[1]黄岩石.独活寄生汤口服联合富血小板血浆关节腔内注射治疗膝骨关节炎的临床研究[J].中医正骨,2021,33(02):1-11.
　HUANG Yanshi.A clinical study of oral application of Duhuo Jisheng Tang(独活寄生汤)combined with intra-articular injection of platelet-rich plasma for treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(02):1-11.
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独活寄生汤口服联合富血小板血浆关节腔内注射治疗膝骨关节炎的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年02期
页码:
1-11
栏目:
临床研究
出版日期:
2021-02-20

文章信息/Info

Title:
A clinical study of oral application of Duhuo Jisheng Tang(独活寄生汤)combined with intra-articular injection of platelet-rich plasma for treatment of knee osteoarthritis
作者:
黄岩石
(南阳市第二人民医院,河南 南阳 473003)
Author(s):
HUANG Yanshi
Nanyang Second General Hospital,Nanyang 473003,Henan,China
关键词:
骨关节炎; 膝;  独活寄生汤;  富血小板血浆;  5-羟色胺;  β-内啡肽;  前列腺素E2;  白细胞介素1β;  白细胞介素6;  肿瘤坏死因子α;  白三烯B4;  基质金属蛋白酶9;  基质金属蛋白酶13;  抗沉默因子1a;  沉默信息调节因子1;  临床试验
Keywords:
osteoarthritis; knee;  DuHuo JiSheng decoction;  platelet-rich plasma;  5-hydroxytryptamine;  β-endorphin;  prostaglandin E2;  interleukin 1β;  interleukin 6;  tumor necrosis factor α;  leukotriene B4;  matrix metalloproteinase 9;  matrix metalloproteinase 13;  anti-silencing factor 1a;  silent mating-type information regulation 2 homolog 1;  clinical trial
摘要:
目的:探讨独活寄生汤口服联合富血小板血浆(platelet-rich plasma,PRP)关节腔内注射治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效和安全性,并初步探讨其作用机制。方法:将104例KOA患者随机分为2组,每组52例。单纯PRP注射组采用PRP关节腔内注射治疗,每2周注射1次,3次为1个疗程,共2个疗程; 联合治疗组在PRP注射的基础上联合独活寄生汤口服治疗,每天1剂,早晚分服,6周为1个疗程,共2个疗程。分别于治疗前以及治疗1个、2个疗程后,记录并比较2组患者膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分,西安大略和麦克马斯特大学(Western Ontario and McMaster Universities,WOMAC)骨关节炎指数,5-羟色胺(5-hydroxytryptamine,5-HT)、β内啡肽(β-endorphin,β-EP)、前列腺素E2(prostaglandin E2,PGE2)、白细胞介素(interleukin,IL)-1β、IL-6、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白三烯B4(leukotriene B4,LTB4)、基质金属蛋白酶(matrix metalloproteinase,MMP)-9、MMP-13血清含量,以及抗沉默因子1a(anti-silencing factor 1a,ASF1a)、沉默信息调节因子1(silent mating-type information regulation 2 homolog 1,SIRT1)mRNA表达量,并观察并发症发生情况。
Abstract:
To explore the clinical curative effects and safety of oral application of Duhuo Jisheng Tang(独活寄生汤,DHJST)combined with intra-articular injection of platelet-rich plasma(PRP)for treatment of knee osteoarthritis(KOA)and to explore its mechanism of action.Methods:One hundred and four KOA patients were enrolled in the study and were randomly divided into monotherapy group and combination therapy group,52 cases in each group.All patients in the 2 groups were treatd with intra-articular injection of PRP,once every 2 weeks for consecutive 2 courses of treatment,three times for each course; moreover,the patients in combination therapy group were treatd with oral application of DHJST,one dose a day in the morning and evening respectively for consecutive 2 courses of treatment,consecutive 6 weeks for each course.The knee pain visual analogue scale(VAS)scores,Western Ontario and McMaster Universities(WOMAC)osteoarthritis index,the serum contents of 5-hydroxytryptamine(5-HT),β-endorphin(β-EP),prostaglandin E2(PGE2),interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α),leukotriene B4(LTB4),matrix metalloproteinase(MMP)-9 and MMP-13 and the mRNA expression levels of anti-silencing factor 1a(ASF1a)and silent mating-type information regulation 2 homolog 1(SIRT1)were recorded and compared between the 2 groups before the treatment and after 1- and 2-course treatment respectively,and the complications were observed.Results:The knee pain VAS scores presented a time-dependent decreasing trend in the 2 groups(combination therapy group:5.48±1.34,2.27±0.48,1.03±0.31 points,F=34.667,P=0.001; monotherapy group:5.63±1.27,3.02±0.61,2.51±0.28 points,F=14.657,P=0.001).The knee pain VAS scores were lower in combination therapy group compared to monotherapy group after 1- and 2-course treatment(t=6.968,P=0.001; t=25.549,P=0.002).The WOMAC osteoarthritis index presented a time-dependent decreasing trend in the 2 groups(combination therapy group:43.25±10.16,24.69±9.07,17.42±8.15 points,F=24.368,P=0.001; monotherapy group:44.07±12.48,30.74±7.65,23.14±10.03 points,F=41.572,P=0.001).The WOMAC osteoarthritis index was lower in combination therapy group compared to monotherapy group after 1- and 2-course treatment(t=3.677,P=0.001; t=3.192,P=0.002).The serum content of 5-HT presented a time-dependent decreasing trend in the 2 groups(combination therapy group:876.59±46.59,677.59±19.79,635.22±15.80 μg/L,F=246.729,P=0.001; monotherapy group:881.34±41.52,701.25±20.61,676.34±17.18 μg/L,F=158.776,P=0.001).The serum content of 5-HT was lower in combination therapy group compared to monotherapy group after 1- and 2-course treatment(t=5.971,P=0.001; t=12.686,P=0.002).The serum content of β-EP presented a time-dependent increasing trend in the 2 groups(combination therapy group:157.68±24.49,233.69±34.27,276.58±31.78 ng/L,F=56.724,P=0.001; monotherapy group:160.05±23.18,198.57±30.50,237.64±35.39 ng/L,F=84.172,P=0.001).

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更新日期/Last Update: 2021-02-20