The Clinical Effect Of Duhuojisheng Decoction Combined With Extracorporeal Shock Wave On Knee Osteoarthritis And Explore Its Effect Mechanism

Objective:Observe the clinical effect of Duhuojisheng Decoction combined with Extracorporeal Shock Wave on Knee Osteoarthritis.And test the expression of Interleukin-1β(IL-1β),Superoxide Dismutase(SOD)and Matrix Metalloproteinase-3(MMP-3)in joint fluid to discuss it’s mechanism.Methods: Collects 87 cases(87 knees)KOA patients as study subjects from December in 2014 to June in 2016,all the patients were diagnosed by outpatient department.They were divide into three groups at randomly.Control group(27 cases)were treated with celecoxib,chinese medicine group(32 cases)were treated with Duhuojisheng decoction,and combine group(28 cases)were treated with extracorporeal shock wave on the basis of the chinese medicine group.Then The limb pain visual analogue score(VAS)and The Lysholm’s functional score were recorded respectively before treatment and after treatment in the 4,12,and 24 weeks,and judged the clinical curative effect in the 24 weeks.Also,the expression of IL-1β,SOD and MMP-3 in the joint fluid of thetwo groups were detected respectively at the same time.Results:(1)The result of clinical effect:(1)Comparison in one group in VAS and Lysholm’s functional score:After treatment 4,12 and 24 weeks had significant difference compared with pre-treatment in both VAS and Lysholm’s functional score(P<0.05).It is shows that the three treatments can reduce KOA patiants’ VAS and Lysholm’s functional score.(2)Comparison between groups in VAS and Lysholm’s functional score:There were no significant difference between the two group in VAS and Lysholm’s functional score at pre-treatment(P>0.05).And there were no significant difference between the chinese medicine group and control group in VAS and Lysholm’s functional score at 4,12 and 24 weeks(P>0.05).But there were significant difference between the combine group and chinese medicine group or control group in VAS and Lysholm’s functional score at 4,12 and 24 weeks(P < 0.05).It is shows that the chinese medicine group and control group have the same effection on down-regulation VAS score and up-regulation Lysholm’s functional score,but the combine group are better than others.(3)The clinical curative effect: The result of judging the clinical curative effect in the 24 weeks shows: the excellence rate of combine group was 82.1%,the excellence rate of chinese medicine group was 62.5%,and the excellence rate of control group was 62.9%,there was no significant difference between chinese medicine group and control group(P>0.05),there wassignificant difference between the combine group and chinese medicine group or control group(P<0.05).It is shows that the chinese medicine group and control group have the same clinical effect,but the combine group are better than others.(2)The result of the expression of IL-1β,SOD and MMP-3:(1)Comparison in one group in IL-1β,SOD and MMP-3: After treatment4,12 and 24 weeks had significant difference compared with pre-treatment in IL-1β,SOD and MMP-3(P<0.05)..It is shows that three treatments can reduce the expression of IL-1β and MMP-3 and increase the expression of SOD.(2)Comparison between groups in IL-1β,SOD and MMP-3: There were no significant difference between the two group in IL-1β,SOD and MMP-3 at pre-treatment(P>0.05).And there were no significant difference between the chinese medicine group and control group in IL-1β,SOD and MMP-3 at 4,12 and 24 weeks(P>0.05).But there were significant difference between the combine group and chinese medicine group or control group in IL-1β,SOD and MMP-3 at 4,12 and24 weeks(P < 0.05).It is shows that the chinese medicine group and control group have the same effection on down-regulation the expression of IL-1β and MMP-3 and up-regulation the expression of SOD,but the combine group are better than others.Conclusion(s):(1)The treatment of Duhuojisheng Decoction combined with Extracorporeal Shock Wave on KOA can significantlyreduce the knee joint pain,improve the function of the knee joint and improve the patient’s quality of life.(2)The mechanism of Duhuojisheng Decoction combined with Extracorporeal Shock Wave on KOA may be cutting the expression of IL-1β and MMP-3 and up-regulating the expression of SOD to delaying the progression of the KOA.