The Observation Of Bone Rheumatism Mixture In The Teratment Of Of Knee Osteoarthritis Cost Effectiveness Analysis And On The Expression Of TIMP-1 And VEGF In The KOA Rat Of Knee Osteoarthritis Model With Removing Double Fore Legs And Hulth Method

Objective:Cost effectiveness analysis of Bone Rheumatism Mixture and Diacerein Capsules treatment of Knee Osteoarthritis were conducted to provide a practical and effective treatment plan for clinical practice; Investigate the effect of Bone Rheumatism Mixture on the expression of TIMP-1 and VEGF in the KOA rat of Knee Osteoarthritis model with removing double fore legs and Hulth method.Methods:In the open experiment,4 weeks for a course of treatment,120 cases of Knee Osteoarthritis patients in accordance with the inclusion criteria were incorporated into the Bone Rheumatism Mixture group and the Diacerein group. Respectively,record clinical symptom score, WOMAC score and VAS score before treatment and after treatment of 2,4,8 weeks.Analyse and evaluate two groups of patients with cost effectiveness analysis.Build the KOA rat with removing double fore legs and improved Hulth method.12 SD rats of 15 days of pregnancy were fed in different cages respectively and used as the experimental subjects,then 80 juvenile rats born 10 days were divided into four groups named model group,normal saline group,glucosamine indomethacin group and bone rheumatism Mixture group according to their weight averagely and randomly. 20 SD rats of every group. The rats in the four groups were removed double fore legs under abdominal anesthesia and then fed in the original maternal cages.After 4 months of removing double fore legs,four groups have the Hulth operation.Drug intervention is started when 5 months and 5 months.The SD rats in the model group were without any intervention. The normal saline group were given saline 10 m L/kg/d by intragastric administration at 8 and 18o’clock..The SD rats in the glucosamine indomethacin group were given Osaminethacine Enteric coated tablets 40mg/kg/d with the same volume of distilled water after melting and shaking by intragastric administration at 8 and 18 o’clock.The SD rats in the Bone Rheumatism Mixture group were given Bone Rheumatism Mixture 10 m L/kg/d by intragastric administration at 8 and 18 o’clock. Lasting for 4weeks is a course of treatment.The rats were sacrificed under anesthesia in the 6th and9 th month,and preserve their knee joint tissue and research the TIMP-1 and VEGF by immunohistochemistry.Results:The comparison cost effectiveness Research:(1)The total effective rate:The total effective rate of the Bone Rheumatism Mixture group is 100% in various node after treatment,it is 34.5% in the Diacerein group after second weeks of treatment.In the 4th and 8th weeks, in the Diacerein group,the total effective rate is 100%.(2)The comparison cost effectiveness ratio: It is 2.84,5.68,5.68 in the Bone Rheumatism Mixture group and 3.69,2.55,2.55 in the Diacerein group after treatment of 2,4,8weeks.(3)Sensitivity analysis:It is 2.41,4.83,4.83 in the Bone Rheumatism Mixture group and 3.14,2.16,2.16 in the Diacerein group after treatment of 2,4,8weeks.Experimental Study:Immunohistochemistry assay of TIMP-1: The positive expression of TIMP-1 is found in knee joint tissueall of all the rats which are 6 and 9months old.The positive expression is the lowest in the model group and is the highest in the Bone Rheumatism Mixture group.There is no significant difference between the model group and the normal saline group, and the positive expression in the glucosamine indomethacin group and the Bone Rheumatism Mixture group is significantly higher than that in the model group and the normal saline group,and the positive expression in the Bone Rheumatism Mixture group is significantly higher than that in the glucosamine indomethacin group.The positive expression of VEGF is found in knee joint tissueall of all the rats which are 6 and 9 months old.The positive expression is the highest in the model group and is the lowest in Bone Rheumatism Mixture group.The positive expression in the glucosamine indomethacin group and the Bone Rheumatism Mixture group is lower than that in the model group and the normal saline group,and it has significant statistical difference.The VEGF expression has no statistically significant difference in 6 months old rats between the Bone Rheumatism Mixture group and the glucosamine indomethacin group.In 9 months old rats,the VEGF expression has no statistically significant difference between the Bone Rheumatism Mixture group and the glucosamine indomethacin group.Conclusion:The comparison cost effectiveness Research:During the study period,the two drugs both have advantages in the treatment of Knee Osteoarthritis.For the cost effectiveness analysis and sensitivity analysis of the treatment of knee osteoarthritis,In the Bone Rheumatism Mixture group,the cost is less and the effect is prominent in the treatment of second weeks,while the effect is prominent and the cost is increased in the treatment of 4th weeks.While the Diacerein group shows better curative effect in low cost basis in the treatment of 4th weeks.Comprehensive comparison, the overall efficacy of the Bone Rheumatism Mixture is better than the Diacerein,lasting effect and overall remission of the disease is better than the Diacerein group which has sluggishness and it can get good results if the treatment period is extended.Experimental Study:The Bone Rheumatism Mixture can up regulate the expression of TIMP-1 and down regulate the expression of VEGF in cartilage of the Knee Osteoarthritis model with removing double fore legs and Hulth method.It may be the mechanism of action about slowing the cartilage’s lesion process of Knee Osteoarthritis.