Objective: To observe the clinical efficacy and part of mechanism of Duhuo Jisheng Tang combined with acupuncture in the treatment of wind cold dampness type knee osteoarthritis (KOA)

in order to provide reference for clinical application. Method: Totally 91 patients with KOA were randomly divided into observation group (49 cases) and control group (42 cases). The control group was given gluconosulfate capsules

0.5 g/time

3 times/days. While the observation group was treated with Duhuo Jisheng Tang

150 mL/time

2 times/days

and the patients were treated with acupuncture at the knee. The course of treatment was 4 weeks. Before and after treatment

the changes in knee joint visual analogue scale (VAS)

Xi'an Ontario McMaster University Osteoarthritis Index (WOMAC) score

traditional Chinese medicine (TCM) symptom score

self-made knee swelling score and comprehensive efficacy and treatment response score were observed

Real-time PCR was used to detect the mRNA expressions of Toll-like receptor-4 (TLR-4) and myeloid factor (MyD88) in synovial fluid of both groups before and after treatment

and the recurrence rates at 3rd and 6th months between both groups were compared. Result: After treatment

VAS

WOMAC

TCM symptom score

self-made knee swelling score and comprehensive efficacy

treatment response score of the two groups of patients were lower than before treatment. Compared with control group

the score was lower in observation group

with statistically significant differences (P<0.05). The expressions of TLR-4 and MyD88 mRNA in the synovial fluid of two groups were lower than those in control group (P<0.05). The total effective rate of observation group

the recurrence rate at 3rd and 6th months were lower than those of control group

with statistically significant differences (P<0.05). Conclusion: Duhuo Jisheng Tang combined with acupuncture has a good efficacy in the treatment of wind cold dampness type KOA

with a low recurrence rate. The mechanism of action may be correlated with the blocking of the TLR-4/MyD88 signaling pathway and the inhibition of the expression of metabolic factors in the downstream chondrocytes and the expression of inflammatory factors.