独活续断汤口服和离子导入治疗肝肾亏虚型膝骨关节炎患者疗效及对膝关节液SDF-1/CXCR4信号通路的影响

刘胜; 刘玲; 房纬; 海兴华

doi:10.13422/j.cnki.syfjx.20192122

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独活续断汤口服和离子导入治疗肝肾亏虚型膝骨关节炎患者疗效及对膝关节液SDF-1/CXCR4信号通路的影响

临床 | 更新时间：2021-02-09

- 独活续断汤口服和离子导入治疗肝肾亏虚型膝骨关节炎患者疗效及对膝关节液SDF-1/CXCR4信号通路的影响
- Effect of Duhuo Xuduan Tang for Oral Administration and Iontophoresis on SDF-1/CXCR4 Signaling Pathway and Relevant Factors of Cartilage Degradation in Knee Joint Fluid of Patients with Knee Osteoarthritis with Liver and Kidney Deficiency
- 中国实验方剂学杂志 2020年26卷第5期页码：69-74
- 作者机构：
  
  1.天津中医药大学　第一附属医院，天津　 300193
  2.天津市第四中心医院，天津　 300140
- 作者简介：
  
  [第一作者]　刘胜，副主任医师，从事软组织损伤疾病的发病机制与治疗研究，E-mail：xygjjzz@sina.com
  *房纬，主任医师，从事软组织损伤疾病的发病机制与治疗研究，E-mail：zydujinli@126.com
- 基金信息：
  
  国家自然科学基金项目(81603711)
- DOI：10.13422/j.cnki.syfjx.20192122
  中图分类号： R22; R242; R2-031;R287
- 收稿日期：2019-04-15，
  
  网络出版日期：2019-07-17，
  
  纸质出版日期：2020-03-05
- 稿件说明：
移动端阅览
刘胜, 刘玲, 房纬, 等. 独活续断汤口服和离子导入治疗肝肾亏虚型膝骨关节炎患者疗效及对膝关节液SDF-1/CXCR4信号通路的影响[J]. 中国实验方剂学杂志, 2020,26(5):69-74.

Sheng LIU, Ling LIU, Wei FANG, et al. Effect of Duhuo Xuduan Tang for Oral Administration and Iontophoresis on SDF-1/CXCR4 Signaling Pathway and Relevant Factors of Cartilage Degradation in Knee Joint Fluid of Patients with Knee Osteoarthritis with Liver and Kidney Deficiency[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 69-74.
刘胜, 刘玲, 房纬, 等. 独活续断汤口服和离子导入治疗肝肾亏虚型膝骨关节炎患者疗效及对膝关节液SDF-1/CXCR4信号通路的影响[J]. 中国实验方剂学杂志, 2020,26(5):69-74. DOI： 10.13422/j.cnki.syfjx.20192122.

Sheng LIU, Ling LIU, Wei FANG, et al. Effect of Duhuo Xuduan Tang for Oral Administration and Iontophoresis on SDF-1/CXCR4 Signaling Pathway and Relevant Factors of Cartilage Degradation in Knee Joint Fluid of Patients with Knee Osteoarthritis with Liver and Kidney Deficiency[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 69-74. DOI： 10.13422/j.cnki.syfjx.20192122.

摘要

目的：

观察独活续断汤口服和离子导入治疗肝肾亏虚型膝骨关节炎(KOA)的临床疗效及对基质细胞衍生因子-1(SDF-1)/C-X-C趋化因子受体4型(CXCR4)信号通路的影响。

方法：

将150例天津中医药大学第一附属医院确诊的肝肾亏虚型KOA患者随机分为对照组、中药口服组和中药离子导入组，每组各50例，对照组给予硫酸氨基葡萄糖胶囊，口服0.5 g/次，2次/d口服，中药口服组给予独活续断汤150 mL/次，2次/d口服，中药离子导入组给予独活续断汤，于髋骨穴、膝关穴、膝眼穴及犊鼻穴进行离子导入，30 min/次，1次/d，三组患者均治疗4周；观察入组患者治疗前后膝关节肿胀程度及疼痛程度变化，并统计临床疗效；酶联免疫夹心吸附测定检测入组患者治疗前后膝关节液中SDF-1，CXCR4，基质金属蛋白酶-3(MMP-3)及MMP-13含量。

结果：

中药口服组疗效优于中药离子导入组和对照组，且复发率最低(

0.05)；与本组治疗前比较，中药口服组治疗后压痛值升高(

0.05)，中药口服组患者视觉模拟评分(VAS)，膝关节肿胀评分、西安大略麦马斯特大学骨关节炎指数评分(WOMAC)及膝关节液SDF-1，CXCR4，MMP-3及MMP-13蛋白含量均降低(

0.05)，且优于中药离子导入组和对照组(

0.05)。

结论：

独活续断汤口服及离子导入治疗肝肾亏虚型KOA均有明显疗效，但口服疗效最佳，其机制可能与抑制SDF-1/CXCR4炎症信号通路及软骨细胞降解有关。

Abstract

Objective:

To observe the clinical efficacy of Duhuo Xuduan Tang for oral administration and iontophoresis in the treatment of knee osteoarthritis (KOA) with liver and kidney deficiency and its effect on stromal cell-derived factor-1 (SDF-1)/C-X-C chemokine receptor type 4 (CXCR4) signaling pathway.

Method:

Totally 150 KOA patients with deficiency of liver and kidney diagnosed in the Teaching Hospital of Tianjin University of Traditional Chinese Medicine(TCM) were randomly divided into control group

oral TCM group and iontophoresis group

with 50 cases in each group. The control group was given glucosamine sulfate capsule

0.5 g/time

twice a day

while the oral TCM group was given Duhuo Xuduan Tang

150 mL/time

twice a day. In the iontophoresis group

Duhuo Xuduan Tang was administered at Kuangu acupoint

Xiguan acupoint

Xiyan acupoint and Dubi acupoint for iontophoresis for 30 minutes

once a day. All of the three groups were treated for 4 weeks. The swelling degree and the pain degree of knee joint before and after treatment were observed

and the clinical efficacy was recorded. The protein contents of SDF-1

CXCR4

matrix metalloproteinase-3 (MMP-3) and matrix metalloproteinase-13 (MMP-13) in knee joint fluid before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA).

Result:

The efficacy of oral TCM group was better than that of iontophoresis group and control group

and the recurrence rate was the lowest (

0.05). Compared with before treatment

the tenderness increased

whereas visual analogue scale(VAS) score

knee swelling score

The Western Ontario and McMaste Universities (WOMAC) score and SDF-1

CXCR4

MMP-3 and MMP-13 protein content in knee joint fluid decreased in oral TCM group after treatment

which were better than those in iontophoresis group and control group (

0.05).

Conclusion:

Duhuo Xuduan Tang for oral administration and iontophoresis has an obvious effect on KOA with liver and kidney deficiency

with the best effect through oral administration. Its mechanism may be related to the inhibition of SDF-1/CXCR4 inflammatory signaling pathway and cartilage decomposition.

关键词

Keywords

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