| 1 Objective : Knee osteoarthritis(KOA) is a common disease in clinical. As our self-made pharmacy, Xiaoyu Jiegu Powder has good effect on treating KOA. Through experiment on rabbit models of KOA and observation the influence of Xiaoyu Jiegu Powder to the Matrix Metalloproteinases 1(MMP-1) and Matrix Metalloproteinases3(MMP-3) in Knee Osteoarthritis Knee joint fluid, the research approaches its partial pharmacological effect and possible mechanism in treating KOA and provides experimental and clinical basis for Xiaoyu Jiegu Powder in treating knee osteoarthritis(KOA) through clinical observation of the treatment of KOA efficacy and safety.2 Methods2.1 Experimental SectionThirty-two around six-month old clean and healthy around six-month old New Zealand white rabbits were chosed, half male and half female, and Normal Group,Model Group, Xiaoyu Jiegu Powder Group, Voltaren Group, each group with 8 rabbits was randomly selected. Rabbits of the four groups except the Control group were modeled with knee plaster brake modeling method. Treat these models with Xiaoyu Jiegu Powder after one-week normal feeding and driving, and prepare specimen after the end of treatment.HE staining was used to observe the cartilage degeneration,ELISA(enzyme linked immunosorbent assay method for determination of the content of the supernatant) was used to measure content of MMP-1, MMP-3 in the synovial fluid cells.2.2 Clinical SectionSixty patients with KOA were selected according to the inclusion criteria and exclusion criteria, and they were randomly divided into Treatment Group(Xiaoyu Jiegu Powder group) and Control Group(Votalin Group) with 30 cases in each. The Treatment Group was given Xiaoyu Jiegu Powder for external use, once a day, eachtime 6-8 hours. The Control Group was given Votalin topical for external use for 4weeks. After the end of treatment, two groups of patinets were observed knee joint pain sensory scores(VAS pain score), Lequesne index score, TCM syndrome score, and erythrocyte sedimentation rate change.And to judge According to the change of main symptoms and signs,the author judged the curative effect and recorded whether there was any obvious toxic side reaction in the treatment process.3 Results3.1 Experimental Section3.1.1 Gross observation: The Normal Group of rabbit knee joint showed normal appearance, no obvious swelling and deformity, articular cartilage translucent, smooth and complete surface, milky white synovial, no obvious swelling, hypertrophy,congestive, colorless transparent synovial fluid; Xiaoyu Jiegu Powder group and Votalin group showed slightly swollen appearance, rough surface articular cartilage compared with Normal group, synovial thickening, slightly swelling; The Model group showed swelling appearance, deformity,red color, rough articular cartilage surface,significantly decreasing cartilage transparency, obvious changed, swelling, and hyperemia synovial inflammation,turbid joint fluid.3.1.2 Observation of the organization under the light microscope; The microscopic appearance of normal group was normal cartilage thickness, uniformly-colored cartilage matrix, smooth cartilage surface, cartilage cells of normal morphology, neatly arranged and clear in hierarchical structure, complete tidal line; Appearance of Xiaoyu Jiegu Powder group were cells arranged in passable rules, occasionally visible small cell cluster phenomenon, articular cartilage cells with mild degeneration, complete tide line;Appearance of Votalin group were cells arranged irregularly, family set-like growing layers of articular cartilage cells, partial unclear and interrupt tide line; The Model group was the most seriously destructed of articular cartilage, cartilage surface was rough, erosional and completely denuded, cells were arranged in disorder, unevenlydistributed, cartilage level was unclear, the tide line disappeared.3.1.3 The expression of content of MMP-1 and MMP-3 in synovial fluid; The testing results of synovial fluid were statistically analyzed, MMP-1 content of each group was compared, the difference was statistically significant(F=124.6, P<0.01). Through multiple comparisons between groups and single factor variance analysis of Q test, the model group was higher than that in normal group, Xiaoyu Jiegu Powder group,Votalin group, and pairwise comparison was statistically significant(P<0.05); The content of MMP-3 was compared in the Normal group and the Model group, and the difference was statistically significant(P<0.01); The value of F of single factor analysis of variance in Model group, Xiaoyu Jiegu Powder group,and Votalin group is151.9, P<0.05; The SNK-q test was performed on the three groups, suggesting that there was statistical significance(P<0.05) in Model group and Xiaoyu Jiegu Powder group, Votalin group, but there was no obvious statistical difference(P>0.05) between Xiaoyu Jiegu Powder group and Votalin group.3.2 Clinical Section3.2.1 The VAS pain scores of Treatment group and Control group before and after treatment were significantly different, and the difference was statistically significant(P<0.01). Meanwhile, in the improvement of knee joint pain, the Treatment group was superior to the Control group.3.2.2 The Lequesne index scores of Treatment group and Control group before and after treatment were significantly different, and the difference was statistically significant(P<0.01). Meanwhile, the Treatment group was superior to the Control group in improving the function of knee joint pain.3.2.3 The quantified TCM syndrome scores of Treatment group and Control group before and after treatment were significantly different, and the difference was statistically significant(P<0.05). Meanwhile, the Treatment group was superior to the Control group in improving symptoms and signs.3.2.4 The erythrocyte sedimentation rate of Treatment group and Control group beforeand after treatment was significantly different, and the difference was statistically significant(P<0.05). but in improving erythrocyte sedimentation rate,there was no significant difference between the two and there was no significant difference(P>0.05).3.2.5 To evaluate the clinical symptoms and signs of efficacy of the two groups of patients, the total effective rate of treatment group was 93.3%, control group 76.6%;The difference in two groups of patients after treatment with statistical analysis was statistical significant(Z=-2.135, P=0.032), showing that the Treatment group is superior to Control group.4 ConclusionThe research shows that Xiaoyu Jiegu Powder has a protective effect on rabbit knee articular cartilage, reducing the content of MMP-1 and MMP-3 in the synovial fluid. It infers it might regulate the expression of MMP-1 in rabbit knee joint fluid,MMP-3 to delay the degeneration of articular cartilage. Clinical observation showed that Xiaoyu Jiegu Powder is effective drug therapy for KOA with no obvious toxic side effect, which is worthy of further promotion and clinical application. |
PDF Full Text Request