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补肾活血祛痹方治疗膝骨关节炎临床疗效及其对血液流变学、抗炎、抗氧化的影响

Keywords: 补肾活血祛痹方,膝骨关节炎

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Abstract:

目的:验证补肾活血祛痹方治疗膝骨关节炎(osteoarthritis,OA)的临床疗效及其相应的作用机制。方法:96例符合膝OA且属肝肾亏虚、经络阻塞症患者按随机数字表分为治疗组(48例),采用补肾活血祛痹中药每日1付治疗;对照组(48例):采用口服双醋瑞因(50mgBid)+塞来昔布(0.2Qd)治疗,均为4周1疗程。通过观察治疗前后VAS评分、Womac评分、Lequesne指数及膝关节休息痛、活动痛、关节压痛、关节活动度,以及全血黏度、血浆黏度、相对黏度、聚集指数、血清IL-1β,NO,iNOS,LPO,SOD等指标变化。同时通过随访和血常规、肝肾功能检测确定不良反应。结果:补肾活血祛痹方剂按西医标准或按中医标准治疗膝OA的临床控制率分别为33.3%,37.5%,有效率为97.9%,明显优于对照组的18.8%,20.8%,95.5%,差别均具有统计学意义,P<0.05或0.01。补肾活血祛痹方能够显著改善42d血液流变学指标,其抑制IL-1β,NO,iNOS,LPO的能力明显优于对照组,分别为58.6%vs47.3%,50.1%vs36%,55.1%vs41.9%,46.7%vs20.6%;(P<0.05或P<0.01)。升高SOD的能力优于治疗组,分别为(2514.71±812.65),(2013.41±781.3),P<0.05。2种治疗方法均未报告不良反应。结论:补肾活血祛痹方治疗膝OA的疗效优于目前临床的常规治疗方案(双醋瑞因+塞来昔布)且无不良反应。

References

[1]  Aigner T,Kim H A,Roach H I. Apoptosis in osteoarthritis.[J] Rheum Dis Clin North Am, 2004,30(3):639.
[2]  Benjamin M,Mcgonagle D. Histopathologic changes at "synovio-entheseal complexes" suggesting a noval mechanism for synovitis in osteoarthritis and spondy larthritis [J].American College of Rheumatology, 2007,56(11):3601.
[3]  Tan A L,Toumi H,Bemjamin M,et al. Combined high resolution magnetic resonance imaging and histological examination to explore the roal of ligaments and tendons in the phenotypic expression of early hand osteoarthritis[J]. Ann Rheum Dis, 2006,65:1267.
[4]  Tan A L,Granger A J,Tanner S F,et al. A high-resolution magnetic resonance imaging study of dital interphalangeal joint arthropathy in psoriatic arthritis and osteoarthritis:are they the same?[J] Arthritis Rheum, 2006,54:1328.
[5]  Chowdhury T,Arghandawis,Brand J,et al. Dynamic compression countercts IL-1beta induced iNOS and COX-2 expression in chondrocyte/agarose constructs [J] .Arthritis Res Ther. 2008,10(2):35.
[6]  Bloma B,Vanderkran P M,Wandenberg W B. Cytokine targeting in osteoarthritis [J].Currdrug Tangets,2007,8(2):283.
[7]  Dionysios J Parachristou,Eugenia Papadakou,Efthimia K Basdra,et al. Involvement of the p38 MAPK-3 NF-κB signal transduction pathway and COX-2 in the pathobiology of meniscus degeneration in humans [J]. Mol Med. 2008,14(3/4):160.
[8]  Chen M H,Wang J L,Wong C Y, et al. Relationship of chondrocyte apoptosis to matrix degradation and swelling potential of osteoarthritic cartilage [J].Formos Med Assoc,2005,104(4): 264.
[9]  Kim H A,Blanco F J. Cell death and apoptosis in osteoarthritic cartilage [J].Curr Drug Targets. 2007,8(2):333.
[10]  Shakibaei M,John T,Schulze-Tanzil G; et al. Suppression of NF-κB activation by curcumin loads to inhibition of expression of cyclo-oxygenase-2 and matrix metalloproteinanse-9 in human articular chondrocytes bimplication for the treatment of osteoarthritis [J]. Biochemical pharmacology, 2007,73(5):1434.
[11]  Durr H D,Martin H,Pellengahr C,et al. The cause of srbchondral bone cysts in osteo arthrosis:a finite element analysis[J]. Acts Orthop Scand, 2004, 75(5):554.
[12]  姚烁,谢人明,孙文基. 当归补血汤现代研究[J]. 中华现代中医杂志,2006,2(6):492.
[13]  杨丽蓉,杨丽. 当归补血汤实验研究[J].实用中医药杂志,2005,21(2):123.
[14]  袁国红,顾立刚. 当归补血汤对血细胞及相关免疫因子的作用[J]. 中国组织工程研究与临床康复,2007,28:5606.
[15]  杨卫东,朱鸿良,赵保路. 丹参的氧自由基清除作用[J].中国药理学通报,1990,6(2):118.
[16]  Qui Y, Rui Y C, Zhang L, et al. VEGF induced hyperpermeability in bovine aortic endothelial cell and inhibitory effect of salvianolic acid B[J]. Acta Pharmacol Sin, 2001,Feb;22(2):117.
[17]  张舰,刘延庆. 南蛇藤属植物的化学成分和药理作用[J]. 国外医学植物药分册,2005,20(5):197.
[18]  佟丽,kamaldmoudgil,陈育尧,等. 南蛇藤提取物对lewis大鼠佐剂性关节炎(AA)预防及治疗作用[J]. 中国免疫学杂志,2008,24(5):124.
[19]  肖长虹,顾为望,张嘉宁,等. 南蛇藤醇提取物对类风湿关节炎话膜增生和软骨侵蚀及降解的抑制作用[J].南方医科大学学报,2007,27(7):945.
[20]  叶任高. 内科学[M]. 6版. 北京:人民卫生出版社, 2005:939.
[21]  中华医学会风湿病学分会.骨关节炎诊治指南(草案)[J].中华风湿病学杂志,2003,7(11):22.
[22]  邱贵兴.骨关节炎诊治指南(2007年版)[J].中华骨科杂志, 2007,27(10):793.
[23]  陈百威,张静.骨关节炎[M]. 北京:人民卫生出版社,2004:18.
[24]  Gencosmanogla B E,Eryavuz M,Dervisoglu S,et al. Effects of some nonsteroidal anti-inflummatory drugs on auricular cartilage of rat in an experimental model of osteoarthritis [J].Res Exp Med,2001,200(3):215.
[25]  郑莜萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002.
[26]  高洁生. 骨关节炎治疗新视角[J].中华风湿病学杂志,2008(12):1.
[27]  李芬,田静,吴轰,等.99 Tc-MDP云克治疗老年发病的风类湿关节炎的临床疗效[J].中国老年学杂志,2006,26(2):264.
[28]  穆荣,陈连,栗占国,等.9s Tc-亚甲基二磷酸盐在类风湿关节炎的疗效及其对炎性细胞因子的抑制作用[J].中华风湿病学杂志,2004,8:39.
[29]  李茂良.云克治疗类风湿性关节炎的特点和治病机制的研究[J].中华风湿病学杂志,2002,6(2):149.
[30]  苏晓华,梁殿权,王效铭.丹参素对大鼠的心肌线粒体氧自由基损伤的保护作用[J].中国病理生理杂志,1992,12(1):20.
[31]  危一松. 丹参水溶性提取物对大鼠心,肝,脑,睾丸脂质过氧化抑制作用[J].赣南医学院学报,1992,12(1):20.
[32]  Luowei Bo,Wang yipping.Magnesium litaospermate B inhibits hypoxia-induced calcium influx and nitric oxide release in indothelial cell[J]. Acta Pharmacol Sin, 2001,22(7):629.
[33]  Xu M, Wang Y P, Luo W B, et al.Salvianolate inhibits proliferation and endothelin release in cultured rat mesangial cells[J]. Acta Pharmacol Sin, 2001, 22(7):629.
[34]  Jizhaoning,Liuguoqing. inhibition of return deprivation induced PCR cell apoptosis by tanshinime ⅡA[J].Acta pharmacol Sin, 2001,22(5):459.

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