Study On The Mechanism Of The Treatment Of Knee Osteoarthritis With Blood Stasis By

[Objective]In this work, the effects of water extract of Pileostegia viburnoides on the expressions of COX2, NO, iNOS and pathomorphology of joint tissue in the knee osteoarthritis of rats were evaluated. The influences of extracts of Pileostegia viburnoides combined with Eupolyphaga sinertsis walke on the hemorheological changes in rats with the model of acute blood stasis and tPA and PAI fibrinolytic systems in knee osteoarthritis rats were investigated. The mechanism of efficacy for activating blood circulation in the treatment of knee osteoarthritis was discussed, which may provide some new ideas and methods for clinical treatment of knee osteoarthritis.[Methods]1. The effect of Pileostegia viburnoides water extract on the contents of COX2, NO, iNOS in the blood and joint fluid of rats with knee osteoarthritis was studied. The SD rats were randomly divided into5groups:normal control group, model group, GS-positive group (glucosamine sulfate group), P. Viburnoides middle dose group and P. viburnoides high dose group. The rat model with knee osteoarthritis was built by injecting a mixture of4%papain solution and0.3mol/L cysteine solution (1:1) into the right knee joint of SD rat at the first,3rd and7th days,20μL at a time. The P. viburnoides middle, high dose groups were intragastrically administrated with4.62g/kg and9.24g/kg of P. viburnoides water extract.The GS-positive group was intragastrically administrated with0.15/kg of glucosamine sulfate. The normal control and model groups were intragastricaly administratd with the same volume of distilled water. After4weeks treatment, testing the related index.2. The methods of investigating influences of extracts of Pileostegia viburnoides combined with Eupolyphaga sinertsis walke on the hemorheological changes in rats with the model of acute blood stasis and tPA and FAI fibrinolytic system in knee osteoarthritis rats:The model of acute blood stasis in rats was made by subcutaneously injecting amount of epinephrine and simulating by ice water to test the changes of hemorheologic indexes. Knee osteoarthritis models were copied to detect the changes of tPA, PAI contents in rats plasma.[Results]1. The contents of COX2, NO, iNOS in the blood and joint fluid in high dose group were significantly lower than the model dose group. The results showed that P. viburnoides can effectively inhibit the histomorphologic changes of articular cartilage tissue and indirectly protect cartilage cells and stimulate the recovery of damaged cartilage cells.2. The P. viburnoides mono-therapy group, P. Viburnoides combined with Eupolyphaga sinertsis walke extract group can improve the hemorheology index of rats in acute blood stasis model in different degrees. The P. viburnoides high dose (water/alcohol) group was better than the low dose (water/alcohol) group to improve rat blood rheology. Combination group was better than the P. viburnoides monotherapy group. Apart from low dose (water/alcohol) group, other treatment groups can increase the plasma level of tPA, reduce the content of PAI, and decrease the PAI/TPA ratio comparing with the model group, and the effect of the combination group was obviously better than the monotherapy group. Thus, the combination can improve the blood rheology and fibrinolytic system activity betterly, and improve the fibrinolytic system caused by knee osteoarthritis in a certain degree.[Conclusion] P. viburnoides can effectively inhibit the expressions of COX2, NO, iNOS in synovial fluid, protect cartilage cells and restore damaged cartilage cells. P. Viburnoides combined with Eupoiyphaga sinertsis walke extract group can improve hemorrheology by increasing the plasma levels of tPA, reducing the content of PAI, and decreasing the PAI/TPA ratio, and improve the blood stasis symptoms of osteoarthritis, which provides the basis for further researches on Pileostegia viburnoides monotherapy and the combination therapy in the treatment of arthritis.