Clinical And Experimental Studies On The Effects Of Guci Decoction On Knee Osteoarthritis

Objective:To evaluate the clinical efficiency of Guci decoction and explore the mechanism of Guci decoction on knee osteoarthritis, thus providing some reliable references for its clinical application.Methods:The clinical study:57patients selected as clinical cases were randomly divided into treatment group and control group. The patients of treatment group were given Guci decoction which was compounded by granule twice a day, while the control group was given Viartril-S three times a day. The scores of the signs and symptoms were noted and compared before and after the treatment. Synovial fluid in knee joint was collected and the levels of IL-1β、 TNF-a in synovial fluid were evaluated by double-antibody enzyme-linked immunosorbent assay. The experimental study:64New Zealand rabbits aging6months were randomly divided into model group (58) and control group (8). The models of knee osteoarthritis were established by the methods of Hulth, while the normal group was not given any treatment. After successfully modeling, the rabbits of model group were randomly divided into three groups:Guci decoction group, Viartril-S group and control group, with16rabbits in every group. And then calculate the does of Guci decoction and Viartril-S. The Guci decoction group was given Guci decoction twice a day while the Viartril-S group was given Viartril-S three times a day. And the control group was given normal saline twice a day. On 15and30days after intervention, rabbit articular cartilage of every group was collected respectively. Observe the histomorphological changes of the articular cartilage by hematoxylin and eosin staining. Observe the expression of collagen type Ⅱ by immunohistochemical staining and assess the integrated optical density of the collagen type Ⅱ positive area in cartilage matrix. And then the apoptosis of chondrocytes was assessed by TUNEL technique and the apoptosis index (AI) was evaluated.Results:①The age and sex differences and the course time have no statistical differences.②The levels of IL-1β、 TNF-α in synovial fluid of the treatment group and control group descend after30days’treatment, but the levels between the two groups have no statistical differences.③The scores of the signs and symptoms of the treatment group and control group descend after30days’treatment, but there were no differences between the two groups.④The articular cartilage surface of the model group was not smooth. The layers of the chondrocytes were poorly aligned and the chondrocytes cluster in the radiation layer. According to the results, the rabbit models of knee osteoarthritis were established successfully.⑤On the fifteenth day of the treatment, the articular cartilage surface of the Guci decoction and the Viartril-S group was not smooth and the chondrocytes distributed uniformly. The chondrocytes of the control group cluster in the radiation layer and the tide line was not complete. Along with the intervention time, the articular cartilage destroys heavily.⑥At the same period, the integrated optical density of the collagen type Ⅱ positive area in cartilage matrix of the Guci decoction and the Viartril-S group is higher than that of the control group, but there were no statistical differences between the Guci decoction and the Viartril-S group.⑦The apoptosis of chondrocytes can be seen in every layers of the articular cartilage and the numbers of chondrocytes decreased along with the intervention time. The apoptosis index of the Guci decoction and the Viartril-S group is lower than that of the control group, but there were no statistical differences between the Guci decoction and the Viartril-S group.Conclusion:①The Guci decoction can decrease the level of IL-1β、TNF-α in synovial fluid of the knee osterthritis patients.②The Guci decoction can alleviate clinical symptoms of knee osteoarthritis.③The rabbit models of knee osteoarthritis can be successfully established by the method of Hulth.④The Guci decoction can inhibit the decrease of expression of collagen type Ⅱ.⑤The Guci decoction can decrease the apoptosis index of chondrocytes, and delay the recessive process of the carticular cartilage.