Tcm Practices Research On The Role Of Effect And Its Mechanism Of Osteoarthritis

Objective: The Objective of this research is to explore the effects ofmanipletion preclusure of traditional Chinese medicine of the degenerativeosteoarthritis and their mechanism. Summarizing and improving Treatment oftraditional Chinese medicine(TCM),we adopted a series of pathological andclinical index, including physiology, biochemistry, molecphysiology, pathologyand clinical medicine, to evaluate therapeutic effect and affective mechanism.We want to provide modern medicine's theoretical base for Treatment oftraditional Chinese medicine (TCM) and carry forward the cream of Treatmentof traditional Chinese medicine(TCM).Methods: In this study, 24 Japanese big-eared rabbits were divided randomlyinto three groups: normal group(A), model group(B) and treated group(C).Every group included 8 Japanese big-eared rabbits and raised with one rabbit inone cage. The model of rabbits knee OA was established by ligating the rightfemoral vein in the model group(B) and treated group(C). 8 weeks aftermodeling, the rabbits in the treated group were treated by manipulations at rightknee of rabbit 15 minutes a time, two times a day for three weeks. The rabbits inthe model group(B) and treated group(C) were treated by nothing. The 3 groupsraised with separated cage and the raising way were the same3 weeks later, the intraosseous pressure were measured, the samples ofthree groups were taken to measure:①SOD activity using a modification of xanthenes oxides(XO) method.②MDA content using a thiobarbituric and(TBA) colorimetric method in synovim tissue of right knee.③CRP content inserum in rabbits of three groups.④content of hyaluronate (HA) in synovialfluid in synovial fluid in right knee of rabbits.⑤activity of plasminogenactivator (PA) and inhibitor of PA(PAI) in cartilage.⑥concentrations of nitricoxide(NO) in synovium.⑦at the same time articular cartilage of internalcondyle of right femur were taken to observe pathologic changes.The results showed as follows:①SOD activity in synovium tissue in themodel group(B) was much higher than that in the normal group(A).②the MDAcontent in the model group(B) was much lower than the in the normal group(A).③the serum CRP content in the model group(B) was much higher than the inthe normal group(A). There were significant differences (P＜0.01) in these valuesbetween the two groups. On the contrary, no apparent differences (P＞0.05) werefound in these values between the treated group(C) and the normal group(A).The SOD activity elevated, the MDA content reduced and the CRP contentdropped obviously in the treated group(C) compared with that in the modelgroup(B). These values differed signify cantly (P＜0.01) between the twogroups.④The HA content in synovial fluid in the treated group(C) was higherthan that in the model group(B), and there was significant difference (P＜0.05)between the two groups. But there were no difference (P＞0.05) between thetreated group(C) and the normal group(A).⑤there was no significant difference(P＞0.05) in levels of PA and PAI in cartilage and the normal group(A) compared with the model group(B), the PA activity in cartilage of the treatinggroup increased, while the PAI activity decreased. There was significantdifference (P＜0.05) between the two groups.⑥There was no significantdifference (P＞0.05) in the NO concentrations in synoviam tissue between thetreated group(C) and the model group(B).⑦Histomorphologic observationsrevealed: in the model group(B), surface of articular cartilage roughered andfissured, cartiale cells decreased, clusteres, degenerated and arrangement wasdisturbes, tidemark indistincted, synovium presented a significant degree ofinflammation, characterized by marked swell, engorgenment and hypertrophy,synovial cells and fiber proliferated highly, and infiltrated by inflammatorycells. In the treated group(C), surface of articular cartilage was smooth,cartilage cells increased and arrangement improved, tidemark was intack,synovium thickened, but no congestion, swell and inflammatory cells werefound.⑧The intraosseous pressure of upper tibia is lower in the treated group(C)than the model group(B) striking (P＜0.01).Clinincally, we selected 80 patient from department of orthopedics inHubei Province Chinese Medicine hospital, the time ranged from January 1st2005 to January 1st 2006, in those, man was 37, woman was 43, their treatmentwas nonsurgical operation. 80 knees were divided into 2 groups random, groupA and group B. Group A contained 52 knees, man was 22, woman was 30, 52knees with degenerative osteoarthritis were treated by manipulation technique15 minutes a time, 2 times a day for 5 weeks. Group B contained 28 knees, man was 11, woman was 17, treated by HA injection in knee, 2ml (20mg) a time, 1times a day for 5 weeks.The symptoms and the Signs of pain swelling tenderness and disabilitywere ased as evaluation indexes of effects of treatment, according to the Scoring,the results showed that the effects of this technique are satisfactory to thepatients.Conclusion: The results of the experimental and clinical study suggestedthat the manipulation predusure has a evident effect on protecting articularCartilage from degenerative changes, prophylaxis and treatment of OA byimproving intraosseous and local tissue microcirculation, inhibiting excessivegrenerating of NO in synovium tissue to decrease liberating and cleffusion of inflammagory substance, dropping PA activity in cartilage, elevating PAI activityto eliminate the intemal factors that resulted in articular cartilage drgenerationand increasing HA contents in synovial fluid.