| Knee osteoarthritis (KOA) is the main cause of older knee pain and disability, its dysfunction due to discomfort as well as the quality of life of patients having adverse effects. According to TCM syndrome differentiation theory, the overall concept and the guidance of Chinese medicine treatment of the disease targeted significant effect, and long-term effects, they could fundamentally control the disease's development, a permanent cure. In this study, finishing in the system knowledge of medicine to the KOA on the basis of relevant literature, the establishment of animal models and clinical studies carried out to explore the pathogenesis of the KOA and Chinese medicine treatment of KOA's effectiveness and feasibility of prevention and treatment. for Chinese medicine, KOA provide reliable experimental data and solid theoretical basis.Objective:To observe the Joint pain relief capsule in experimental knee pain of osteoarthritis of serum, synovial fluid biochemical parameters, free radicals, cytokines, and cartilage cells, cartilage matrix and synovial effects and to explore its mechanism of pathogenesis and clinical efficacy. Methods:New Zealand rabbits were randomly divided into four groups, A normal group, B model group, C control group, D treatment group. After modeling of the serum, the content of synovial fluid SOD, NO and free radicals, cytokines, iNOS content of cartilage and synovial membrane is to determine. cartilage cells, cartilage matrix, synovial, etc. and using cell morphology, biochemical cartilage, cartilage nuclear DNA content in image analysis, TUNEL to analyze the indicators such as observation of cartilage death; to observe the standards met the inclusion of 120 patients with knee osteoarthritis according to the principle of randomization into 2 groups, respectively, joint pain relief capsule in treating 60 patients, bolus control group,60 cases.4 weeks for a course of treatment, medication for 12 weeks (three courses) and to evaluate the effect observed after treatment.Results:By measuring the serum of rabbit knee joint fluid of SOD, NO, IL-1, TNF-α, MMP-1 and iNOS content in cartilage and synovium that joint pain can reduce the articular capsule in NO, iNOS, IL-1, TNF-a and oxygen free radical content and activity of MMP-1, increased SOD content of intra-articular, with the control group there was significant difference (P<0.05). The nuclear DNA content in rabbit cartilage image analysis showed that the Joint pain relief capsule can significantly reduce the pain of rabbit cartilage nucleus heterochromatin number compared with the control group, no significant difference (P> 0.05); by cartilage biochemical determination, showing joint pain capsules with the promotion of rabbit cartilage matrix synthesis, inhibiting its degradation in the control group showed no significant difference (P> 0.05), combined with Masson staining confirmed that joint pain capsules also have to stop rabbit cartilage collagen transformation. End in situ labeling, agarose gel electrophoresis showed that joint pain capsules can reduce endogenous oxidative DNA damage, reduced DNA cleavage and the number of low molecular weight fragments, reducing the number of apoptotic chondrocytes; histologically proven treatment group can prevent articular cartilage collagen type of change, significant cartilage repair. Clinical studies have shown that treatment group was 52.63%, 84.21% total efficiency, control group was 27.59%, total effective rate 68.97%, in comparison with a significant difference (P<0.05); clinical symptoms improved, the increase patient self-care ability and social function of activity and improve quality of life, has very important significance.Conclusion:The results showed that the joints NO, iNOS, IL-1, TNF-a, MMP-1 and oxygen free radicals are caused by knee osteoarthritis important medium; chondrocyte apoptosis excessive degeneration of articular cartilage may be the important one of the reasons The endogenous oxidative DNA damage is its molecular pathological mechanisms; cartilage cell morphology, cartilage matrix changes in knee osteoarthritis is the main pathological changes. Joint pain relief capsule in treating knee OA pain mechanism of action may improve immunity, improve cartilage cell function, promote cartilage repair; suppress synovitis of change, slow down cartilage degeneration; microcirculation and hemorheology, reduce intraosseous pressure; reduce synovial fluid NO, IL-1 and TNF-a content and activity of MMPs, reduced iNOS expression in cartilage and synovium, removing oxygen free radicals, improve the activity of SOD, which played slow the degeneration of cartilage, promoting cartilage repair. This study of Chinese medicine for the prevention and treatment of knee osteoarthritis to provide a reliable experimental data and solid theoretical basis. |
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