| OBJECTIVE: To explore the possible mechanism of osteoarthritis intervention in the lumbar degeneration model of rats,and to observe the clinical effect of Gubi Mixture in the intervention of lumbar osteoarthritis.METHODS: Twelve healthy SD rats aged 15 days were placed in different cages and kept alone until the young rats were born.On the 10 th day after the birth of the pups,88 young rats were randomly divided into the blank control group,the saline group,the Gubi Mixture group and the aminoglycosin group.The four groups underwent abdominal anesthesia to remove the forelimbs.At the age of 5 months,the rats in the two groups of rats were given the corresponding drug intervention in the saline group,the Gubi Mixture group and the aminoglycosin group.The blank control group did not do any intervention.After 4 weeks of continuous intervention,the rats in each group were sacrificed.The lumbar spine specimens were examined by HE,red staining and green staining for histomorphology,bone metrology analysis,Real-Time PCR and western blot to detect Aggrecan,COL-II,MMP-13,IL-6,ALP and OPG.Sixty-six patients with lumbar osteoarthritis who met the inclusion criteria were randomly divided into the Gubi Mixture group and the western medicine control group.The intervention time was 4 weeks,before treatment,2 weeks,4 weeks,and 8weeks after treatment.The node was evaluated by the improved JOA evaluation of low back pain,VAS and Roland-Morris scores.RESULTS: The HE and red-green staining of the Gubi Mixture group showed that the lumbar intervertebral disc annulus structure was still intact,the collagen fibers were rough,and the glass fibers were slightly changed.The expression of fibroblasts between collagen fibers increased,the nucleus pulposus slightly shrunk,and the cartilage endplate was intact.The growth cartilage is closely arranged.The structure of the anesthetic group of the glycosaminoglycan group is still intact,the collagen fibers are rough and slightly glassy,the expression of fibroblasts between collagen fibers is increased,the nucleus pulposus slightly shrinks,and the calcification layer of the endplate becomes thick.The blank control group and the saline group had several large radial fissures,which were separated from the cartilage endplates.Part of the nucleus pulposus is separated from the annulus fibrosus and has a partial tendency.The cartilage endplate has signs of destruction and is partially separated from the vertebral body.The Gubi Mixture group analysis showed that the trabecular bone ofthe lumbar cartilage endplate was dense,with small separation and large area,and it was statistically significant compared with the other three groups(P<0.05).Real-Time PCR detection of rat lumbar intervertebral discs showed that the expression of COL-II m RNA was significantly up-regulated compared with other groups(P<0.05);MMP-13 m RNA expression was significantly lower than other groups(P<0.05);The expression of Aggrecan m RNA in the group was significantly higher than that in the other three groups(P<0.05).Real-Time PCR was used to detect the expression of IL-6m RNA in the lumbar vertebral body.The expression of the aminoglycoside group and the Gubi Mixture group were lower than those of the blank control group.The saline group was down-regulated(P<0.05),and the expression level of the aminoglycosin group was lower than that of the Gubi Mixture group(P<0.05).The expression of ALP and OPG m RNA suggested that the Gubi Mixture group was significantly up-regulated compared with other groups(P<0.05).).Western blot analysis of intervertebral disc tissue showed that the content of COL-II and Aggrecan protein in the Gubi Mixture group was up-regulated compared with other groups(P<0.05),while the expression of MMP-13 protein was down-regulated compared with other groups(P<0.05).The OPG bone sputum Gubi Mixture group was significantly up-regulated compared with the other groups(P<0.05),and the IL-6protein expression level was the lowest in the aminoglycosin group.The VAS,Roland-Morris scores and modified JOA scores at the 2nd,4th,and 8th week after intervention in the Gubi Mixture group and the western medicine control group were compared.The two groups were compared before and after treatment(P<0.05).Among the VAS scores,there was no significant difference between the two groups at the 2nd week and the 4th week(P>0.05),but at the 8th week,the VAS score of the Gubi Mixture group was better than the western medicine control group(P<0.05).In the JOA score,there was a significant difference between the two groups at the 4th week and the 8th week(P<0.05).In the Roland-Morris score,the two groups began to show significant differences at the 4th week and the 8th week(P<0.05).The Roland-Morris score showed that lumbar dysfunction continued to improve after 4weeks of treatment,and the score of the Gubi Mixture group was superior to the western control group.Compared with the improved JOA score,the effective rate was96.97%,the effective rate was 66.67%,the effective rate of western medicine control group was 87.87%,and the effective rate was 57.58%.There was no significant difference between the two groups(P >0.05).Conclusion: Gubi mixture can delay the degeneration of intervertebral disc and endplate trabecular bone in the model of lumbar degeneration of double forelimb erect rats.At the same time,both osteophyte and dexamethasone can protect the degeneration of cartilage endplate of lumbar intervertebral disc tissue.Gubi mixture may play a part in delaying the degeneration of intervertebral disc tissue in the model of lumbar degenerative degeneration of the anterior extremity erectile rat by up-regulating COL-II,Aggrecan m RNA and down-regulating MMP-13 m RNA and protein expression,and the Gubi mixture may be inhibited.The expression of IL-6 m RNA and protein,up-regulation of ALP and OPG m RNA expression plays a part in the mechanism of vertebraldegeneration in the lumbar degenerative model of double forelimb erectile rats.There was no significant difference in the overall clinical efficacy rate between the two groups.However,the comparison of the scores of the nodes in the 8th week showed that the Gubi Mixture group can control the follow-up effect of pain,improve the quality of life of patients,effectively improve the symptoms and signs of low back pain,and stabilize the symptoms during recovery.The aspect is superior to the western medicine control group,which indicates that the comprehensive treatment of increasing the Gubi Mixture can improve the life dysfunction index of patients with lumbar osteoarthritis and stably maintain the recovery symptoms of patients.With the extension of the course of treatment,the difference in curative effect is more obvious. |
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