痹湯)and glucosamine hydrochloride capsules for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(09):19-22.
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口服蠲痹湯和鹽酸氨基葡萄糖膠囊治療膝骨關節(jié)炎的療效觀察及作用機制研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年09期
頁碼:
19-22
欄目:
膝骨關節(jié)炎
出版日期:
2016-09-20

文章信息/Info

Title:
A clinical study on the curative effect and mechanism of action of oral applications of Juanbi Tang(蠲痹湯)and glucosamine hydrochloride capsules for treatment of knee osteoarthritis
作者:
康武林; 袁普衛(wèi); 李小群; 董博; 楊鋒; 王曉玲; 孫菊; 余紅超; 劉德玉; 昝強
陜西中醫(yī)藥大學附屬醫(yī)院,陜西 咸陽 712000
Author(s):
KANG Wulin; YUAN Puwei; LI Xiaoqun; DONG Bo; YANG Feng; WANG Xiaoling; SUN Ju; YU Hongchao; LIU Deyu; ZAN Qiang
The Affiliated Hospital to Shanxi University of Chinese Medicine,Xianyang 712000,Shanxi,China
關鍵詞:
骨關節(jié)炎; 膝;  中藥療法;  蠲痹湯;  鹽酸氨基葡萄糖;  Toll樣受體4;  腫瘤壞死因子-α;  臨床試驗
Keywords:
osteoarthritis; knee;  drug therapy(TCD);  Juanbi Tang;  glucosamine hydrochloride;  toll-like receptor 4;  tumor necrosis factor-alpha;  clinical trial
摘要:
目的:觀察口服蠲痹湯和鹽酸氨基葡萄糖膠囊治療膝骨關節(jié)炎的臨床療效并探討其作用機制。方法:將80例膝骨關節(jié)炎患者隨機分為2組,每組40例,分別采用口服蠲痹湯和鹽酸氨基葡萄糖膠囊、單純口服鹽酸氨基葡萄糖膠囊治療。蠲痹湯口服每日1劑,水煎400 mL,早晚各200 mL,連續(xù)服用8周; 鹽酸氨基葡萄糖膠囊口服每次2粒,每日3次,連續(xù)服用8周。分別于治療前、治療開始后8周測量并比較2組患者膝關節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分、日本骨科協(xié)會(Japanese orthopaedic association,JOA)膝關節(jié)功能評分以及Toll樣受體4(toll-like receptor 4,TLR4)、腫瘤壞死因子-α(tumor necrosis factor-α,TNF-α)的血清含量。結果:①膝關節(jié)疼痛VAS評分和JOA膝關節(jié)功能評分。治療前2組患者膝關節(jié)疼痛VAS評分及JOA膝關節(jié)功能評分比較,組間差異均無統(tǒng)計學意義[(8.01±1.16)分,(8.05±1.12)分,t=0.157,P=0.876;(70.02±9.86)分,(68.32±10.28)分,t=0.755,P=0.453]。治療開始后8周,口服蠲痹湯和鹽酸氨基葡萄糖膠囊組膝關節(jié)疼痛VAS評分低于單純口服鹽酸氨基葡萄糖膠囊組[(2.33±0.68)分,(5.86±0.97)分,t=18.850,P=0.000],JOA膝關節(jié)功能評分高于單純口服鹽酸氨基葡萄糖膠囊組[(86.24±5.32)分,(79.46±7.54)分,t=4.647,P=0.000]; 2組患者膝關節(jié)疼痛VAS評分均低于治療前(t=26.720,P=0.000; t=9.348,P=0.000),JOA膝關節(jié)功能評分均高于治療前(t=9.156,P=0.000; t=5.526,P=0.000)。②TLR4、TNF-α血清含量。治療前2組患者TLR4、TNF-α血清含量比較,組間差異均無統(tǒng)計學意義[(17.90±6.80)ng·mL-1,(18.40±6.50)ng·mL-1,t=0.336,P=0.738;(188.70±38.90)pg·mL-1,(192.40±46.50)pg·mL-1,t=0.386,P=0.701]。治療開始后8周,口服蠲痹湯和鹽酸氨基葡萄糖膠囊組TLR4、TNF-α血清含量均低于單純口服鹽酸氨基葡萄糖膠囊組[(11.40±3.60)ng·mL-1,(15.10±4.30)ng·mL-1,t=4.173,P=0.000;(122.40±39.20)pg·mL-1,(158.20±37.37)pg·mL-1,t=4.181,P=0.000],2組患者TLR4、TNF-α血清含量均低于治療前(t=5.343,P=0.000; t=2.678,P=0.000; t=7.593,P=0.000; t=3.636,P=0.000)。結論:口服蠲痹湯和鹽酸氨基葡萄糖膠囊治療膝骨關節(jié)炎,能夠緩解或消除膝關節(jié)疼痛,改善膝關節(jié)功能,其療效優(yōu)于單純口服鹽酸氨基葡萄糖膠囊; 其作用機制可能是通過抑制TLR4的表達,使TNF-α的表達受到抑制,從而減輕了炎癥反應。
Abstract:
Objective:To explore the curative effect and mechanism of action of oral applications of Juanbi Tang(蠲痹湯,JBT)and glucosamine hydrochloride capsules for the treatment of knee osteoarthritis(KOA).Methods:Eighty patients with KOA were randomly divided into 2 groups,40 cases in each group.The patients were treated with oral applications of JBT and glucosamine hydrochloride capsules(group A)and monotherapy of oral applications of glucosamine hydrochloride capsules(group B)respectively.The JBT were taken at a dose of 400 ml,200 ml at a time,twice a day for 8 consecutive weeks.The glucosamine hydrochloride capsules were taken three times a day,2 capsules at a time for 8 consecutive weeks.The knee pain visual analogue scale(VAS)scores,Japanese orthopaedic association(JOA)knee functional scores and the serum contents of toll-like receptor 4(TLR4)and tumor necrosis factor-α(TNF-α)were measured and compared between the 2 groups before treatment and at 8 weeks after the beginning of the treatment respectively.Results:There was no statistical difference in knee pain VAS scores and JOA knee functional scores between the 2 groups before treatment(8.01+/-1.16 vs 8.05+/-1.12 points,t=0.157,P=0.876; 70.02+/-9.86 vs 68.32+/-10.28 points,t=0.755,P=0.453).At 8 weeks after the beginning of the treatment,the knee pain VAS scores were lower in group A compared to group B(2.33+/-0.68 vs 5.86+/-0.97 points,t=18.850,P=0.000),and the JOA knee functional scores were higher in group A compared to group B(86.24+/-5.32 vs 79.46+/-7.54 points,t=4.647,P=0.000).The knee pain VAS scores of the 2 groups were lower after the treatment compared to pre-treatment(t=26.720,P=0.000; t=9.348,P=0.000),and the JOA knee functional scores of the 2 groups were higher after the treatment compared to pre-treatment(t=9.156,P=0.000; t=5.526,P=0.000).There was no statistical difference in the serum contents of TLR4 and TNF-α between the 2 groups before treatment(17.90+/-6.80 vs 18.40+/-6.50 ng/ml,t=0.336,P=0.738; 188.70+/-38.90 vs 192.40+/-46.50 pg/ml,t=0.386,P=0.701).The serum contents of TLR4 and TNF-α were lower in group A compared to group B at 8 weeks after the beginning of the treatment(11.40+/-3.60 vs 15.10+/-4.30 ng/ml,t=4.173,P=0.000; 122.40+/-39.20 vs 158.20+/-37.37 pg/ml,t=4.181,P=0.000).The serum contents of TLR4 and TNF-α of the 2 groups were lower after the treatment compared to pre-treatment(t=5.343,P=0.000; t=2.678,P=0.000; t=7.593,P=0.000; t=3.636,P=0.000).Conclusion:Oral applications of JBT and glucosamine hydrochloride capsules can relieve or eliminate the knee pain and improve the knee function in the treatment of KOA,and it surpasses the monotherapy of oral applications of glucosamine hydrochloride capsules in the clinical curative effect.It can inhibit the expression of TNF-α through inhibiting the expression of TLR4,which may be the mechanisms of action for reducing the inflammatory reaction.

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備注/Memo

備注/Memo:
基金項目:國家自然科學基金項目(81574006); 陜西省重點科技創(chuàng)新團隊項目(2013KCT-26)
袁普衛(wèi) Email:[email protected]

更新日期/Last Update: 1900-01-01