Objective: To observe the clinical efficacy of Duhuo Jisheng Tang in the treatment of liver-and-kidney-deficiency type knee osteoarthritis (KOA)

and analyze the changes in small molecule compounds in synovial fluid before and after treatment with Duhuo Jisheng Tang. Method: A total of 73 patients with KOA diagnosed at the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine were selected and randomly divided into observation group (42 cases) and control group (31 cases). The observation group was treated with Duhuo Jisheng Tang

150 mL/time

2 times a day

for oral administration. The control group was given glucosamine sulfate capsules

0.5 g/time

3 times a day

for oral administration. Two groups were treated for a month. Visual analogue scale score (VAS)

Western Ontario and McMaste Universities (WOMAC)

self-made knee joint swelling score and comprehensive therapeutic response were taken as clinical outcome indexes. Synovial fluid of all of the patients with KOA was extracted before and after treatment. Supernatant liquid chromatograph and component analysis were used to analyze the differences in synovial fluid metabolism between two groups before and after treatment. PCA potential difference biomarkers were analyzed by EZinfo 2.0 software. Result: After 1 month of treatment

the scores of VAS

WOMAC and knee swelling of the patients in two groups were significantly alleviated compared with those before treatment (P<0.05). After 1 month of treatment

compared with control group

VAS

WOMAC

knee swelling score

comprehensive treatment response evaluation in observation group were significantly higher (P<0.05). Compared with before treatment

in observation group and control group

the levels of pantothenic acid in the knee joint fluid

the expression of tyrosine

tyrosine and the expression of benzoic acid

citric acid and proline were increased after treatment (P<0.05). Compared with control group

the expressions of pantothenic acid

kynurenine and tyrosine in the synovial fluid in observation group were lower

the expressions of benzoic acid

citric acid and proline were higher (P<0.05)

and the expressions of taurine

β-cryptoxanthin and lysine in synovial fluid of observation group were significantly increased (P<0.05). Conclusion: Duhuo Jisheng Tang could reduce joint pain

swelling degree

and improve the range of activities and the quality of life of patients with liver-and-kidney-deficiency type KOA. At the same time

the expressions of pantothenic acid

kynurenine

tyrosine

benzoic acid

citric acid

proline

taurine

β-cryptoxanthin and lysine in synovial fluid were also changed with the improvement of symptoms in liver-and-kidney-deficiency type KOA patients.