| 毕春强,乌达美,谢 飞,宋 雪,杨大伟.独活寄生汤联合关节腔内注射玻璃酸钠对肝肾亏虚型膝骨关节炎患者关节液Wntβ-catenin信号通路的影响[J].,2022,(15):2883-2887 |
| 独活寄生汤联合关节腔内注射玻璃酸钠对肝肾亏虚型膝骨关节炎患者关节液Wntβ-catenin信号通路的影响 |
| Effect of Duhuo Jisheng Decoction and Combined with Intra-Articular Injection of Sodium Hyaluronate on Joint Fluid Wntβ-catenin Signaling Pathway of Patients with Knee Osteoarthritis with Liver and Kidney Deficiency |
| 投稿时间：2022-02-23 修订日期：2022-03-18 |
| DOI：10.13241/j.cnki.pmb.2022.15.016 |
| 中文关键词: 独活寄生汤 玻璃酸钠 肝肾亏虚型 膝骨关节炎 Wntβ-catenin 信号通路 |
| 英文关键词: Duhuo Jisheng decoction Sodium hyaluronate Liver and kidney deficiency Knee osteoarthritis Wntβ- catenin Signaling pathway |
| 基金项目:北京市中医药科技项目（JJ2016-21）；中国中医科学院广安门医院南区院级课题（Y2019-08） |
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| 中文摘要: |
| 摘要 目的：观察独活寄生汤联合关节腔内注射玻璃酸钠治疗肝肾亏虚型膝骨关节炎（KOA）的疗效及对关节液Wntβ-catenin信号通路的影响。方法：选取我院2019年1月-2020年12月收治的80例肝肾亏虚型KOA患者，按随机数字表法分为对照组（40例，关节腔内注射玻璃酸钠治疗）和观察组（40例，独活寄生汤联合关节腔内注射玻璃酸钠治疗），观察两组治疗后的临床总有效率，对比两组治疗前后中医证候积分，西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、Lequesne指数、疼痛视觉模拟量表（VAS）评分，关节液白细胞介素-6 （IL-6）、肿瘤坏死因子-α（TNF-α）和白细胞介素-1（IL-1）的水平，关节液Wnt-5a mRNA、β-catenin mRNA表达量。结果：与对照组相比，观察组的临床总有效率更高（P<0.05）。治疗后，两组膝关节疼痛、腰膝沉重、下肢酸楚、活动不利、神疲乏力、畏寒肢冷评分较治疗前下降，且观察组低于对照组（P<0.05）。治疗后，两组Lequesne指数评分、WOMAC评分、VAS评分较治疗前下降，且观察组低于对照组（P<0.05）。治疗后，两组关节液IL-6、TNF-α、IL-1水平较治疗前下降，且观察组较对照组低（P<0.05）。治疗后，两组关节液Wnt-5a mRNA、β-catenin mRNA表达量较治疗前下降，且观察组低于对照组（P<0.05）。结论：独活寄生汤联合关节腔内注射玻璃酸钠治疗肝肾亏虚型KOA，可促进症状改善，提高临床总有效率，降低关节液炎症因子水平，其作用机制可能与调节Wntβ-catenin信号通路有关。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the curative effect of Duhuo Jisheng decoction combined with intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis (KOA) with liver and kidney deficiency and its effect on joint fluid Wntβ-catenin signaling pathway. Methods: 80 KOA patients with liver and kidney deficiency who were treated in our hospital from January 2019 to December 2020 were selected, according to the random number table method, they were divided into control group (40 cases, treated with intra-articular injection of sodium hyaluronate) and observation group (40 cases, treated with Duhuo Jisheng decoction combined with intra-articular injection of sodium hyaluronate). The total clinical effective rates of the two groups were observed, and the osteoarthritis indexes of Western Ontario and McMaster Universities in the United States (WOMAC), Lequesne index, pain visual analogue scale (VAS) score, joint fluid interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1) levels, the articular fluid Wnt-5a mRNA, β-catenin mRNA expression levels in two groups before and after treatment were compared. Results: Compared with the control group, the total clinical effective rate of the observation group was higher(P<0.05). After treatment, the scores of knee pain, heavy waist and knee, lower limb soreness, restricted activity, mental fatigue and chilly limbs in two groups decreased compared with those before treatment, and the observation group was lower than the control group(P<0.05). After treatment, the Lequesne index score, WOMAC and VAS scores in two groups decreased compared with those before treatment, and the observation group was lower than the control group (P<0.05). After treatment, the joint fluid IL-6, TNF-α and IL-1 levels in the two groups were lower than those before treatment, and the observation group was lower than the control group (P<0.05). After treatment, the Wnt-5a mRNA and β-catenin mRNA expression levels in the two groups were decreased compared with before treatment, and the observation group was lower than the control group (P<0.05). Conclusion: Duhuojisheng decoction combined with intra-articular injection of sodium hyaluronate in the treatment of KOA with liver and kidney deficiency can promote the improvement of symptoms, improve the total clinical effective rate and reduce the level of articular fluid inflammatory factors. Its mechanism may be related to the regulation of Wntβ- catenin signaling pathway. |
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