摘要
【目的】观察抗骨增生胶囊联合双醋瑞因胶囊治疗膝骨关节炎的临床疗效以及对血清及关节液中趋化素(Chemerin)和肿瘤坏死因子样弱凋亡诱导因子(TWEAK)的影响。【方法】将150例膝骨关节炎患者随机分为研究组和对照组,每组各75例。对照组给予双醋瑞因胶囊治疗,研究组在对照组基础上联用抗骨增生胶囊治疗,4周为1个疗程,连续治疗3个疗程。观察2组患者治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟量表(VAS)评分、Lysholm膝关节量表(LKSS)评分、炎症因子[白细胞介素1(IL-1)、白细胞介素6(IL-6)、环氧合酶2(COX-2)]以及血清和关节液Chemerin及TWEAK表达水平,评价2组患者的临床疗效及安全性。【结果】(1)治疗3个疗程后,研究组的总有效率为90.7%(68/75),对照组为77.3%(58/75),研究组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的WOMAC评分和VAS评分均较治疗前明显降低(P<0.01),LKSS评分均较治疗前明显升高(P<0.01),且研究组对WOMAC评分和VAS评分的降低作用及对LKSS评分的升高作用均明显优于对照组(P<0.01)。(3)治疗后,2组患者血清IL-1、IL-6、COX-2水平均较治疗前明显降低(P<0.01),且研究组对血清IL-1、IL-6、COX-2水平的降低作用明显优于对照组(P<0.01)。(4)治疗后,2组患者血清和关节液Chemerin、TWEAK表达水平均较治疗前明显下降(P<0.01),且研究组对血清及关节液Chemerin、TWEAK表达水平的下降作用均明显优于对照组(P<0.01)。(5)治疗期间,2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】抗骨增生胶囊联合双醋瑞因胶囊治疗膝骨关节炎更具临床优势,可显著降低患者血清和关节液Chemerin、TWEAK表达水平,减轻炎症反应。
Objective To investigate the clinical effect of Kanggu Zengsheng Capsules combined with Diacerein Capsules in the treatment of knee osteoarthritis and to observe their influence on chemerin and tumor necrosis factor-like weak inducer of apoptosis(TWEAK)in the serum and synovial fluid.Methods One hundred and fifty patients with knee osteoarthritis were randomized into the study group and the control group,75 cases in each group.The control group was treated with Diacerein Capsules,and the study group was treated with Kanggu Zengsheng Capsules combined with Diacerein Capsules.Four weeks constituted a course of treatment,and the treatment for the two groups lasted for 3 continuous courses.Before and after treatment,the scores of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),visual analog scale(VAS)knee pain scores,Lysholm knee scale(LKSS)scores,and inflammatory factors such as interleukin 1(IL-1),interleukin 6(IL-6)and cyclooxygenase 2(COX-2)as well as the expression levels of chemerin and TWEAK in the serum and synovial fluid of the two groups were observed.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After treatment for 3 courses,the total effective rate of the study group was 90.7%(68/75),and that of the control group was 77.3%(58/75).The intergroup comparison showed that the clinical efficacy of the study group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,WOMAC scores and VAS scores in the two groups were obviously decreased and LKSS scores were obviously increased in comparison with those before treatment(P<0.01).The intergroup comparison after treatment showed that the study group had stronger effect on decreasing WOMAC scores and VAS scores and on increasing LKSS scores than the control group(P<0.01).(3)After treatment,serum levels of IL-1,IL-6,and COX-2 in the two groups were significantly decreased in comparison with those before treatment(P<0.01),and the study group had stronger effect on decreasing the serum levels of IL-1,IL-6,and COX-2 than the control group(P<0.01).(4)After treatment,the expression levels of chemerin and TWEAK in the serum and synovial fluid of the two groups were significantly decreased in comparison with those before treatment(P<0.01),and the study group had stronger effect on decreasing the expression levels of chemerin and TWEAK in the serum and synovial fluid than the control group(P<0.01).(5)During the trial,the difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion Kanggu Zengsheng Capsules combined with Diacerein Capsules have more clinical advantages in the treatment of knee osteoarthritis than Diacerein Capsules alone,which can significantly decrease the expression levels of chemerin and TWEAK in the serum and synovial fluid,and relieve the inflammatory response.
作者
李国伟
李文霞
仝允辉
王源
LI Guo-Wei;LI Wen-Xia;TONG Yun-Hui;WANG Yuan(Dept.of Osteoarthritis,Luoyang Bone-setting Hospital(Henan Orthopedic Hospital),Luoyang 471000 Henan,China)
出处
《广州中医药大学学报》
CAS
2021年第4期663-669,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
抗骨增生胶囊
双醋瑞因
膝骨关节炎
趋化素
肿瘤坏死因子样弱凋亡诱导因子
Kanggu Zengsheng Capsules
Diacerein Capsules
knee osteoarthritis
chemokine
tumor necrosis factor-like weak inducer of apoptosis(TWEAK)
