| Objective1.Published articles about Xianling Gubao capsule for KOA were searched on the related retrieval platform and prepared for meta analysis.The published time were setted from December 2013 to January 2019.The inclusion and exclusion criteria were formulated,the documents were screened and the data were extracted,and the relevant statistical analysis was carried out by using Revman 5.3 software.2.To investigate the effect of Xianling Gubao capsule on the expression of Caspase3,ER a,and ERR a in articular cartilage of KOA rats.Method1.Published articles about Xianling Gubao capsule for KOA were searched on the related retrieval platform(pubmed,Cochrane Library,Web of science,EMbase Wanfang,Vip,China’s full-text database).The published time were setted from December 2013 to January 2019.The inclusion and exclusion criteria were formulated,the documents were screened and the data were extracted,and the relevant statistical analysis was carried out by using Revman 5.3 software.2.24 female Sprague-Dawley rats were randomly divided into experimental group,positive control group,negative control group,and blank group(6 rats/group).The rats in the blank control group only double knee patella were dislocated,and osteoarthritis models were established in the other three groups of rats by disconnection of double anterior cruciate ligament and resection of double medial meniscus.One week after operation,the experimental group was given Xianling GuBao capsule at the ratio of 30.85 mg/100 g,the positive control group was given Celecoxib capsule at the ratio of 11.7 mg/100 g.The blank control group and the negative control group were fed with the same volume of distilled water at the same time.After 1.5 months of continuous administration,Western Blot(WB)was used to detect the expression of Caspase 3,ER a,and ERR a protein.Result1.14 papers were included finally.All the literatures were in Chinese.The total number of cases were 1141,including 568 cases of Xianling Gubao capsule combined with routine treatment group and 573 cases of routine treatment group.Meta analysis showed that:(1)4 literatures comparing the cure rate of KOA in two groups,the cure rate of Xianling Gu Bao capsule combined with routine treatment group was better than that of routine treatment group(Z=2.03,P=0.04,RR=1.39,95%CI[1.01,1.90].(2)11 literatures comparing the total effective rate of KOA treatment between the two groups.The total effective rate of Xianling Gubao capsule combined with routine treatment group was higher than that of routine treatment group(Z=6.18,P<0.00001,RR=1.18,95%CI[1.12,1.25].(3)7 literatures comparing the VAS scores for the treatment of KOA between two groups,and the VAS score of the Xianling Gubao capsule combined with the routine treatment group was lower than that of the routine treatment group(Z=4.34,P<0.0001,RR=-1.17,95%CI[-1.69,-0.64]).(4)2 literatures comparing the JOA scores for the treatment of KOA between two groups,and there was no statistical difference between the two groups(Z=5.20,P<0.00001,RR=1.40,95%CI[0.87,1.92]).(5)6 literatures comparing the Lysholm scores for the treatment of KOA between two groups,and the VAS score of the Xianling Gubao capsule combined with the routine treatment group was higher than that of the routine treatment group(Z=5.48,P<0.00001,MD=13.86,95%CI[9.67,18.05]).(6)5 literatures which compared the adverse reactions of the two groups in the treatment of KOA.The adverse reaction of the Xianling Gubao capsule combined with the routine treatment group was lower than that of the routine treatment group(Z=2.84,P=0.005,MD=0.45,95%CI[0.26,0.78]).2.After 6 weeks of continuous administration,four group of weight comparison by variance homogeneity test were P=0.822>0.05,showing that the variance was homogeneous,and there was a negative correlation between each groups(F=0.18,p=0.9084>0.05).Degeneration of articular cartilage of blank group,experimental group and positive control group is superior to the negative control group.The expression of Caspase 3 protein in blank group,experimental group and positive control group was lower than that in negative control group(P<0.05).The expression of ERR a and ER a protein in blank group,experimental group and positive control group was higher than that in negative control group(P<0.05).There was no significant difference in Caspase3 and ER a protein between the experimental group and the positive control group(P>0.05),but the expression of ERR a protein in the positive control group was higher than that in the experimental group(P>0.05).Conclus ion1.Comparing with routine therapy alone,Xianling Gubao capsule combined with routine group is more effective and safer in the treatment of KOA.2.Xianling Gu Bao capsule may be involved in regulating the apoptosis of articular chondrocytes in KOA rats.The underlying mechanism of its treatment of KOA may be to inhibit the expression of apoptotic protease Caspase3 in chondrocytes by increasing the expression of ERRa and ER α protein.But the specific mechanism still needs deeper research. |
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