Efficacy Of Externalapplication Of Synovitis 1^st Decoction On The Early Knee Synovitis Of Rabbits Induced By Papain

Background: Knee osteoarthritis(KOA)is a chronic disease with joint degeneration,generally associated with synovitis symptoms in early osteoarthritis,it will seriously affect patients' life quality if not get timely treatment.External application of Chinese medicine as a treatment of traditional Chinese medicine,can take the active ingredients of Chinese herbal medicine directly through the skin directly to patients and also have convenient,fast,curative effect and other characteristics.Synovitis I Decoction is the common external application of clinical medicine by Guo Weihuai an old expert,it is widely used in bone and joint sections in Henan Luoyang Orthopedic Hospital.It can significantly alleviate the initial joint swelling,pain and other symptoms in patients with KOA,clinical curative effect is excellent,but its role is unclear.Objective: To explore the relationship of the knee synovitis with the molding time by an experiment through of low concentration of papain induced rabbit early osteoarthritis.To clear the best time of the papain model after the formation of osteoarthritis and synovitis,to provide the basis phase model for after topical drug therapy.Based on a period of experiments,to observe the knee joint synovial tissue of papain,IL-1?,TNF-?in synovial tissue,the concentration of VEGF by early synovitis of knee osteoarthritis model after synovitis I decoction treatment of rabbits knee joint synovial tissue of papain.To investigate the mechanism of synovitis I Decoction of the knee osteoarthritis synovial inflammation.Methods: 12 New Zealand white rabbits were randomly divided into 3 groups according to a random number table.Each group comprising of 4 rabbits.At the beginning of the experiment(1st/4th/7th day),0.5ml mixture composed of 2% papainand 0.03 M L-cysteine was injected into the right knee of rabbits to establish the model of knee osteoarthritis.At the end of the intra-articular injection,respectively after the 1st,2nd and 3rd weeks,the synovium and infrapatellar fat pad tissue 0.3g was taken from the right knee.At the same time in third weeks,the synovium and infrapatellar fat pad tissue 0.3g was taken from the left knee fat as a control group.Observation of morphological and pathological about synovial tissue found that there are a large number of effusions and synovitis in the first week after modeling.24 New Zealand white rabbits were randomly divided into external application of Chinese medicine group and vitamin treatment group,model group,each group consisting of 8 rabbits.The model was made by the above methods,it has treatment by external application of Chinese medicine and Votalin topical after first weeks of modeling,model group without treatment.In observation of the knee joint of local skin temperature,it takes the right knee joint synovial tissue fat pad and patellar 0.3g and divide into two in the thirteenth days after the treatment.One of them is cut and homogenized,use enzyme-linked immunosorbent assay(ELISA)determination of IL-1? and TNF-?concentrations after centrifuged supernatant,another one for pathological observation and VEGF immunohistochemically analysis.Results: After one course of treatment,model group of knee joint local skin temperature was higher than the external application of herbal group and vitamin topical treatment group(P < 0.05);The concentration of TNF-? and IL-1? in synovial tissue,the model group were higher than that of external application of herbal group and vitamin topical treatment group(P < 0.05),there are no statistically significant difference between the external application of herbal group and vitamin topical treatment group(P > 0.05);The semi quantitative analysis about VEGF immunohistochemistry in synovial tissue,the model group were expression and higher than that of external application of herbal group and vitamin topical treatment group(P< 0.05),there are no statistically significant difference between the external application of herbal group and vitamin topical treatment group(P > 0.05);In model group,pathological observation of synovial membrane synovial hyperplasia,infiltration of inflammatory cells,vascular proliferation obviously.Compared with the model group,external application of herbal group synovial angiogenesis,less infiltration of inflammatory cells.Ventolin treatment group synovial hyperplasia less in vascular proliferation and inflammatory cell infiltration.Conclusion: This study found that synovitis I decoction can reduce joint swelling,skin temperature and other symptoms of the early stage of a rabbit model of knee osteoarthritis.It can reduce the IL-1?,TNF-?,VEGF content of synovial tissue but also can improve the morphology of the synovial membrane.The mechanism of synovitis I Decoction can probably via reducing the IL-1?,TNF-? and other inflammatory factors,decreasing KOA synovial fluid and synovial inflammation by inhibiting VEFG effects.