| Objective: To observe the bone rheumatism mixture in the treatment of patients withknee osteoarthritis clinical curative effect; to establish a human disease processes todouble forelegs vertical combined with Hulth method KOA rat knee osteoarthritismodel similarity, based on the success of model, the effect of bone arthralgia mixtureon the model of joint cartilage cell apoptosis.Methods:59patients met the inclusion criteria of knee osteoarthritis patients, the opentest, namely the patient the choice of medication according to their own will. Wereincorporated into the western medicine group (glucosamine potassium sulfatecapsules and celecoxib capsules), Gubi Decoction group (plus bone Tongbi mixturebased on the control group of Western Medicine on) for4weeks, respectively atbaseline, second weeks, fourth weeks,12after taking the drug Thursday a node withthe dimensions of VAS, WOMAC, clinical symptom score, SF-36score, to compareand analyze the difference between the two groups;48SD rats of10days old, wererandomly divided into normal control group, to double forelimb erect group, shamHulth group, united front limbs erect to double forelegs vertical plus Hulth group, atotal of4group,12rats in each group. Normal control group without any treatment,the rest three groups were intraperitoneal anesthesia to double forelimb modeloperation, postoperative in primary rat cage rearing continue breast-feeding feeding.To double forelimb erect joint sham Hulth group after operation four months after thefake Hulth operation; to both vertical and Hulth group after four months after Hulthoperation. Four groups of second in the1months after operation, the knee joint wereintraperitoneal anesthesia, were collected from each rat, through fixed, decalcified,dehydration, embedding, slicing specimen making, HE staining, toluidine bluestaining, safranine fast green staining and immunohistochemistry analysis. Based onthe success of evaluation model, then select52SD rats of10days old, were inintraperitoneal anesthesia to double forelimb model operation, postoperative inprimary rat feeding to continue breast-feeding feeding cage; in Hulth operation wasfour months to double limb postoperatively, in Hulth at1month after operation wererandomly divided into blank control group, Gubi Decoction group, glucosamine indometacin group, saline group, with13rats in each group. Gubi Decoction groupaccording to0.5ml/100g weight give Gubi mixture fed; glucosamine indometacingroup was given according to the weight of2mg/100g glucosamine indometacin(dissolved in the same volume of saline.) by gavage; saline group according to0.5ml/100g weight given normal saline; blank control group without any intervention,continuous intragastric administration for4weeks anesthesia, rats were sacrificed,remove the knee joint tissues, HE staining, toluidine blue staining, safranine fastgreen staining and apoptosis related protein immunohistochemical observation.Results: the Gubi Decoction group second weeks after treatment VAS, WOMACscore, clinical symptoms score lower than that before treatment (P<0.05), SF-36bodypain (BP) dimensions scores higher than that before treatment (P<0.05), the otherdimensions no significant change (P>0.05). Fourth weeks after treatment VAS,WOMAC score, clinical symptoms score lower than that before treatment (P<0.05,SF-36) in physiological function (RP), mental health (MH), general health (GH) hadno significant change (P>0.05), the other dimension score higher than that beforetreatment (P<0.05).12weeks after treatment VAS, WOMAC score, clinicalsymptoms and signs were lower than before treatment, SF-36score of each dimensionhigher than that before treatment (P <0.05); the control group2weeks after treatmentVAS, WOMAC score, clinical symptoms score lower than that before treatment(P<0.05), SF-36bodily pain (BP) dimensions scores higher than that before treatment(P<0.05), the other dimensions no significant change (P>0.05).4weeks aftertreatment VAS, WOMAC score, clinical symptoms score lower than that beforetreatment (P<0.05, SF-36) in physiological function (RP), and emotional function(RE), energy (VT) and other dimensions were higher than those before treatment(P<0.05treatment), treatment for12weeks VAS, WOMAC score, clinical symptomsscore lower than that before treatment (P<0.05), SF-36score in addition to energy(VT), emotional function (RE), the other dimension score higher than that beforetreatment (P<0.05); to observe the morphology of normal control group by HEstaining, toluidine blue staining, safranine fast green staining showed that the cartilagesurface is smooth, smooth, uniform distribution of chondrocytes, ranking neat, each level clearly. To double forelimb erect group, sham Hulth group, united front limbs todouble forelegs vertical joint Hulth group showed articular cartilage surface ulcers orfracture, and even the emergence of local defects, significantly reduced the number ofcartilage cells, cartilage layer of uneven dyeing, partial loss of staining was observed;cluster like growth has the joint of each layer of cartilage cell, deep visiblehypertrophic chondrocytes; especially to both vertical and Hulth group was the mostobviously. Through each drug intervention, and the normal control group, normalsaline group, Gubi Decoction group, glucosamine indometacin group, articularcartilage surface was smooth, flat surface, joint cartilage cells is continuous, uniformdistribution, sorting is neat, the level is clear, no obvious cell cluster phenomenon,tide line is more complete, dyeing uniformity. Through each drug intervention, andthe normal control group, normal saline group, Gubi Decoction group, glucosamineindometacin group, articular cartilage surface was smooth, flat surface, joint cartilagecells is continuous, uniform distribution, sorting is neat, the level is clear, no obviouscell cluster phenomenon, tide line is more complete, dyeing uniformity.Conclusion: Gubi Decoction group in improving the quality of life and social activityability of patients than the western medicine group. Research results show thatcomprehensive therapy with Gubi mixture can improve the quality of life index andseverity in patients with knee osteoarthritis, and displayed along with extendedtreatment course, difference effect more obvious; successfully established to bothupright, to both vertical joint false Hulth, to both vertical and Hulth three the model,which went double forelimb erect joint Hulth model of knee joint degeneration ismore typical, this model is simple, reproducible, and similar to human upright thepathogenesis of osteoarthritis of the knee. Mechanism of action of bone Tongbimixture intervention of osteoarthritis of the knee may be inhibition of cartilagedegeneration of cells apoptosis and delay the cartilage tissue. |
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