The Change Of The Knee Joint Checked By MRI After Knee Osteoarthritis Was Treated By Guishaokangxi Granules And The Influence Of Chondrocyte Proliferation After The IL-1α Was Induced By It

Objective: The study was to discuss the pathogenesis of knee Osteoarthritis (KOA) from Traditional Chinese Medicine. According to the pathological mechanism of deficiency of kidney and stasis with the treatment of invigorating the kidney and promoting blood circulation, Guishaokangxi Granules was used to be the trial study by added-subtracted of the famous TCM prescription Duhuojishengtang. The influence of chondrocyte proliferation was known after the IL-1αwas induced by Guishaokangxi Granules. The OA was precisely staged by knee MRI and knee joint was analyzed with ration. Such the degree as the liquid loading of joint capsule,marrow edema under cartilage,cartilage destroy,the hyperplasia of synovial membrane and meniscus injury was comprehensively estimated, providing diagnosis basis for the choice of clinical treatment protocol and objective credible data for medicine efficacy. At the same time, the clinical quantization index was investigated and the relationship between clinical syndrome efficacy and MRI cartilage change was further observed by continuously adopted index of VAS,WOMAC .Method:1 .theoretical methods :such methods as philology,logic and reason as well as comparison and similarity was adopted.2.experimental methods: (1)material from the human hip joints after operation ,the chondrocyte was cultivated with conventional method.(2)the influence of chondrocyte by Guishaokangxi Granules was investigated with MTT colorimetry.3.Clinical study method: The total of the patients was 60 divided by two groups(30 patients in treatment group and control group respectively) with the treatment period of 4 weeks adopted by the trial method of randomly parallel control. The patients in the treatment group were treated with Guishaokangxi Granules once a day; while with 250mg Viartril-S three times a day in control group. The WOMAC index,VAS and adverse reaction was estimated pre and post treatment respectively. The total of 42 patient with knee Osteoarthritis were collected, among which 18 patients and 24 patients practiced the check MRI in half a year and a year respectively after Guishaokangxi Granules. Statistical analysis was made with SPSS13.0 after the end of trial.Result: 1 .theoretical study result:Traditional Chinese Medicine believe that knee Osteoarthritis belonged to the "Bizheng" ,with the fundamental pathogenesis of the deficiency of liver and kidney as well as qi and blood deficiency, with the exterior pathogenesis of qi and blood stasis as well as cold,phlegm dampness obstructed in venation. The pathologic characteristics was ben deficiency biao stasis. The main treatment method of knee osteoarthritis should invigorate the kidney and promote the blood.2.Experimental study result: (1) successfully cultivate chondrocyte; (2)The influence of chondrocyte proliferation by Guishaokangxi Granules was investigated with MTT colorimetry . The result showed that Guishaokangxi Granules three concentration of 0.0750 mg/ul,0.3750mg/ul,0.7500mg/ul can all significantly promote the chondrocyte proliferation after IL-1αinducement , with significant statistical difference (P<0.01) .The intension of chondrocyte proliferation in three concentration was 0.7500 > 0.3750 >0.0750 mg/ul, with significant difference among them(P<0.01).3.Clinical study result:(1)The total of 60 patients with KOA was collected , randomly divided by two groups(treatment group and control group) with 30 patients respectively. The total efficacy in Guishaokangxi Granules group was better than Viartril-S group with significant difference.WOMAC index in the two groups decreased compared to the pre treatment respectively with significant difference(P<0.01),but no significant difference in the two group(P>0.05) ;VAS in two groups decreased compared to the pre treatment with significant difference(P<0.01),but Guishaokangxi Granules had better role in acesodyne with significant difference in two groups; Adverse reaction was not found in two group.(2)The 42 patients with KOA, among which 18 checked MRI after taking Guishaokangxi Granules half a year and 24 a year, was investigated in such aspects as the amount of liquid loading in joint capsule,the extent of marrow edema under cartilage,the hyperplasia of synovial membrane and meniscus degrading. Control or improvement rate of cartilage destroy accounted for 71.4%(12/42);The extent of meniscus degrading didn't obvious change in before and after treatment; The control rate of the hyperplasia of synovial membrane in treatment accounted for 71.4%(30/42),with the progression and improvement for 14.3%respectively(6/42).Conclusion: Guishaokangxi Granules can improve the clinical symptoms of the patients with KOA with the characteristics of safety and efficiency. The study had proved that Guishaokangxi Granules had the role of protecting cartilage. Clinical image indicated that the granules can promote the absorption of liquid loading of joint capsule and marrow edema under cartilage as well as stay cartilage destroy,the hyperplasia of synovial membrane and meniscus degrading.