Correlations between different TCM differentiation syndrome types of knee osteoarthritis and expressions of matrix metalloproteinases and inflammatory factors in joint fluid
Objective It is to explore the correlations between different traditional Chinese medicine(TCM)syndrome differentiation types and expressions of matrix metalloproteinases and inflammatory factors in joint fluid in patients with knee osteoarthritis(KOA).Methods Fifty KOA patients hospitalized in the Orthopedics Department of Gansu Provincial Hospi-tal of Traditional Chinese Medicine from December 2021 to October 2022 were selected,and they were divided into Qi-stag-nation and blood stasis group,damp-heat impediment obstruction group,cold-dampness impediment obstruction group,liv-er and kidney deficiency group and Qi-blood deficiency group according to TCM syndrome differentiation,with 10 cases in each group.The levels of inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],matrix metalloproteinases[matrix metalloproteinase-1(MMP-1),matrix metalloproteinase-2(MMP-2),ma-trix metalloproteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9),and matrix metalloproteinase-13(MMP-13)]in the knee joint fluid of patients of each syndrome type were detected by double-antibody sandwich enzyme-linked immu-nosorbent assay,and the correlations between different syndrome types and levels of matrix metalloproteinases and inflam-matory factors were analyzed by Spearmen method.Results The expression levels of IL-1β,IL-6,TNF-α,MMP-9 and MMP-13 in joint fluid of patients with syndrome of Qi-stagnation and blood-stasis and syndrome of damp-heat impediment obstruction were obviously higher than those of patients with syndrome of cold-dampness impediment obstruction,syndrome of liver-kidney deficiency and syndrome of Qi-blood deficiency(all P<0.05),the expression level of MMP-1 in joint fluid of patients with syndrome of damp-heat impediment obstruction was obviously higher than that of patients with syndrome of Qi-stagnation and blood stasis,syndrome of liver-kidney deficiency and syndrome of Qi-blood deficiency(all P<0.05).Syndrome of Qi stagnation and blood stasis,syndrome of damp-heat impediment obstruction were positively correlated with the levels of IL-1β,IL-6 and TNF-α(r=0.385,0.492,0.334,0.655,0.537,0.584,all P<0.05),while syndrome of cold-dampness impediment obstruction was negatively correlated with the level of TNF-α(r=-0.284,P<0.05),syn-drome of liver-kidney deficiency and syndrome of Qi-blood deficiency were negatively correlated with the levels of IL-1β,IL-6 and TNF-α(r=-0.447,-0.471,-0.237,-0.506,-0.350,-0.397,all P<0.05).Syndrome of Qi stag-nation and blood stasis was positively correlated with the levels of MMP-9 and MMP-13(r=0.485,0.411,all P<0.05),syndrome of damp-heat impediment obstruction was positively correlated with the levels of MMP-1,MMP-9 and MMP-13(r=0.672,0.541,0.613,all P<0.05),and syndrome of liver-kidney deficiency and syndrome of Qi-blood deficiency were negatively correlated with the levels of MMP-1,MMP-9,MMP-13(r=-0.319,-0.392,-0.461,-0.407,-0.388,-0.485,all P<0.05).Conclusion There are some differences in the levels of inflammatory factors and matrix metallo-proteinases in joint fluids between KOA patients with different TCM syndrome types,and there is a certain correlation be-tween TCM syndrome types and the levels of inflammatory factors and matrix metalloproteinases in joint fluids,which can be used as auxiliary indexes for the TCM differentiation and treatment of KOA,and provide objective bases for the differentia-tion and treatment of localization of TCM syndromes.
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